149 results on '"Gainforth, Heather L."'
Search Results
2. IKT Guiding Principles: demonstration of diffusion and dissemination in partnership
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Shwed, Alanna, Hoekstra, Femke, Bhati, DivyaKanwar, Athanasopoulos, Peter, Chernesky, John, Martin Ginis, Kathleen, McBride, Christopher B., Mortenson, W. Ben, Sibley, Kathryn M., Sweet, Shane N., and Gainforth, Heather L.
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- 2023
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3. Exploring smoking cessation experiences among persons with spinal cord injury: Informing theory-based recommendations for interventions
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Wuerstl, Kelsey R., McBride, Christopher B., Deschênes-Bilodeau, Joëlle, Hoekstra, Femke, and Gainforth, Heather L.
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- 2023
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4. Theoretical components of smoking cessation interventions for persons with physical disabilities: A scoping review
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Wuerstl, Kelsey R., Todd, Kendra, Lawrason, Sarah, Shwed, Alanna, Holmes, Ben, and Gainforth, Heather L.
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- 2023
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5. Applying state space grids methods to characterize counsellor-client interactions in a physical activity behavioural intervention for adults with disabilities
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Hoekstra, Femke, Martin Ginis, Kathleen A., Collins, Delaney, Dinwoodie, Miranda, Ma, Jasmin K., Gaudet, Sonja, Rakiecki, Diane, and Gainforth, Heather L.
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- 2023
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6. Barriers and facilitators to changing bowel care practices after spinal cord injury: a Theoretical Domains Framework approach
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Lucci, Vera-Ellen M., McKay, Rhyann C., McBride, Christopher B., McGrath, Maureen S., Willms, Rhonda, Gainforth, Heather L., and Claydon, Victoria E.
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- 2022
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7. Investigating the influence of interaction modality on the communication patterns of spinal cord injury peer mentors
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Shaw, Robert B., Giroux, Emily E., Gainforth, Heather L., McBride, Christopher B., Vierimaa, Matthew, and Martin Ginis, Kathleen A.
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- 2022
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8. Outcomes of peer mentorship for people living with spinal cord injury: perspectives from members of Canadian community-based SCI organizations
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Sweet, Shane N., Hennig, Lauren, Shi, Zhiyang, Clarke, Teren, Flaro, Haley, Hawley, Stephanie, Schaefer, Lee, and Gainforth, Heather L.
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- 2021
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9. Understanding peer mentorship programs delivered by Canadian SCI community-based organizations: perspectives on mentors and organizational considerations
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Sweet, Shane N., Hennig, Lauren, Pastore, Olivia L., Hawley, Stephanie, Clarke, Teren Y., Flaro, Haley, Schaefer, Lee, and Gainforth, Heather L.
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- 2021
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10. Theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury.
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Hoekstra, Femke, Gainforth, Heather L., Broeksteeg, Rogier, Corras, Stephanie, Collins, Delaney, Gaudet, Sonja, Giroux, Emily E., McCallum, Shannon, Ma, Jasmin K., Rakiecki, Diane, Rockall, Shannon, van den Berg-Emons, Rita, van Vilsteren, Anniek, Wilroy, Jereme, and Martin Ginis, Kathleen A.
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- 2024
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11. Enhancing participation while aging with spinal cord injury: applying behaviour change frameworks to develop intervention recommendations
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Giroux, Emily E., Casemore, Sheila, Clarke, Teren Y., McBride, Christopher B., Wuerstl, Kelsey R., and Gainforth, Heather L.
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- 2021
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12. Guidance for behavioural interventions aiming to support family support providers of people with spinal cord injury: A scoping review
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McKay, Rhyann C., Wuerstl, Kelsey R., Casemore, Shelia, Clarke, Teren Y., McBride, Christopher B., and Gainforth, Heather L.
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- 2020
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13. A case study of using community-based consensus methods to facilitate shared decision-making among a spinal cord injury network.
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Giroux, Emily E., Athanasopoulos, Peter, Sweet, Shane N., and Gainforth, Heather L.
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SPINAL cord injuries ,URINARY catheters ,DECISION making ,RESEARCH personnel ,MEDICAL care wait times ,WOUND care - Abstract
Spinal cord injury (SCI) research and policy decisions are rarely made in partnership with people with SCI, making them less relevant, applicable, and used by those whom the decisions are intended to support. Across disciplines, consensus methods have been promoted as a viable solution for supporting shared research and policy-based decision-making. In this paper, we describe a partnered approach between academic researchers and the Ontario SCI Alliance, a non-profit, SCI community mobilization network to co-develop and co-disseminate a community-based consensus exercise. The community-based consensus exercise included two modified Delphi surveys and one in-person retreat. The partnership's goal with this exercise was to facilitate shared decision-making for the development of their upcoming strategic plan. We then interviewed partners and participants from the Delphi and in-person retreat to discuss successes, challenges, and lessons learned from the exercise. Survey 1 was disseminated to over 2,500 members of the Ontario SCI community and received 374 responses (276 coming from people with SCI). Survey 2 had 118 responses, with 87 coming from people with SCI. The retreat had 73 attendees, including people with SCI, family/friends of people with SCI, clinicians, researchers, and SCI community and research organization staff/volunteers. The retreat included a presentation of the survey results, a clinician/researcher panel, and externally-facilitated working groups. All survey responses and retreat materials were synthesized. Using the synthesized feedback, the Ontario SCI Alliance was able to implement several changes for the Ontario SCI community, including higher-quality primary care experiences (reduced wait times, more accessible examining rooms), the development of a wound care strategy with the Ontario government, and an advocacy campaign for public coverage for catheters and urinary care supplies. From the five interviews conducted, five themes were co-constructed regarding the successes, challenges, and lessons learned from the exercise: (1) Inclusion, Diversity, Equity, and Accessibility; (2) Partnership; (3) Design Considerations; (4) Transparency and Clarity in Communication; and (5) Sustainability. Findings from this community case study demonstrate the feasibility of conducting a community-level consensus exercise among an equity-deserving group while providing detailed guidance for how to ensure future research and policy-based decision-making is shared across diverse knowledge users. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Transforming research systems for meaningful engagement: a reflexive thematic analysis of spinal cord injury researchers’ barriers and facilitators to using the integrated knowledge translation guiding principles.
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Gainforth, Heather L., Shwed, Alanna, Giroux, Emily E., Hoekstra, Femke, McKay, Rhyann C., Schaefer, Lee, Sibley, Kathryn M., Kaiser, Anita, McPhail, Lowell, McBride, Christopher B., Munro, Barry, and West, Christopher R.
