The role of theory to develop and evaluate a toolkit to increase clinical measurement and interpretation of walking speed and distance in adults post-stroke

The iWalk study showed that 10-meter walk test (10mWT) and 6-minute walk test (6MWT) administration post-stroke increased among physical therapists (PTs) following introduction of a toolkit comprising an educational guide, mobile app, and video. We describe the use of theory guiding toolkit developm...

Full description

Saved in:
Bibliographic Details
Published in:Disability and rehabilitation Vol. 44; no. 14; pp. 3719 - 3735
Main Authors: Salbach, Nancy M., MacKay-Lyons, Marilyn, Solomon, Patricia, Howe, Jo-Anne, McDonald, Alison, Bayley, Mark T., Veitch, Surabhi, Sivarajah, Lavan, Cacoilo, Joseph, Mihailidis, Alex
Format: Journal Article
Language:English
Published: England Taylor & Francis 03.07.2022
Subjects:
knowledge translation
process evaluation
standardized assessment
stroke rehabilitation
theory
Toolkit
walking
process evaluation
stroke rehabilitation
standardized assessment
walking
Toolkit
knowledge translation
theory
ISSN:0963-8288, 1464-5165, 1464-5165
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The iWalk study showed that 10-meter walk test (10mWT) and 6-minute walk test (6MWT) administration post-stroke increased among physical therapists (PTs) following introduction of a toolkit comprising an educational guide, mobile app, and video. We describe the use of theory guiding toolkit development and a process evaluation. We used the knowledge-to-action framework to identify research steps; and a guideline implementability framework, self-efficacy theory, and the transtheoretical model to design and evaluate the toolkit and implementation process (three learning sessions). In a before-and-after study, 37 of the 49 participating PTs completed online questionnaires to evaluate engagement with learning sessions, and rate self-efficacy to perform recommended practices pre- and post-intervention. Thirty-three PTs and 7 professional leaders participated in post-intervention focus groups and interviews, respectively. All sites conducted learning sessions; attendance was 50-78%. Self-efficacy ratings for recommended practices increased and were significant for the 10mWT (p ≤ 0.004). Qualitative findings highlighted that theory-based toolkit features and implementation strategies likely facilitated engagement with toolkit components, contributing to observed improvements in PTs' knowledge, attitudes, skill, self-efficacy, and clinical practice. The approach may help to inform toolkit development to advance other rehabilitation practices of similar complexity. Implications for Rehabilitation Toolkits are an emerging knowledge translation intervention used to support widespread implementation of clinical practice guideline recommendations. Although experts recommend using theory to inform the development of knowledge translation interventions, there is little guidance on a suitable approach. This study describes an approach to using theories, models and frameworks to design a toolkit and implementation strategy, and a process evaluation of toolkit implementation. Theory-based features of the toolkit and implementation strategy may have facilitated toolkit implementation and practice change to increase clinical measurement and interpretation of walking speed and distance in adults post-stroke.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0963-8288
1464-5165
1464-5165
DOI:10.1080/09638288.2020.1867653