Changing minds, changing lives from the top down: an investigation of the dissemination and adoption of a Canada-wide educational intervention to enhance health care professionals' intentions to prescribe physical activity.
OBJECTIVE
The purposes of the current study were to (1) describe the restructuring and dissemination of a Canada-wide intervention curriculum designed to enhance health care professionals' prescription of physical activity to patients with physical disabilities, and (2) examine interventionists' social cognitions for, and their acceptance and adoption of, the new curriculum.


METHODS
A participatory curriculum development process was utilized, resulting in a theory- and evidence-based curriculum. Interventionists (N = 28) were trained in curriculum delivery and most (n = 22) completed measures of Theory of Planned Behavior (TPB) constructs assessing their cognitions for delivering the new curriculum at pre- and post-training and at 6-month follow-up. Interventionists also completed a Diffusion of Innovations (DOI) measure assessing their opinion of whether the new curriculum met characteristics that would facilitate its adoption and use.


RESULTS
Interventionists reported strong TPB cognitions for curriculum use before training. Significant increases emerged for some TPB constructs (ps ≤ 0.025) from pre- to post-training, and significant decreases were seen in some TPB constructs (ps ≤ 0.024) between post-training and 6-month follow-up. The interventionists rated the new curriculum as high on all the DOI characteristics.


CONCLUSIONS
The theory-driven, participatory development process facilitated interventionists' social cognitions towards and adoption of the new curriculum. Positive increases in TPB cognitions from pre- to post-training were not maintained at follow-up. Further research is needed to determine if these changes in cognitions are indicative of a curriculum "reinvention" process that facilitates long-term curriculum use. Understanding curriculum adoption and implementation is a crucial step to determining the potential population impact of the intervention.
Department of Kinesiology, McMaster University, Ivor Wynne Centre E110, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada, tomasojr@mcmaster.ca.
Jennifer R
JR
Tomasone
Kathleen A
KA
Martin Ginis
Paul A
PA
Estabrooks
Laura
L
Domenicucci
D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D003071:Cognition; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009043:Motor Activity