- Abstract
AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo develop an in-depth understanding of spinal cord injury (SCI) researchers’ barriers and facilitators to deciding to use 1) a partnered approach to research and, 2) systematically developed principles for guiding Integrated Knowledge Translation (IKT) in spinal cord injury research (IKT Guiding Principles).Qualitative interview study with North American SCI researchers who were interested in using a partnered research approach. The research was conducted using an IKT approach, and interview data were analyzed using reflexive thematic analysis.Thirteen SCI researchers whose research focused on prevention, clinical, rehabilitation, and/or community SCI research were interviewed. Three themes were co-constructed with partners: 1) the principles are necessary but not sufficient for the implementation of a partnered approach to research; 2) relational capacity building is needed; and 3) institutional transformation is needed to value, resource, and support meaningful engagement.Supporting change that enables SCI researchers to adopt and implement the IKT Guiding Principles will require transformation at the individual (
theme 1 ), relational (theme 2 ), and institutional levels (theme 3 ). Findings provide clear, practical, and tangible actions to promote change that can support meaningful engagement in the SCI Research System.Providing researchers with clear, procedural information and strategies to use each of the Integrated Knowledge Translation Guiding Principles in practice can support the implementation of the principles and partnered research in rehabilitation-based research.Fostering and evaluating resources and initiatives that help researchers network, build connections, and receive mentorship could help spinal cord injury researchers partner more effectively.Academic, research, and funding systems must ensure their practices, structures, culture, and processes enable, value, resource, support, and/or incentivize partnered research to ensure the research being conducted is relevant and useful in addressing the needs and priorities of research users.Providing researchers with clear, procedural information and strategies to use each of the Integrated Knowledge Translation Guiding Principles in practice can support the implementation of the principles and partnered research in rehabilitation-based research.Fostering and evaluating resources and initiatives that help researchers network, build connections, and receive mentorship could help spinal cord injury researchers partner more effectively.Academic, research, and funding systems must ensure their practices, structures, culture, and processes enable, value, resource, support, and/or incentivize partnered research to ensure the research being conducted is relevant and useful in addressing the needs and priorities of research users. [ABSTRACT FROM AUTHOR]- Published
- 2024
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15. Principles and related strategies for spinal cord injury research partnership approaches: a qualitative study
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Hoekstra, Femke and Gainforth, Heather L.
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- 2022
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16. Supporting meaningful research partnerships: an interview study applying behavior change theory to develop relevant recommendations for researchers.
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Shwed, Alanna, Giroux, Emily E, Hoekstra, Femke, McKay, Rhyann C, Schaefer, Lee, West, Christopher R, McPhail, Lowell T, Sibley, Kathryn M, McBride, Christopher B, Munro, Barry, Kaiser, Anita, Panel, SCI Guiding Principles Consensus, and Gainforth, Heather L
- Abstract
Research partnerships, while promising for ensuring translation of relevant and useable findings, are challenging and need support. This study aimed to apply behavior change theory to understand and support researchers' adoption of a research partnership approach and the Integrated Knowledge Translation (IKT) Guiding Principles for conducting and disseminating spinal cord injury (SCI) research in partnership. Using an IKT approach, SCI researchers across Canada and the USA completed a survey (n = 22) and were interviewed (n = 13) to discuss barriers and facilitators to deciding to partner and follow the IKT Guiding Principles. The Behaviour Change Wheel, Theoretical Domains Framework (TDF), and Mode of Delivery Ontology were used to develop the survey, interview questions, and guided analyses of interview data. COM-B and TDF factors were examined using descriptive statistics and abductive analyses of barriers and facilitators of decisions to partner and/or use the IKT Guiding Principles. TDF domains from the interview transcripts were then used to identify intervention, content, and implementation options. 142 factors (79 barriers, 63 facilitators) related to deciding to partner, and 292 factors (187 barriers, 105 facilitators) related to deciding to follow the IKT Guiding Principles were identified. Barriers to partnering or use the IKT Guiding Principles were primarily related to capability and opportunity and relevant intervention options were recommended. Interventions must support researchers in understanding how to partner and use the IKT Guiding Principles while navigating a research system, which is not always supportive of the necessary time and costs required for meaningful research partnerships. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Evaluating the ParticipACTION 'Think Again' Campaign
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Gainforth, Heather L., Jarvis, Jocelyn W., and Berry, Tanya R.
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Introduction: ParticipACTION's 2011 "Think Again" campaign aimed to draw parents', and specifically mothers', attention to the amount of physical activity (PA) their children do relative to the national guidelines (physical activity guidelines [PAG]). Purpose: To evaluate ParticipACTION's "Think Again" campaign in the context of the hierarchy of effects model. Methods: Data were drawn from "Think Again" campaign evaluations conducted among two cohorts of parents with children ages 5 to 11 years (3 months postcampaign launch [T1], n = 702; 15 months postlaunch [T2], n = 670). Results: At T2, campaign awareness was weakly associated with parents agreeing that their children were not active enough (p = 0.01, d = 0.18). Parents who were aware of the campaign showed greater knowledge of PAG (ps < 0.01, ?s > 0.14), had higher outcome expectations about their children engaging in PA (p < 0.01, d = 0.16), had stronger intentions to help their child meet the guidelines (p < 0.01, d = 0.18), and engaged in more parental support behaviors (p < 0.001, d = 0.31) as compared with parents who were not aware. At T1, parents aware of the campaign had greater perceived behavioral control (PBC) to influence their child's PA participation (p < 0.01, d = 0.22), whereas parents not aware of the campaign had greater PBC to find practical ways to help their child be active (p < 0.01, d = 0.26). Parental awareness of the campaign was not associated with children meeting the PAG at either time point (ps > 0.05). Conclusions: The campaign appeared marginally effective for increasing parental knowledge of PAG and for creating realistic awareness of children's PA levels. Additional intervention strategies are needed to produce larger effects and to change parental behavior.
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- 2016
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18. Developing Interventions to Change Recycling Behaviors: A Case Study of Applying Behavioral Science
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Gainforth, Heather L., Sheals, Kate, Atkins, Lou, Jackson, Richard, and Michie, Susan
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The Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW) are frameworks that can be used to develop recycling interventions. The aim of this study was to demonstrate the utility of these frameworks for developing recycling interventions. 20 semistructured interviews with university building users were analyzed using the TDF and BCW. Environmental context and resources, beliefs about consequences, knowledge, and intention were identified as the key theoretical domains influencing recycling behaviors. The BCW was used to develop recommendations for intervention. This research is the first case study to demonstrate how the TDF and the BCW can be used to develop recycling interventions.
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- 2016
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19. Evaluating the ParticipACTION “Think Again” Campaign
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Gainforth, Heather L., Jarvis, Jocelyn W., Berry, Tanya R., Chulak-Bozzer, Tala, Deshpande, Sameer, Faulkner, Guy, Rhodes, Ryan E., Spence, John C., Tremblay, Mark S., and Latimer-Cheung, Amy E.
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- 2016
20. RE-AIMing conferences: evaluating the adoption, implementation and maintenance of the Rick Hansen Institute’s Praxis 2016
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Gainforth, Heather L., Baxter, Kristy, Baron, Justine, Michalovic, Emilie, Caron, Jeffrey G., and Sweet, Shane N.
