School of Kinesiology and Health Studies, Queen's University, 28 Division Street, Kingston, ON, Canada.
School of Medicine, Queen's University, Kingston, ON, Canada.
BMC Med Inform Decis Mak. 2023 Apr 6;23(1):57. doi: 10.1186/s12911-023-02147-x.
Canada's 24-Hour Movement Guidelines for Adults have shifted the focus from considering movement behaviours (i.e., physical activity, sedentary behaviour, and sleep) separately to a 24-h paradigm, which considers how they are integrated. Accordingly, primary care providers (PCPs) have the opportunity to improve their practice to promote all movement behaviours cohesively. However, PCPs have faced barriers to discussing physical activity alone (e.g., time, competing priorities, inadequate training), leading to low frequency of physical activity discussions. Consequently, discussing three movement behaviours may seem challenging. Tools to facilitate primary care discussions about physical activity have been developed and used; however, few have undergone usability testing and none have integrated all movement behaviours. Following a synthesis of physical activity, sedentary behaviour, and sleep tools for PCPs, we developed the Whole Day Matters Tool and User Guide that incorporate all movement behaviours. The present study aimed to explore PCPs' perceptions on the usability, acceptability, and future implementation of the Whole Day Matters Tool and User Guide to improve their relevancy among PCPs.
Twenty-six PCPs were observed and audio-video recorded while using the Tool and User Guide in a think-aloud procedure, then in a near-live encounter with a mock service-user. A debriefing interview using a guide informed by Normalization Process Theory followed. Recordings were transcribed verbatim and analysed using content analysis and a critical friend to enhance rigour.
PCPs valued aspects of the Tool and User Guide including their structure, user-friendliness, visual appeal, and multi-behaviour focus and suggested modifications to improve usability and acceptability. Findings are further discussed in the context of Normalization Process Theory and previous literature.
The Tool and User Guide were revised, including adding plain language, reordering and renaming sections, reducing text, and clarifying instructions. Results also informed the addition of a Preamble and a Handout for adults accessing care (i.e., patients/clients/service-users) to explain the evidence underpinning the 24-Hour Movement Guidelines for Adults and support a person-centered approach. These four resources (i.e., Tool, User Guide, Preamble, Handout) have since undergone a consensus building process to arrive at their final versions before being disseminated into primary care practice.
加拿大 24 小时成人运动指南将关注点从分别考虑运动行为（即体力活动、久坐行为和睡眠）转移到 24 小时范式，该范式考虑了它们是如何整合的。因此，初级保健提供者（PCP）有机会改善实践，以协调地促进所有运动行为。然而，PCP 在讨论体力活动时面临障碍（例如，时间、竞争优先级、培训不足），导致体力活动讨论的频率较低。因此，讨论三种运动行为可能具有挑战性。已经开发和使用了促进初级保健讨论体力活动的工具；然而，很少有工具经过可用性测试，也没有一个工具整合了所有的运动行为。在对 PCP 的体力活动、久坐行为和睡眠工具进行综合之后，我们开发了 Whole Day Matters 工具和用户指南，其中包含了所有的运动行为。本研究旨在探讨 PCP 对 Whole Day Matters 工具和用户指南的可用性、可接受性和未来实施的看法，以提高它们在 PCP 中的相关性。
26 名 PCP 在使用工具和用户指南进行思考 aloud 程序时进行了观察和音频-视频记录，然后在与模拟服务用户进行近乎实时的互动中使用。随后使用正常化进程理论指南进行了汇报访谈。逐字转录记录并使用内容分析和关键朋友进行分析，以提高严谨性。
PCP 对工具和用户指南的结构、用户友好性、视觉吸引力和多行为重点等方面表示赞赏，并提出了改进可用性和可接受性的修改建议。研究结果还结合正常化进程理论和以往文献进行了讨论。
对工具和用户指南进行了修订，包括添加了通俗易懂的语言、重新排序和重命名部分、减少文本以及阐明说明。结果还为添加序言和为获取医疗服务的成年人（即患者/客户/服务用户）提供的传单提供了信息，以解释支持成人 24 小时运动指南的证据，并支持以人为本的方法。这四个资源（即工具、用户指南、序言、传单）已经经过了共识构建过程，以达成最终版本，然后再将其传播到初级保健实践中。
