Department of Rehabilitation Medicine, Adelante Centre of Expertise in Rehabilitation and Audiology, zandbergsweg 111, 6432 CC, Hoensbroek, The Netherlands.
Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER, Postal Box 616, 6200 Maastricht, The Netherlands.
Health Promot Int. 2021 Apr 15;36(2):334-348. doi: 10.1093/heapro/daaa050.
A randomized controlled trial was conducted comparing the effects of a biopsychosocial course (PRESTO-Play) vs. physical activity promotion (PRESTO-Fit) to reduce disability related to musculoskeletal disorders in music students. The current study provides an external validation and a formative and process evaluation, allowing for a better interpretation of results. First, a group of experts was asked to complete a structured evaluation of design and content of the trial. Second, quantitative and qualitative data were analysed from different stakeholders (students, therapists and conservatory staff) using questionnaires, logs, field notes and emails to evaluate fidelity, dose delivered, dose received, reach and context. Results are presented descriptively. Two authors independently identified key responses that were merged into themes. Although no difference in disability was found between interventions, closer evaluation revealed that participants in PRESTO-Play reported that they learned about prevention of physical complaints and were more satisfied with course contents compared with PRESTO-Fit. Study design and contents of the interventions were found to be valid, with an appropriate dose delivered. Feedback from students and logs suggested that behavioural change and psychosocial principles in PRESTO-Play might have not been implemented optimally. Only moderate fidelity in both groups and too little contrast between interventions could have influenced results. Low attendance rates and a presumed lack of generalization further decreased possible effectiveness. Context greatly influenced implementation. Implementing a future health course with closer collaboration with the institution could optimize accessibility and communication, encourage attendance and enhance motivation for behavioural change.
一项随机对照试验比较了生物心理社会课程（PRESTO-Play）与促进身体活动（PRESTO-Fit）对减少音乐学生肌肉骨骼疾病相关残疾的效果。本研究提供了外部验证以及形成性和过程评估，以便更好地解释结果。首先，要求一组专家对试验的设计和内容进行结构化评估。其次，通过问卷、日志、现场记录和电子邮件从不同利益相关者（学生、治疗师和音乐学院工作人员）收集定量和定性数据，以评估保真度、提供的剂量、接受的剂量、覆盖范围和背景。结果以描述性方式呈现。两位作者独立确定了关键回复，并将其合并为主题。尽管干预措施之间没有发现残疾差异，但更仔细的评估表明，与 PRESTO-Fit 相比，PRESTO-Play 的参与者报告说他们了解预防身体投诉的知识，并且对课程内容更满意。研究设计和干预内容被认为是有效的，提供了适当的剂量。来自学生和日志的反馈表明，PRESTO-Play 中的行为改变和心理社会原则可能没有得到最佳实施。两组的保真度都只有中等水平，干预之间的差异太小，这可能影响了结果。低出席率和预期的缺乏概括性进一步降低了可能的效果。背景极大地影响了实施。与机构更紧密地合作实施未来的健康课程可以优化可及性和沟通，鼓励出勤率并提高行为改变的动机。