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- 2019
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21. Systematic overviews of partnership principles and strategies identified from health research about spinal cord injury and related health conditions: A scoping review.
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Hoekstra, Femke, Trigo, Francisca, Sibley, Kathryn M., Graham, Ian D., Kennefick, Michael, Mrklas, Kelly J., Nguyen, Tram, Vis-Dunbar, Mathew, and Gainforth, Heather L.
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- 2023
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22. Strategies to improve access to physical activity opportunities for people with physical disabilities.
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Herbison, Jordan D, Osborne, Meaghan, Andersen, Jessica, Lepage, Pierre, Pagé, Véronique, Levasseur, Caroline, Beckers, Mélissa, Gainforth, Heather L, Lamontagne, Marie-Eve, and Sweet, Shane N
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Community-based physical activity opportunities have been shown to help adults with physical disabilities improve their participation in daily activities and reduce social isolation. Despite the known benefits, substantial barriers and challenges inhibit accessibility to these physical activity opportunities. To facilitate the co-construction of strategies to overcome accessibility issues pertaining to community-based physical activity opportunities. In total, 45 individuals with physical disabilities, patients at a rehabilitation hospital, staff members of disability organizations, staff of local or provincial government agencies/departments, kinesiologists, occupational therapists, graduate students, and peer mentors participated in one of four World Cafés held in their respective cities. World Café is a methodology for fostering collaborative, solution-focused conversation that aims to solve problems through collective intelligence. Participants were divided into groups of three to four people and invited to engage in evolving rounds of discussions responding to prompts about accessibility to physical activity in their communities. Transcripts were analyzed using content analysis. In total, 17 strategies were identified, addressing 5 areas: representation and visibility (e.g. prioritize hiring people with a disability), finances (e.g. reduce direct costs for participants), connection and social support (e.g. foster social networks that provide informational support), education and programming (e.g. enhance awareness of existing services and resources), and government programs and policies (e.g. enforce accessibility standards for indoor and outdoor spaces). The findings of this study provide strategies and practical applications for community programs and governments to consider for increasing access to physical activity opportunities for people with physical disabilities. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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23. A review protocol on research partnerships: a Coordinated Multicenter Team approach
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Hoekstra, Femke, Mrklas, Kelly J., Sibley, Kathryn M., Nguyen, Tram, Vis-Dunbar, Mathew, Neilson, Christine J., Crockett, Leah K., Gainforth, Heather L., and Graham, Ian D.
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- 2018
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24. Evaluating the impact of a network of research partnerships: a longitudinal multiple case study protocol
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Hoekstra, Femke, Martin Ginis, Kathleen A., Allan, Veronica, Kothari, Anita, and Gainforth, Heather L.
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- 2018
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25. Examining the Feasibility and Effectiveness of a Community-Based Organization Implementing an Event-Based Knowledge Mobilization Initiative to Promote Physical Activity Guidelines for People With Spinal Cord Injury Among Support Personnel
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Gainforth, Heather L., Latimer-Cheung, Amy E., Athanasopoulos, Peter, and Ginis, Kathleen A. Martin
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- 2015
26. Outcomes of spinal cord injury peer mentorship: A community-based Delphi consensus approach
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Shi, Zhiyang, Michalovic, Emilie, McKay, Rhyann, Gainforth, Heather L., McBride, Christopher B., Clarke, Teren, Casemore, Sheila, and Sweet, Shane N.
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- 2023
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27. Delivery of an Exercise Program for Breast Cancer Survivors on Treatment in a Community Setting
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Leach, Heather J., Gainforth, Heather L., and Culos-Reed, S. Nicole
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- 2017
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28. Investigating the peer Mentor-Mentee relationship: characterizing peer mentorship conversations between people with spinal cord injury.
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McKay, Rhyann C., Giroux, Emily E., Baxter, Kristy L., Casemore, Sheila, Clarke, Teren Y., McBride, Christopher B., Sweet, Shane N., and Gainforth, Heather L.
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AFFINITY groups ,STATISTICS ,SPINAL cord injuries ,SCIENTIFIC observation ,SAMPLE size (Statistics) ,MOTIVATIONAL interviewing ,MENTORING ,MANN Whitney U Test ,CRONBACH'S alpha ,INTER-observer reliability ,INTERPERSONAL relations ,RESEARCH funding ,SOUND recordings ,SCALE analysis (Psychology) ,THEMATIC analysis ,DATA analysis ,BEHAVIOR modification - Abstract
This study aimed to: (1) develop a coding manual to characterize topics discussed and conversation techniques used during peer mentorship conversations between people with spinal cord injury (SCI); (2) assess the reliability of the manual; and (3) apply the manual to characterize conversations. The study was conducted in partnership with three Canadian provincial SCI organizations. Twenty-five phone conversations between SCI peer mentors and mentees were audio-recorded and transcribed verbatim. Ten transcripts were inductively analyzed to develop a coding manual identifying topics and techniques used during the conversations. Inductive technique codes were combined and deductively linked to motivational interviewing and behaviour change techniques. Two coders independently applied the coding manual to all transcripts. Code frequencies were calculated. The coding manual included 14 topics and 31 techniques. The most frequently coded topics were personal information, recreational programs, and chronic health services for mentors and mentees. The most frequently coded techniques were giving personal information, social smoothers, and closed question for mentors; and giving personal information, social smoothers, and sharing perspective for mentees. This research provides insights into topics and techniques used during real-world peer mentorship conversations. Findings may be valuable for understanding and improving SCI peer mentorship programs. SCI peer mentorship conversations address a wide range of rehabilitation topics ranging from acute care to living in the community. Identification of the topics discussed, and techniques used in SCI peer mentorship conversations can help to inform formalized efforts to train and educate acute and community-based rehabilitation professionals. Identifying commonly discussed topics in SCI peer mentorship conversation may help to ensure that peer mentors are equipped with the necessary knowledge and resources, or the development of those resources be prioritized. Developing a method to characterize the topics discussed and techniques used during SCI peer mentorship conversations may aid in designing methods to evaluate how rehabilitation professionals provide support to people with SCI. [ABSTRACT FROM AUTHOR]
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- 2023
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29. Assessing Connections Between Behavior Change Theories Using Network Analysis
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Gainforth, Heather L., West, Robert, and Michie, Susan
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- 2015
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30. Couples' experiences with sexuality after spinal cord injury.
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Osborne, Jake B., Rocchi, Meredith A., McBride, Christopher B., McKay, Rhyann, Gainforth, Heather L., Upper, Randy, and Sweet, Shane N.
