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UBC Theses and Dissertations

Advancing physical activity intervention measurement and development among people with spinal cord injury : a behaviour change science and integrated knowledge translation approach Ma, Jasmin


The purpose of this dissertation was to advance physical activity (PA) intervention measurement and development among people with spinal cord injury (SCI) by 1) comparing the agreement and strengths and weaknesses of the two most commonly used PA measures for people with SCI; and 2) using both integrated knowledge translation (IKT) and behaviour change theory for intervention development. Study 1 compared the use of accelerometers and the Physical Activity Recall Assessment for People with SCI for measuring PA in people with SCI. A qualitative analysis explored the strengths and weaknesses of each measure in capturing the different components of PA (i.e., frequency, intensity, time, and type). Findings suggested these measures may be best used concurrently and the results informed the PA measurement strategy used in study 3. Study 2 described the process of developing an IKT and theory-based intervention for increasing PA among people with SCI. The IKT process involved 5 phases: i) a synthesis of the evidence base through two systematic reviews and a meta-analysis, ii) key informant interviews with people with SCI, iii) a national survey of physiotherapists, iv) an expert panel meeting to inform key intervention recommendations, and v) a pilot-test of the intervention among physiotherapists to assess its feasibility and efficacy of the intervention to increase factors that influence its implementation. The IKT process resulted in the selection of the Health Action Process Approach model as the intervention’s theoretical framework and to organize the delivery of tailored strategies that related to the key themes of education, referral, and prescription. Study 3 was a randomized controlled trial of the efficacy of the intervention to change PA behaviour, fitness, and psychosocial predictors of PA among people with SCI. Significant, medium to large sized effects were found on PA behaviour, psychosocial predictors of PA and fitness in the intervention group compared to control. Together, the dissertation studies highlight the importance of refining intervention evaluation and development and provides an example process for doing so by combining behaviour change theory with IKT.

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