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为亨廷顿病患者开发并提供身体活动干预措施:促进向临床实践的转化

Development and Delivery of a Physical Activity Intervention for People With Huntington Disease: Facilitating Translation to Clinical Practice.

作者信息

Quinn Lori, Trubey Rob, Gobat Nina, Dawes Helen, Edwards Rhiannon Tudor, Jones Carys, Townson Julia, Drew Cheney, Kelson Mark, Poile Vincent, Rosser Anne, Hood Kerenza, Busse Monica

机构信息

School of Healthcare Sciences (L.Q., M.B.), Schools of Medicine and Biosciences (A.R.), and South East Wales Trials Unit (R.T., J.T., C.D., M.K., V.P., K.H.), Cardiff University, Cardiff, United Kingdom; Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York; Wales School of Primary Care Research (N.G.), Cochrane Institute of Primary Care Research, School of Medicine, Cardiff University, Cardiff, United Kingdom; Department of Sport and Health Sciences (H.D.), Oxford Brookes University, Oxford, United Kingdom; and Centre for Health Economics and Medicines Evaluation (R.T.E., C.J.), Bangor University, Bangor, United Kingdom.

出版信息

J Neurol Phys Ther. 2016 Apr;40(2):71-80. doi: 10.1097/NPT.0000000000000119.

Abstract

BACKGROUND AND PURPOSE

We studied the development and delivery of a 14-week complex physical activity intervention for people with Huntington disease, where detailed information about the intervention was fully embedded in the trial design process.

METHODS

Intervention Development: The intervention was developed through a series of focus groups. The findings from the focus groups informed the development of a logic model for the physical activity intervention that was broadly consistent with the framework of self-determination theory. Intervention Delivery: Key components underpinning the delivery of the intervention were implemented including a defined coach training program and intervention fidelity assessment methods. Training of coaches (physical therapists, occupational therapists, research nurses, and exercise trainers) was delivered via group and 1:1 training sessions using a detailed coach's manual, and with ongoing support via video calls, and e-mail communication as needed. Detailed documentation was provided to determine costs of intervention development and coach training.

RESULTS

Intervention delivery coaches at 8 sites across the United Kingdom participated in the face-to-face training. Self-report checklists completed by each of the coaches indicated that all components of the intervention were delivered in accordance with the protocol. Mean (standard deviation) intervention fidelity scores (n = 15), as measured using a purpose-developed rating scale, was 11 (2.4) (out of 16 possible points). Coaches' perceptions of intervention fidelity were similarly high. The total cost of developing the intervention and providing training was £30,773 ($47,042 USD).

DISCUSSION AND CONCLUSIONS

An important consideration in promoting translation of clinical research into practice is the ability to convey the detailed components of how the intervention was delivered to facilitate replication if the results are favorable. This report presents an illustrative example of a physical activity intervention, including the development and the training required to deliver it. This approach has the potential to facilitate reproducibility, evidence synthesis, and implementation in clinical practice.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A122).

摘要

背景与目的

我们研究了一项针对亨廷顿舞蹈症患者的为期14周的综合体育活动干预措施的制定与实施情况,其中关于该干预措施的详细信息已完全融入试验设计过程。

方法

干预措施制定:该干预措施通过一系列焦点小组讨论得以制定。焦点小组讨论的结果为体育活动干预措施的逻辑模型的制定提供了依据,该模型与自我决定理论框架大致相符。干预措施实施:实施了干预措施实施过程中的关键组成部分,包括明确的教练培训计划和干预保真度评估方法。通过使用详细的教练手册,以小组培训和一对一培训的形式对教练(物理治疗师、职业治疗师、研究护士和运动教练)进行培训,并根据需要通过视频通话和电子邮件通信提供持续支持。提供了详细的文件以确定干预措施制定和教练培训的成本。

结果

英国各地8个地点的干预措施实施教练参加了面对面培训。每位教练填写的自我报告清单表明,干预措施的所有组成部分均按照方案实施。使用专门制定的评分量表测得的平均(标准差)干预保真度得分(n = 15)为11(2.4)(满分16分)。教练对干预保真度的看法同样很高。制定干预措施和提供培训的总成本为30,773英镑(47,042美元)。

讨论与结论

促进临床研究转化为实践的一个重要考虑因素是,若结果良好,能否传达干预措施实施方式的详细组成部分以促进重复实施。本报告展示了一项体育活动干预措施的示例,包括其制定过程和实施所需的培训。这种方法有可能促进临床实践中的可重复性验证、证据综合及实施。可查看视频摘要以获取作者的更多见解(见补充数字内容1,http://links.lww.com/JNPT/A122)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f8/4795097/8ebea9aaef65/jnpt-40-071-g001.jpg

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