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AFFINITY groups ,SPINAL cord injuries ,SOCIAL support ,HUMAN sexuality ,RESEARCH methodology ,INTERVIEWING ,MENTORING ,EXPERIENCE ,QUALITATIVE research ,PSYCHOSOCIAL factors ,SEX customs ,COMMUNICATION ,SOUND recordings ,RESEARCH funding ,SEXUAL partners ,THEMATIC analysis ,EMOTIONS ,JUDGMENT sampling ,HEALTH promotion - Abstract
To explore sexuality after spinal cord injury (SCI) from the perspectives of individuals with SCI and their romantic partners. A sample of 8 Canadian adults with SCI (6 men, 2 women) and their partners participated in this study (N = 16). Semi-structured dyadic and individual interviews were conducted, discussions surrounding sexuality and intimacy were extracted, and a qualitative description of the interview data was performed using thematic analysis. Three major themes were identified: the changing definition of sex; emotions; and practical support. Couples' conversations around the changing definition of sex after SCI addressed the taboo topic of sexuality and the importance of communication between couples, peers, and healthcare providers. Emotions included fears of losing intimacy, embarrassment in managing bladder and bowel interference, and acceptance in balancing being a romantic partner and a caregiver. Finally, couples reported challenges accessing practical support including medical interventions and sexual health nurses, but saw value in peer mentorship programs. Couples explored a changing definition of sex following SCI that was complicated by the taboo nature of discussing sexuality, experienced a range of emotions throughout the recovery process, and had difficulties navigating the healthcare system for appropriate support. Healthcare professionals should promote discussion and provide support for sexuality following SCI, but during initial rehabilitation may be too early. Healthcare providers should prepare people with SCI and their partners for the inevitable trial-and-error process involved in sexual rehabilitation. Rehabilitation professionals could direct couples to SCI peer mentorship programs to help normalize the experiences and emotions of sexual rehabilitation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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31. Using Network Analysis to Understand Knowledge Mobilization in a Community-based Organization
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Gainforth, Heather L., Latimer-Cheung, Amy E., Moore, Spencer, Athanasopoulos, Peter, and Martin Ginis, Kathleen A.
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- 2015
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32. Recognition of knowledge translation practice in Canadian health sciences tenure and promotion: A content analysis of institutional policy documents.
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Sibley, Kathryn M., Khan, Masood, Banner, Davina, Driedger, S. Michelle, Gainforth, Heather L., Graham, Ian D., and Plamondon, Katrina
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DOCUMENT clustering ,CONTENT analysis ,POLICY analysis ,DESCRIPTIVE statistics ,UNIVERSITY research - Abstract
Background and objective: There has been growing emphasis on increasing impacts of academic health research by integrating research findings in healthcare. The concept of knowledge translation (KT) has been widely adopted in Canada to guide this work, although lack of recognition in tenure and promotion (T&P) structures have been identified as barrier to researchers undertaking KT. Our objective was to explore how KT is considered in institutional T&P documentation in Canadian academic health sciences. Methods: We conducted content analysis of T&P documents acquired from 19 purposively sampled research-intensive or largest regional Canadian institutions in 2020–2021. We coded text for four components of KT (synthesis, dissemination, exchange, application). We identified clusters of related groups of documents interpreted together within the same institution. We summarized manifest KT content with descriptive statistics and identified latent categories related to how KT is considered in T&P documentation. Results: We acquired 89 unique documents from 17 institutions that formed 48 document clusters. Most of the 1057 text segments were categorized as dissemination (n = 851, 81%), which was included in 47 document clusters (98%). 15 document clusters (31%) included all four KT categories, while one (2%) did not have any KT categories identified. We identified two latent categories: primarily implicit recognition of KT; and an overall lack of clarity on KT. Conclusions: Our analysis of T&P documents from primarily research-intensive Canadian universities showed a lack of formal recognition for a comprehensive approach to KT and emphasis on traditional dissemination. We recommend that institutions explicitly and comprehensively consider KT in T&P and align documentation and procedures to reflect these values. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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33. Principles to guide spinal cord injury research partnerships: a Delphi consensus study.
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Gainforth, Heather L., McKay, Rhyann C., Hoekstra, Femke, Maffin, Jocelyn, Sibley, Kathryn M., and Jung, Mary E.
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CONSENSUS (Social sciences) , *MEDICAL rehabilitation , *SPINAL cord injuries , *PARTICIPANT-researcher relationships , *PATIENT participation , *PATIENTS , *SOCIAL justice , *RESEARCH funding , *SCALE analysis (Psychology) , *DESCRIPTIVE statistics , *QUESTIONNAIRES , *INTRACLASS correlation , *DECISION making , *STATISTICAL sampling , *REHABILITATION research , *DELPHI method , *TRUST - Abstract
To establish consensus regarding principles that should be used to guide spinal cord injury (SCI) research partnerships between researchers and research users. A three-round Delphi consensus exercise was carried out with researchers and/or research users involved in one or more SCI research partnerships. Participants considered a list of 125 partnership principles. In rounds 1 and 2, participants rated their agreement that a principle should guide SCI research partnerships on an 11-point Likert scale. After each round, principles that received a mean score of ≥8.0 or 70% of participants rated the principle ≥8.0 were retained. In round 3, participants categorized principles as essential, desirable, irrelevant, or unsure. At least 20 individuals participated in each round. In round 1, 103 principles met consensus criteria and eight principles were added. In round 2, 93 principles met the criteria. In round 3, 29 principles were categorized as essential and eight as desirable. Recommended principles focused on the interpersonal, relational, and logistical aspects of partnerships. Principles that did not reach consensus related to social justice and actionable impact. Findings provide insight into 37 principles that could be used to combat tokenism and inform future guidance to meaningfully engage partners in SCI research. Consensus-based research partnership principles (i.e., norms or beliefs) were identified and could be prioritized to help support spinal cord injury (SCI) researchers and research users combat tokenism and meaningfully engage research users as partners in the co-creation of knowledge. The resulting list of recommended research partnership principles was used to inform the development of guidance to support quality partnerships between SCI researchers and research users within and outside the rehabilitation context (). Guidance supporting meaningful research partnerships may accelerate the time between discovery and use of research in practice. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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34. Researchers’ and Research Users’ Experiences With and Reasons for Working Together in Spinal Cord Injury Research Partnerships: A Qualitative Study.
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Hoekstra, Femke, Schaefer, Lee, Athanasopoulos, Peter, and Gainforth, Heather L.
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SPINAL cord injuries ,RESEARCH personnel ,USER experience ,QUALITATIVE research ,ROLE models ,WORK experience (Employment) ,THEMATIC analysis - Abstract
Background: Research partnership approaches are becoming popular within spinal cord injury (SCI) health research system, providing opportunities to explore experiences of and learn from SCI research partnership champions. This study aimed to explore and describe SCI researchers’ and research users’ (RU’) experiences with and reasons for conducting and/or disseminating (health) research in partnership in order to gain more insight into potentially ways to build capacity for and foster change to support research partnerships within a health research system. Methods: Underpinned by a pragmatic perspective, ten semi-structured timeline interviews were conducted with researchers and RU who have experiences with SCI research partnerships. Interviews focused on experiences in participants’ lives that have led them to become a person who conducts and/or disseminates research in partnership. Data were analysed using narrative thematic analysis. Results: We identified three threads from participants’ stories: (1) seeing and valuing different perspectives, (2) inspirational role models, and (3) relational and personal aspect of research partnerships. We identified sub-threads related to experiences that participants draw on how they came to be a person who engage in (health) research partnerships, and sub-threads related to participants’ reasons for engaging in research partnerships. While most sub threads were identified from both researchers’ and RU’ perspectives (eg, partnership successes and failures), some were unique for researchers (morally the right thing to do) or RU (advocating). Conclusion: Using a narrative and pragmatic approach, this study provided a new understanding of SCI researchers’ and RU’ partnership experiences over time. We found that participants’ research partnership experiences and motivations align with components of leadership theories. The findings from this study may be used to inform strategies and policy programs to build capacity for conducting and disseminating (health) research in partnership, within and beyond SCI research. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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35. Design of a Planner-Based Intervention to Facilitate Diet Behaviour Change in Type 2 Diabetes.
