Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway (USN), Postbox 235, 3603 Kongsberg, Norway.
Department of Political Science and Management, University of Agder (UiA), Universitetsveien 25, 4604 Kristiansand, Norway.
Health Promot Int. 2023 Jun 1;38(3). doi: 10.1093/heapro/daac048.
Worksites are important settings for implementing health promotion programs. Evidence for sustainable upscaling of physical activity (PA) programs and critical evaluation of the implementation process are scarce. In this article, we address the following research questions: (i) To what extent is the implementation process of PA programs theoretically informed? (ii) What characterizes the implementation process of PA programs in theory driven studies? (iii) Which facilitators and barriers are identified in the implementation process and at what level? We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The databases Medline (Ovid) and Sportdiscuss (Ebsco) were searched for peer-reviewed original articles published in English (2000-2020), from a European, North American, New Zealand and Australian context. Reported implementation components and facilitators/barriers (F/Bs) were detected, interpreted and analyzed according to implementation theory. Appraisal of methodological quality on included studies was executed. Of 767 eligible studies, 17 studies were included, 11 of which conducted a theory-based process evaluation of the implementation. They implemented composite PA programs, at two or more levels with internal or mixed implementation teams. F/Bs were most frequently related to the implementation component 'fidelity', corresponding to organizational and implementer level, and the component 'reach' corresponding to program and participant level. Notably, only one study reported F/Bs on the socio-political level. Despite more frequent use in recent years of theory-based implementation, few studies reported implementation effectiveness. Major challenges regarding incoherent use of theoretical concepts and scarcity of empirically tested frameworks are discussed.
工作场所是实施健康促进计划的重要场所。关于可持续扩大体育活动（PA）计划规模和对实施过程进行批判性评估的证据很少。在本文中，我们提出了以下研究问题：（i）PA 计划的实施过程在多大程度上具有理论依据？（ii）理论驱动研究中 PA 计划实施过程的特点是什么？（iii）在实施过程中和什么层次上确定了哪些促进因素和障碍？我们遵循了系统评价和荟萃分析的首选报告项目指南。在欧洲、北美、新西兰和澳大利亚的背景下，从 Medline（Ovid）和 Sportdiscuss（Ebsco）数据库中搜索了 2000 年至 2020 年期间发表的英文同行评审原始文章。根据实施理论，检测、解释和分析报告的实施组件以及促进因素/障碍（F/B）。对纳入研究的方法学质量进行了评估。在 767 项符合条件的研究中，有 17 项研究被纳入，其中 11 项对实施进行了基于理论的过程评估。它们实施了综合 PA 计划，在两个或更多层次上，由内部或混合实施团队实施。F/B 最常与实施组件“保真度”相关，对应于组织和实施者层面，以及组件“范围”，对应于计划和参与者层面。值得注意的是，只有一项研究报告了社会政治层面的 F/B。尽管近年来越来越多地使用基于理论的实施方法，但很少有研究报告实施效果。讨论了关于理论概念使用不一致和缺乏经验验证框架的主要挑战。
