Article
Translating Effective Clinic-Based Physical Activity Interventions into Practice

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Abstract

An increasing number of studies report on the efficacy of physical activity interventions conducted in, or in conjunction with, clinical settings. This article reviews the status of the literature with regard to translation to practice and describes methods that will heighten the likelihood of translation. In general, few physical activity programs have been designed for translation, and the diffusion models underlying most reported programs have relied on an assumption of linear diffusion into practice. However, recent developments are encouraging and examples are provided of programs that utilize relationship or systems approaches to translation.

Section snippets

Dissemination of Physical Activity Recommendations

Much has been published on the essential nature of regular physical activity across the lifespan for psychological and physical health during pregnancy, physical development of children, and sustained health-related quality of life throughout adulthood and into the senior years.5, 6, 7, 8, 9, 10 These findings have been formulated into a range of recommendations and disseminated, most broadly by the U.S. Surgeon General’s report on Physical Activity and Health.11 As a result of these

Current Evidence Base for Medical Office-Based Physical Activity Interventions

The attraction of using medical offices as a location for physical activity interventions developed primarily for two reasons. First, because of the breadth of the population that is served by primary care providers, medical offices represent a location to deliver interventions that could have a broad public health impact. In fact, a recent study suggests that as many as 90% of patients would consider participating in a physical activity intervention initiated through a medical office.18

Lack of Evidence That Promising Clinic-Based Interventions Are Translated Into Practice

Translation of research into practice can be defined as the uptake, implementation, and sustainability of research findings within standard care. This brief review of recent studies, the USPSTF review, and Community Guide findings suggest that there is evidence that medical office-based physical activity interventions can lead to successful behavior change when applied in a manner that consistently implements the 5A’s of behavior-change counseling. As such, there is a need to achieve

Move More: An Example of a Multilevel Systems Approach to Translation

A trial was recently completed that utilized a multileveled systems approach to heighten the likelihood of system uptake, implementation, and sustainability of the intervention.40, 61 Figure 3 depicts the application of a systems model to the development, testing, and translation of Move More, a medical office-based team building physical activity intervention (see Table 1 and Estabrooks et al.40 for the Move More application of the 5A’s).

The targeted delivery sites for Move More were primary

Recommendations for Researchers to Enhance Translation of Clinic-Based Physical Activity Interventions

We recommend three general areas of consideration prior to the development and efficacy testing of any clinic-based physical activity intervention. First, consistent with a systems approach to translation, it is necessary to identify and understand the system structure(s) in which the intervention will be delivered.45 It is advisable to complete an assessment of the explicit purpose or mission of an organization. The research team should also understand the roles of individuals within the

Conclusion

As illustrated in Figure 2, Figure 3, a systems perspective model of physical activity translation research focuses on interactions among the physical activity program, the delivery setting(s), and the research or evaluation design. This model stresses the importance of contextual factors and the interactions among contextual factors and outcomes (moderator effects). Although oversimplified, these figures illustrate the complexity and importance of understanding that program delivery staff is

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