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Cradock, Kevin A., Quinlan, Leo R., Finucane, Francis M., Gainforth, Heather L., Ginis, Kathleen A. Martin, Sanders, Elizabeth B.-N., and ÓLaighin, Gearóid
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TYPE 2 diabetes ,DIET ,WATER consumption ,CHANGE theory - Abstract
Diet behaviour is influenced by the interplay of the physical and social environment as well as macro-level and individual factors. In this study, we focus on diet behaviour at an individual level and describe the design of a behaviour change artefact to support diet behaviour change in persons with type 2 diabetes. This artefact was designed using a human-centred design methodology and the Behaviour Change Wheel framework. The designed artefact sought to support diet behaviour change through the addition of healthy foods and the reduction or removal of unhealthy foods over a 12-week period. These targeted behaviours were supported by the enabling behaviours of water consumption and mindfulness practice. The artefact created was a behaviour change planner in calendar format, that incorporated behaviour change techniques and which focused on changing diet behaviour gradually over the 12-week period. The behaviour change planner forms part of a behaviour change intervention which also includes a preparatory workbook exercise and one-to-one action planning sessions and can be customised for each participant. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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36. Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities.
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Sweet, Shane N., Shi, Zhiyang, Rocchi, Meredith, Ramsay, Jean, Pagé, Véronique, Lamontagne, Marie-Eve, and Gainforth, Heather L.
- Abstract
First, to examine whether participants reported changes in (1) leisure-time physical activity (LTPA) participation and social inclusion variables and (2) well-being outcomes before and after joining a community-based LTPA program for adults with physical disabilities. Second, to explore the longitudinal relationship between LTPA and the other aforementioned outcomes. A double baseline longitudinal design with measurements at 4-6 weeks (baseline 1) and immediately (baseline 2) before and 2 and 4 months after joining the community-based LTPA program. Community. Adults (N=43) with a physical disability who reported no cognitive impairment, were new members of the community-based LTPA program, and spoke English or French. A community-based physical activity program for adults with physical disabilities. Participants were provided an individualized exercise program and accessed the program at designated times during the week. Primary: LTPA (LTPA Questionnaire for People with Spinal Cord Injury), participation (Patient-Perceived Participation in Daily Activities Questionnaire), and social inclusion. Secondary: depression severity, self-esteem, resilience, and life satisfaction. After joining the program, participants reported an increase in total LTPA (mean baseline2 , 177.80±211.32; mean 2months , 299.31±298.70; mean 4months , 288.14±292.14), moderate-to-vigorous LTPA (mean baseline2 , 83.95±123.95; mean 2months , 142.00±198.38; mean 4months , 163.23±182.08), and participation in health (mean baseline2 , 6.24±1.16; mean 2months , 6.58±1.25; mean 4months , 6.97±0.82) and family-related activities (mean baseline2 , 12.18±2.43; mean 2months , 12.60±2.30; mean 4months , 13.47±2.01). A significant increase (β=3.46, P <.001) in social inclusion before joining the program was followed by a decrease (β=−1.09, P <.05) 4 months later. Improvements related to depression severity were noted (β baseline1−baseline2 =−1.51, P <.05; β baseline2−4 months =−0.28, P >.05). The results support the role of a community-based LTPA program in increasing LTPA levels and enhancing participation in some activities among adults with physical disabilities. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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37. Integrated Knowledge Translation Guiding Principles for Conducting and Disseminating Spinal Cord Injury Research in Partnership.
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Gainforth, Heather L., Hoekstra, Femke, McKay, Rhyann, McBride, Christopher B., Sweet, Shane N., Martin Ginis, Kathleen A., Anderson, Kim, Chernesky, John, Clarke, Teren, Forwell, Susan, Maffin, Jocelyn, McPhail, Lowell T., Mortenson, W. Ben, Scarrow, Gayle, Schaefer, Lee, Sibley, Kathryn M., Athanasopoulos, Peter, and Willms, Rhonda
- Abstract
To address a gap between spinal cord injury (SCI) research and practice by rigorously and systematically co-developing integrated knowledge translation (IKT) guiding principles for conducting and disseminating SCI research in partnership with research users. The process was guided by the internationally accepted The Appraisal of Guidelines for REsearch & Evaluation (AGREE) II Instrument for evaluating the development of clinical practice guidelines. North American SCI research system (ie, SCI researchers, research users, funders). The multidisciplinary expert panel (n=17) and end users (n=35) included individuals from a North American partnership of SCI researchers, research users, and funders who have expertise in research partnerships. Not applicable. Clarity, usefulness, and appropriateness of the principles. Data regarding 125 principles of partnered research were systematically collected from 4 sources (review of reviews, scoping review, interviews, Delphi consensus exercise). A multidisciplinary expert panel held a 2-day meeting to establish consensus, select guiding principles, and draft the guidance. The panel reached 100% consensus on the principles and guidance document. The final document includes a preamble, 8 guiding principles, and a glossary. Survey data showed that the principles and guidance document were perceived by potential end users as clear, useful, and appropriate. The IKT Guiding Principles represent the first rigorously co-developed, consensus-based guidance to support meaningful SCI research partnerships. The principles are a foundational tool with the potential to improve the relevance and impact of SCI research, mitigate tokenism, and advance the science of IKT. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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38. Teaching Behavior Change Theory in Canada: Establishing Consensus on Behavior Change Theories That Are Recommended to Be Taught to Undergraduate Students in Courses Addressing Health Behavior Change.
