Evidence-Based Approaches to Dissemination and Diffusion of Physical Activity Interventions

Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, Australia.
American Journal of Preventive Medicine (Impact Factor: 4.53). 11/2006; 31(4 Suppl):S35-44. DOI: 10.1016/j.amepre.2006.06.008
Source: PubMed


With the increasing availability of effective, evidence-based physical activity interventions, widespread diffusion is needed. We examine conceptual foundations for research on dissemination and diffusion of physical activity interventions; describe two school-based program examples; review examples of dissemination and diffusion research on other health behaviors; and examine policies that may accelerate the diffusion process. Lack of dissemination and diffusion evaluation research and policy advocacy is one of the factors limiting the impact of evidence-based physical activity interventions on public health. There is the need to collaborate with policy experts from other fields to improve the interdisciplinary science base for dissemination and diffusion. The promise of widespread adoption of evidence-based physical activity interventions to improve public health is sufficient to justify devotion of substantial resources to the relevant research on dissemination and diffusion.

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    • "Within the field of health promotion several effective workplace interventions to promote PA in general have been developed [44], however few studies report on the dissemination and implementation of these interventions [37,45]. Nevertheless, a thorough evaluation of these workplace interventions is necessary as it can provide valuable information on the level of intervention implementation and fidelity, feasibility and effectiveness of an intervention, and it is needed to identify ways to improve practice [36]. "
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    ABSTRACT: Background: Originating from the interdisciplinary collaboration between public health and the transportation field a workplace intervention to promote commuter cycling, 'Bike to Work: cyclists are rewarded', was implemented. The intervention consisted of two cycling contests, an online loyalty program based on earning 'cycling points' and the dissemination of information through folders, newsletters, posters and a website. The study purpose was to evaluate the dissemination efforts of the program and to gain insights in whether free participation could persuade small and middle-sized companies to sign up. Methods: The RE-AIM framework was used to guide the evaluation. Two months after the start of the intervention a questionnaire was send to 4880 employees. At the end of the intervention each company contact person (n = 12) was interviewed to obtain information on adoption, implementation and maintenance.Comparison analyses between employees aware and unaware of the program were conducted using independent-samples t-tests for quantitative data and chi-square tests for qualitative data. Difference in commuter cycling frequency was assessed using an ANOVA test. Non-parametric tests were used for the comparison analyses between the adopting and non-adopting companies. Results: In total seven of the twelve participating companies adopted the program and all adopting companies implemented all intervention components. No significant differences were found in the mean number of employees (p = 0.15) or in the type of business sector (p = 0.92) between adopting and non-adopting companies. Five out of seven companies had the intention to continue the program. At the individual level, a project awareness of 65% was found. Employees aware of the program had a significantly more positive attitude towards cycling and reported significantly more commuter cycling than those unaware of the program (both p < 0.001). Participation was mainly because of health and environmental considerations. Conclusions: The results of the dissemination study are promising. The adoption and implementation rates indicate that the 'Bike to Work: cyclists are rewarded' program seems to be a feasible workplace intervention. At the individual level, a higher score of commuter cycling was found among the employees aware of the program. Nevertheless, more evidence regarding long term effectiveness and sustainability of the intervention is needed.
    BMC Public Health 06/2013; 13(1):587. DOI:10.1186/1471-2458-13-587 · 2.26 Impact Factor
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    • "Rogers' (1995) diffusion of innovations theory explains the adoption and diffusion of new practices within a given social system. The theory has found useful application in research from a broad range of fields, including education and public health (Dearing, 2009), and more specifically in school-based physical activity interventions (McKenzie, Sallis, & Rosengard, 2009; Owen, Glanz, Sallis, & Kelder, 2006). Adoption is defined as the process of a potential adopter becoming aware of, and eventually using a given innovation on a regular basis, whereas diffusion is defined as widespread adoption of the innovation among members of the social system (Metzler, Lund, & Gurvitch, 2008). "
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    ABSTRACT: Physical activity promotion in the academic classroom (PAPAC) is an effective means for increasing children's school-based physical activity. In the context of a South Carolina policy requiring elementary schools to provide children with 90 min of physical activity beyond physical education every week, the purpose of this study was to test a theoretical model of elementary classroom teachers' (ECT) PAPAC adoption drawing from Rogers' (1995) diffusion of innovations theory and a social ecological perspective. ECTs (N = 201) were assessed on their policy awareness, perceived school support for PAPAC, perceived attributes of PAPAC, domain-specific innovativeness, and self-reported PAPAC. Partial least squares analysis supported most of the hypothesized relationships. Policy awareness predicted perceived school support, which in turn predicted perceived attributes and domain-specific innovativeness. Perceived compatibility, simplicity, and observability, and domain-specific innovativeness predicted self-reported PAPAC. This study identifies variables that should be considered in policy-driven efforts to promote PAPAC adoption.
    Journal of Teaching in Physical Education 01/2013; 32(4):419-440. · 0.74 Impact Factor
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    • "Given the limited number of published population-based interventions in this setting [38], we conducted a study to describe the impact of an intervention to increase the adoption of multiple physical activity promoting policies and practices in childcare services. What distinguished this study from previous research is the scale of the intervention and its assessment of setting wide adoption of these practices. "
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    ABSTRACT: Background There is considerable scope to improve the delivery of practices that increase the physical activity of children in centre based childcare services. Few studies have reported the effectiveness of interventions to address this, particularly at a population level. The primary aim of this study was to describe the impact of an intervention to increase the adoption of multiple policies and practices to promote physical activity in centre based childcare services. Methods A quasi experimental study was conducted in centre based childcare services (n =228) in New South Wales (NSW), Australia and involved a three month intervention to increase the adoption of eight practices within childcare services that have been suggested to promote child physical activity. Intervention strategies to support the adoption of practices included staff training, resources, incentives, follow-up support and performance monitoring and feedback. Randomly selected childcare services in the remainder of NSW acted as a comparison group (n = 164) and did not receive the intervention but may have been exposed to a concurrent NSW government healthy eating and physical activity initiative. Self reported information on physical activity policies, fundamental movement skills sessions, structured physical activity opportunities, staff involvement in active play and provision of verbal prompts to encourage physical activity, small screen recreation opportunities, sedentary time, and staff trained in physical activity were collected by telephone survey with childcare service managers at baseline and 18 months later. Results Compared with the comparison area, the study found significantly greater increases in the prevalence of intervention services with a written physical activity policy, with policy referring to placing limits on small screen recreation, and with staff trained in physical activity. In addition, non-significant trends towards a greater increase in the proportion of intervention services conducting daily fundamental movement skill sessions, and such services having a physical activity policy supporting physical activity training for staff were also evident. Conclusion The intervention was effective in improving a number of centre based childcare service policies and practices associated with promoting child physical activity. Adoption of a broader range of practices may require more intensive and prolonged intervention support.
    International Journal of Behavioral Nutrition and Physical Activity 08/2012; 9(1):101. DOI:10.1186/1479-5868-9-101 · 4.11 Impact Factor
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