The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Scand J Occup Ther. 2023 Nov;30(8):1523-1540. doi: 10.1080/11038128.2023.2242380. Epub 2023 Aug 9.
The ADAPT Program have improved activities of daily living (ADL) in women with fibromyalgia. To understand the functioning of the program, it is relevant to evaluate how program theory components are linked to outcomes (mechanisms) and how the randomised controlled trial (RCT) context, influenced delivery and outcomes.
To evaluate ADAPT in terms of dose, mechanisms of change and contextual factors.
MATERIAL/METHODS: Dose was recorded on the = 21 participants receiving ADAPT in the IMPROvE trial (NCT01352052). A subsample of = 16 attended one of three 2-hour focusgroups, evaluating mechanisms of change and contextual factors. Interview questions explored participants' interaction with four program components, i.e. how the 'client-centred approach', 'group-based peer-exchange format', 'teaching-learning strategies' and 'long-term program format' triggered mechanisms facilitating/hindering outcomes. Moreover, how randomisation procedures influenced delivery and outcomes.
Attending a long-term educational peer-exchange program, in which participants experienced met by a health professional that legitimised difficulties, facilitated participants knowledge, insights and motivation for changing habits. With time and support, participants experienced increased acceptance of their situation and began to implement more effective ways to perform ADL tasks.
CONCLUSIONS/SIGNIFICANCE: Results support previous findings of improved ADL ability post-ADAPT and provide initial evidence to support the ADAPT Program theory.
ADAPT 计划改善了纤维肌痛女性的日常生活活动（ADL）。为了了解该计划的运作情况，评估计划理论组成部分如何与结果（机制）相关联以及随机对照试验（RCT）背景如何影响交付和结果是很重要的。
根据剂量、变化机制和环境因素来评估 ADAPT。
材料/方法：在 IMPROvE 试验（NCT01352052）中，对接受 ADAPT 的 21 名参与者记录了剂量。16 名参与者中的一个亚组参加了三个 2 小时的焦点小组之一，评估了变化机制和环境因素。访谈问题探讨了参与者与四个计划组成部分的互动情况，即“以客户为中心的方法”、“基于小组的同伴交流形式”、“教学策略”和“长期计划形式”如何触发促进/阻碍结果的机制。此外，还探讨了随机程序如何影响交付和结果。
参加长期的教育性同伴交流计划，参与者会受到专业医疗人员的接待，这会使他们的困难得到认可，从而促进参与者对改变习惯的了解、洞察力和动力。随着时间的推移和支持，参与者对自己的情况的接受度提高，并开始实施更有效的方法来完成 ADL 任务。
结论/意义：结果支持 ADAPT 后 ADL 能力提高的先前发现，并为 ADAPT 计划理论提供了初步证据支持。