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Gainforth, Heather L., Dineen, Tineke E., Giroux, Emily E., and Forneris, Tanya
- Subjects
- *
BEHAVIOR , *CHANGE theory , *HEALTH behavior , *UNDERGRADUATES , *SOCIAL cognitive theory , *COGNITIVE learning theory - Abstract
There is little guidance on which behavior change theories should be taught in undergraduate courses addressing health behavior change. Delphi consensus methods provide a formal, systematic, and reproducible method for establishing consensus among experts. Objective. Use a Delphi methodology to establish consensus regarding behavior change theories that should be taught to undergraduate students enrolled in health behavior change courses. Method. An online Delphi consensus exercise was completed by instructors who were identified through a systematic search of 94 University course calendars to be teaching health behavior change content to undergraduate students in Canada. In Round 1, 22 participants generated a list of theories taught in undergraduate courses. In Rounds 2 and 3, participants indicated their level of agreement using an 11-point Likert-type scale as to which theories should be taught. Theories that reached predetermined consensus criteria were retained in each round. Results. In Round 1, participants listed over 50 different theories being taught in undergraduate courses. After Round 2, nine theories met consensus criteria which were refined to only six theories in Round 3 (i.e., behavior change wheel, self-determination theory, self-efficacy theory, social ecological model, social cognitive theory, theory of planned behavior). Conclusions. A wide range of theories are taught in undergraduate courses. However, only a minority of these theories reached consensus criteria as being theories that should be taught to undergraduate students enrolled in courses addressing health behavior change. Findings can be used to improve the consistency and quality of instruction of behavior change theories at the undergraduate level. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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39. Can Persuasive Messages Encourage Individuals to Create Action Plans for Physical Activity?
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Sweet, Shane N., Brawley, Lawrence R., Hatchell, Alexandra, Gainforth, Heather L., and Latimer-Cheung, Amy E.
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PHYSICAL activity ,EXERCISE ,BEHAVIOR modification ,HEALTH behavior ,SPORTS psychology - Abstract
Given the positive influence of action planning on physical activity, persuasive messages could be designed to promote action planning. The purpose of this paper was to test action planning messages in two studies. Participants were allocated to one of two message groups, reading either a physical activity only or physical activity plus action planning message (Study 1) and either a gain-framed or loss-framed action planning message (Study 2). The percent of individuals who created an action plan and the quality of the plans were evaluated. In Study 1, individuals in the physical activity plus action planning group created as many action plans as the physical activity only group, but their plans were higher quality. In Study 2, Week 2 differences between the gain- and loss-framed message groups were found for action planning. To our knowledge, these studies were the first to investigate message-induced action planning as a behavior. More research is needed to optimize these messages. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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40. Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus.
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Bourne, Jessica E, Ivanova, Elena, Gainforth, Heather L, and Jung, Mary E
- Abstract
Behavior change techniques (BCTs) are used to target theoretical mechanisms of action predicted to bring about behavior change. Reporting BCTs and connecting them to mechanisms of action is critical to understanding intervention processes of change. This article identifies the BCTs associated with an exercise intervention for individuals at risk of type 2 diabetes and determines the extent to which these BCTs target associated mechanisms of action. BCTs were mapped onto social cognitive theory (SCT) and the theoretical domains framework (TDF) using published literature identifying links between BCTs and SCT/TDF and expert consensus. Two coders then used the 93-item BCT taxonomy (BCTTv1) to independently code BCTs within the intervention. The BCTs used in the current intervention enabled identification of the theoretical mechanisms of action targeted in the intervention. More than 70% of the intervention content incorporated at least one BCT. More than 50% of the BCTs used targeted SCT constructs and more than 70% of BCTs used targeted at least one of the 14 TDF domains. Five BCTs did not map onto either SCT or TDF. This research provides a systematic method of linking BCTs to mechanisms of action. This process increases the transparency of intervention content and identification of the mechanisms of action targeted in the current intervention. Reporting interventions in this manner will enable the most potent mechanisms of actions associated with long-term behavior change to be identified and utilized in future work. Trial Registration : ClinicalTrials.gov # NCT02164474. Registered on June 12, 2014. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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41. RE-AIMing conferences: a reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute's Praxis 2016.
- Author
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Sweet, Shane N, Michalovic, Emilie, Baxter, Kristy, Baron, Justine, and Gainforth, Heather L
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This article reported on the reach, effectiveness, and maintenance dimensions of a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) analysis to evaluate Praxis 2016, a conference aimed to develop solutions to overcome challenges to translating research into practice in the spinal cord injury (SCI) community. Reach indicators were collected from the Praxis 2016 organizing committee. For effectiveness and maintenance, attendees (n = 106) completed a questionnaire pre-, post-, and 9-month post-Praxis 2016 assessing (a) capability (e.g., knowledge), (b) motivation, (c) opportunities, and (d) the groups they currently, need to, and/or plan to work with to develop solutions to overcome the challenges of translating SCI research into practice. They also reported their satisfaction with Praxis 2016. Qualitative interviews with attendees and organizers post-Praxis 2016 were conducted. Praxis 2016 reached 28% of their intended audience. For effectiveness, attendees' knowledge significantly increased (t(59)= 3.83, p <.001), they reported a greater need to work with members within the SCI community from pre- to post-Praxis 2016, and were generally satisfied with Praxis 2016. Regarding maintenance, more attendees reported needing to work with researchers, clinicians and SCI community organizations at 9-month post-Praxis 2016. The interviewees reported increased knowledge and capacity to network with the SCI community, but highlighted concerns for the long-term impact of Praxis 2016. Praxis 2016 was an effective approach to create short-term change in knowledge, and to expand knowledge translation networks. Further efforts could build on Praxis 2016 to foster long-term success in overcoming the challenges in translating SCI research into practice. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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42. Investigating Characteristics of Quality Peer Mentors With Spinal Cord Injury.
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Gainforth, Heather L., Giroux, Emily E., Shaw, Robert B., Casemore, Sheila, Clarke, Teren Y., McBride, Christopher B., Garnett, Claire V., and Sweet, Shane N.
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To identify characteristics (1) of high- and low-quality spinal cord injury (SCI) peer mentors; (2) that should be used to match SCI peer mentors and mentees. The study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation approach. The Delphi exercise was completed in three rounds. In Round 1, people with SCI completed a thought-listing exercise to identify characteristics of high- and low-quality peer mentors and for matching. In Rounds 2 and 3, people with SCI and community organization staff rated characteristics from the previous round on an 11-point scale. After the final round, the remaining characteristics were thematically analyzed. Community-based peer mentorship programs in three Canadian provinces. People with SCI and SCI community organization staff (Round 1, n=45; Round 2, n=27; Round 3, n=25). Not applicable. Consensus-based list of characteristics. Participants reached consensus on 215 characteristics of quality peer mentors and 11 characteristics for peer mentor-mentee matching (ICC=0.96). A consensus-based characterization of high- and low-quality peer mentorship was created and included six overarching themes: competencies, personality characteristics, emotional state, mentor outlook, reason for mentoring, and role model. A consensus-based characterization of quality peer mentorship was co-developed with input from over 50 members of the SCI community. Findings highlight that peers have both interpersonal and intrapersonal characteristics that contribute to quality mentorship. The findings highlighted the importance of matching mentors on lived experience and shared interests. Findings will inform future research and SCI peer mentorship programs. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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43. Exploring Parents' Message Receipt and Message Enactment of the World's First Integrated Movement Behaviour Guidelines for Children and Youth.
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Tennant, Emily M., Tremblay, Mark S., Faulkner, Guy, Gainforth, Heather L., and Latimer-Cheung, Amy E.
