title: Translation of the otago exercise program for adoption and implementation in the United States.
abstract: BACKGROUND
  The Otago Exercise Program (OEP) is an evidence-based fall prevention program developed, evaluated, and disseminated in New Zealand. The program was designed for delivery in the home by physical therapists (PTs). It was not known if American PTs would require additional training and resources to adopt the OEP. This article describes the process of translating the OEP for dissemination in the US. Processes included reviewing and piloting the New Zealand training materials to identify implementation challenges, updating training materials to be consistent with American physical therapy practices, piloting the updated training materials in an online format, and determining if the online format reached the target PT audience. METHODS – PROCESS ACTIVITIES: The New Zealand manual was reviewed by expert American PTs and a training webinar was piloted with 56 American PTs. Feedback suggested that the program itself was understood by PTs, but training materials required modification related to documentation and reimbursement policies. Additional content was developed and integrated into an online training module. The online training was piloted and then deemed adequate by seven PT subject matter experts. The online training was launched in March 2013. Demographic and practice data were collected to characterize the PTs attending the online training as well as perceived barriers and facilitators to implementation (n = 522). Perceived facilitators include the effectiveness of the OEP to facilitate adoption, but the lack of agency support, billing and reimbursement challenges pose a significant barrier to OEP implementation.
  
  
  CONCLUSIONS
  The OEP required additional information to facilitate adoption by American PTs. Online training that specifically targets PTs appears to effectively reach the target audience and be well received by participants. More research is required to determine the impact of online training on a PT's adoption and implementation of this material into their practice.
authors.affiliation: Center for Aging and Health, University of North Carolina, School of Medicine , Chapel Hill, NC , USA.
authors.forename: Tiffany E
authors.initials: TE
authors.lastname: Shubert
authors.affiliation: College of Public Health, The University of Georgia , Athens, GA , USA.
authors.forename: Matthew Lee
authors.initials: ML
authors.lastname: Smith
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health , College Station, TX , USA.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
authors.affiliation: Center for Aging and Health, University of North Carolina, School of Medicine , Chapel Hill, NC , USA.
authors.forename: Cristine B
authors.initials: CB
authors.lastname: Clarke
authors.affiliation: University of North Carolina Center for Health Promotion and Disease Prevention , Chapel Hill, NC , USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Bomberger
authors.affiliation: Division of Geriatrics, University of North Carolina, School of Medicine , Chapel Hill, NC , USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Roberts
authors.affiliation: Division of Geriatrics, University of North Carolina, School of Medicine , Chapel Hill, NC , USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Busby-Whitehead
keywords: aging; balance; fall prevention; health promotion; physical therapy; policy