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PHYSICAL activity ,PARENT-child relationships ,GUIDELINES ,MEDICAL informatics ,CHILDREN'S health ,YOUTH health ,HEALTH behavior - Abstract
The Canadian 24-Hour Movement Guidelines for Children and Youth are novel in how they integrate the guideline recommendations for the full continuum of movement behaviours, from sleep to vigorous physical activity. Research suggests that the integrated guidelines strategy is perceived favourably, and this study is the first to compare this strategy to traditional segregated guidelines on its effectiveness to disseminate health information. Specifically, this study explored (1) the influence of the integrated guidelines strategy on parents' message receipt and message enactment to support their child meet the guidelines, and (2) the relationship between message receipt and message enactment in a youth movement behaviour context. In this prospective randomized experiment, parents (n= 162) were randomized to read integrated, segregated, or control guidelines and complete pre, post, and 2-week follow-up surveys. Repeated-measures ANOVAs revealed significantly higher message enactment outcomes among participants in the integrated guidelines group (p< .05). Message receipt and enactment outcomes were significantly correlated (r> .171, p< .05). These findings highlight that parents' initial receipt of a message is important for subsequent behaviour change in a youth movement behaviour context. Furthermore, the integrated guidelines strategy may have an advantage in promoting guideline update and should continue to be explored. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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44. The use of behaviour change theories and techniques in research-informed coach development programmes: a systematic review.
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Allan, Veronica, Vierimaa, Matthew, Gainforth, Heather L., and Côté, Jean
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BEHAVIOR modification ,COACHES (Athletics) ,CONCEPTUAL structures ,PROFESSIONAL employee training ,SYSTEMATIC reviews ,THEORY ,PSYCHOLOGY - Abstract
Coaches are often targeted in interventions to enhance athlete outcomes. While coach development programmes (CDPs) may change coach behaviour, little is known about theories and techniques used to design and implement effective programmes. Examining the use of behaviour change theories and techniques (BCTs) can aid in understanding and improving CDPs. Adhering to PRISMA guidelines, the purpose of this research was to conduct a systematic review examining the use of behaviour change theories and BCTs in CDPs. In total, 29 CDPs met the inclusion criteria. Data were extracted using the Theory Coding Scheme and Behaviour Change Technique Taxonomy (v1). Only six CDPs were explicitly based on behaviour change theory, and no single theory or combination of theories was used more than once. The number of BCTs used per CDP ranged between one and nine. There was no significant difference between theory-based and non-theory-based CDPs concerning the number of BCTs used per CDP. Theoretical frameworks and techniques that have the potential to effectively change coach behaviours are not being used frequently or consistently in the design and implementation of CDPs. To design CDPs that change coach behaviours and facilitate positive outcomes, further research examining theoretical influences on coach behaviours is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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45. Associations between Practitioner Personality and Client Quit Rates in Smoking Cessation Behavioural Support Interventions.
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Gainforth, Heather L., Aujla, Sarita Y., Beard, Emma, Croghan, Emma, and West, Robert
- Subjects
CONFIDENCE intervals ,MEDICAL care ,EVALUATION of medical care ,MEDICAL personnel ,PATIENTS ,PHYSICIANS ,SUPPORT groups ,SMOKING cessation ,BEHAVIORAL objectives (Education) ,ODDS ratio - Abstract
Introduction: There is wide variation in the success rates of practitioners employed to help smokers to stop, even once a range of potential confounding factors has been taken into account.Aim: This paper examined whether personality characteristics of practitioners might play a role success rates.Methods: Data from 1,958 stop-smoking treatment episodes in two stop-smoking services (SSS) involving 19 stop-smoking practitioners were used in the analysis. The outcome measure was clients’ biochemically verified quit status 4 weeks after the target quit date. The five dimensions of personality, as assessed by the Ten-Item Personality Inventory, were included as predictor variables: openness, conscientiousness, agreeableness, extraversion, and neuroticism. A range of client and other practitioner characteristics were used as covariates. A sensitivity analysis was conducted to determine if managers' ratings of practitioner personality were also associated with clients’ quit status.Results: Multi-level random intercept models indicated that clients of practitioners with a higher extraversion score had greater odds of being abstinent at four weeks (self-assessed: OR = 1.10, 95% CI = 1.01–1.19; manager-assessed: OR = 1.32, 95% CI = 1.21–1.44).Conclusions: More extraverted stop smoking practitioners appear to have greater success in advising their clients to quit smoking. Findings need to be confirmed in larger practitioner populations, other SSS, and in different smoking cessation contexts. If confirmed, specific training may be needed to assist more introverted stop smoking practitioners. [ABSTRACT FROM AUTHOR]- Published
- 2018
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46. Evaluation of a community-based, family focused healthy weights initiative using the RE-AIM framework.
- Author
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Jung, Mary E., Bourne, Jessica E., and Gainforth, Heather L.
- Subjects
ADAPTABILITY (Personality) ,REGULATION of body weight ,CAREGIVERS ,CONCEPTUAL structures ,DOCUMENTATION ,FAMILIES ,HEALTH behavior ,HEALTH maintenance organizations ,INTERVIEWING ,LONGITUDINAL method ,NUTRITION ,SURVEYS ,TIME ,SOCIAL support ,COMMUNITY-based social services ,HUMAN services programs ,HEALTH literacy ,PHYSICAL activity - Abstract
Background: Childhood overweight and obesity is a major public health concern. Community-based interventions have the potential to reach caregivers and children. However, the overall health impact of these programs is rarely comprehensively assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using the RE-AIM framework. Methods: Ten sites implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [Mage = 35.6] and 151 children [Mage = 13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews and surveys. Effectiveness outcome variables were assessed at pre- and post-intervention and 6-month follow-up. Results: Reach: HT participants were almost entirely recruited from existing programs within sites. Effectiveness: Caregivers' nutrition related efficacy beliefs increased following HT (ps < .03). Participation in HT was not associated with significant changes in physical activity or nutrition behaviour or perceived social support (ps > .05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (ps < .05). Adoption: Thirty-five percent of sites approached to implement HT expressed interest. The 10 sites selected recruited existing staff members to implement HT. Implementation: Program objectives were met 72.8% of the time and 71 adaptations were made. HT was finance- and time-dependent. Maintenance: Two sites fully implemented HT in the follow-up year and 5 sites incorporated aspects of HT into other programs. Conclusions: Working alongside organizations that develop community programs to conduct comprehensive, arms-length evaluations can systematically highlight areas of success and challenges. Overall HT represents a feasible community-based intervention; however further support is required in order to ensure the program is effective at positively targeting the desired outcomes. As a result of this evaluation, modifications are currently being implemented to HT. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
47. Diet Behavior Change Techniques in Type 2 Diabetes: A Systematic Review and Meta-analysis.
- Author
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Cradock, Kevin A., ÓLaighin, Gearóid, Finucane, Francis M., McKay, Rhyann, Quinlan, Leo R., Martin Ginis, Kathleen A., and Gainforth, Heather L.
- Subjects
TYPE 2 diabetes ,BEHAVIOR modification ,TREATMENT of diabetes ,TYPE 2 diabetes treatment ,DIABETES complications ,META-analysis ,PEOPLE with diabetes - Abstract
Objective: Dietary behavior is closely connected to type 2 diabetes. The purpose of this meta-analysis was to identify behavior change techniques (BCTs) and specific components of dietary interventions for patients with type 2 diabetes associated with changes in HbA1c and body weight.Research Design and Methods: The Cochrane Library, CINAHL, Embase, PubMed, PsycINFO, and Scopus databases were searched. Reports of randomized controlled trials published during 1975-2017 that focused on changing dietary behavior were selected, and methodological rigor, use of BCTs, and fidelity and intervention features were evaluated.Results: In total, 54 studies were included, with 42 different BCTs applied and an average of 7 BCTs used per study. Four BCTs-"problem solving," "feedback on behavior," "adding objects to the environment," and "social comparison"-and the intervention feature "use of theory" were associated with >0.3% (3.3 mmol/mol) reduction in HbA1c. Meta-analysis revealed that studies that aimed to control or change the environment showed a greater reduction in HbA1c of 0.5% (5.5 mmol/mol) (95% CI -0.65, -0.34), compared with 0.32% (3.5 mmol/mol) (95% CI -0.40, -0.23) for studies that aimed to change behavior. Limitations of our study were the heterogeneity of dietary interventions and poor quality of reporting of BCTs.Conclusions: This study provides evidence that changing the dietary environment may have more of an effect on HbA1c in adults with type 2 diabetes than changing dietary behavior. Diet interventions achieved clinically significant reductions in HbA1c, although initial reductions in body weight diminished over time. If appropriate BCTs and theory are applied, dietary interventions may result in better glucose control. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
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48. Barriers and facilitators to the implementation of a school-based physical activity policy in Canada: application of the theoretical domains framework.
- Author
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Weatherson, Katie A., McKay, Rhyann, Gainforth, Heather L., and Jung, Mary E.
- Subjects
PHYSICAL activity ,ELEMENTARY school teachers ,STUDENTS ,SCHOOL day ,SCHOOL districts ,EXERCISE ,HEALTH policy ,PSYCHOLOGY ,SCHOOL health services ,QUALITATIVE research ,THEORY - Abstract
Background: In British Columbia Canada, a Daily Physical Activity (DPA) policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers' implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF) to understand teachers' barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day.Methods: Interviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for sub-themes within each domain. Two researchers performed coding.Results: A total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250), Beliefs about consequences (n = 225), Social influences (n = 193), Knowledge (n = 100), and Intentions (n = 88). Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social/professional role and identity, Beliefs about Consequences. Forty-one qualitative sub-themes were identified across the fourteen domains and exemplary quotes were highlighted.Conclusions: Teachers identified barriers and facilitators relating to all TDF domains, with ECR, Beliefs about consequences, Social influences, Knowledge and Intentions being the most often discussed influencers of DPA policy implementation. Use of the TDF to understand the implementation factors can assist with the systematic development of future interventions to improve implementation. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
49. A theoretical analysis of the barriers and facilitators to the implementation of school-based physical activity policies in Canada: a mixed methods scoping review.
- Author
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Weatherson, Katie A., Gainforth, Heather L., and Jung, Mary E.
- Subjects
- *
PHYSICAL activity , *SCHOOLS , *CHILDREN'S health , *EDUCATION policy , *ELEMENTARY schools , *EXERCISE , *HEALTH planning , *HEALTH promotion , *HEALTH policy , *SCHOOL health services - Abstract
Background: Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation.Methods: A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student's physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains.Results: The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers' perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student's PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains.Conclusions: With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future.Registration: A protocol for this review was not registered. [ABSTRACT FROM AUTHOR]- Published
- 2017
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- View/download PDF
50. Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysis.
- Author
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Cradock, Kevin A., ÓLaighin, Gearóid, Finucane, Francis M., Gainforth, Heather L., Quinlan, Leo R., and Martin Ginis, Kathleen A.
- Subjects
TYPE 2 diabetes treatment ,BEHAVIOR modification ,BODY weight ,CINAHL database ,COMBINED modality therapy ,CONFIDENCE intervals ,GLYCOSYLATED hemoglobin ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,MEDLINE ,META-analysis ,ONLINE information services ,PROBABILITY theory ,REDUCING diets ,RESEARCH funding ,STATISTICS ,T-test (Statistics) ,TERMS & phrases ,TIME ,WEIGHT loss ,SYSTEMATIC reviews ,EVIDENCE-based medicine ,PROFESSIONAL practice ,STATISTICAL significance ,EFFECT sizes (Statistics) ,RANDOMIZED controlled trials ,INTER-observer reliability ,RESEARCH bias ,PHYSICAL activity ,DATA analysis software ,MEDICAL coding ,DESCRIPTIVE statistics ,EVALUATION - Abstract
Background: Changing diet and physical activity behaviour is one of the cornerstones of type 2 diabetes treatment, but changing behaviour is challenging. The objective of this study was to identify behaviour change techniques (BCTs) and intervention features of dietary and physical activity interventions for patients with type 2 diabetes that are associated with changes in HbA
1c and body weight. Methods: We performed a systematic review of papers published between 1975-2015 describing randomised controlled trials (RCTs) that focused exclusively on both diet and physical activity. The constituent BCTs, intervention features and methodological rigour of these interventions were evaluated. Changes in HbA1c and body weight were meta-analysed and examined in relation to use of BCTs. Results: Thirteen RCTs were identified. Meta-analyses revealed reductions in HbA1c at 3, 6, 12 and 24 months of -1. 11 % (12 mmol/mol), -0.67 % (7 mmol/mol), -0.28 % (3 mmol/mol) and -0.26 % (2 mmol/mol) with an overall reduction of -0.53 % (6 mmol/mol [95 % CI -0.74 to -0.32, < 0.00001]) in intervention groups compared to control P groups. Meta-analyses also showed a reduction in body weight of -2.7 kg, -3.64 kg, -3.77 kg and -3.18 kg at 3, 6, 12 and 24 months, overall reduction was -3.73 kg (95 % CI -6.09 to -1.37 kg, = 0.002). P Four of 46 BCTs identified were associated with >0.3 % reduction in HbA1c : 'instruction on how to perform a behaviour', 'behavioural practice/rehearsal', 'demonstration of the behaviour' and 'action planning', as were intervention features 'supervised physical activity', 'group sessions', 'contact with an exercise physiologist', 'contact with an exercise physiologist and a dietitian', 'baseline HbA1c >8 %' and interventions of greater frequency and intensity. Conclusions: Diet and physical activity interventions achieved clinically significant reductions in HbA1c at three and six months, but not at 12 and 24 months. Specific BCTs and intervention features identified may inform more effective structured lifestyle intervention treatment strategies for type 2 diabetes. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
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