Evaluation of knowledge translation and workforce development through targeted exercise for falls prevention education programs for exercise physiologists
- Authors: Pascoe, Deborah
- Date: 2015
- Type: Text , Thesis , PhD
- Full Text:
- Description: There is a wealth of evidence supporting the positive effects of exercise for falls prevention. The problem that faces researchers, policy makers, accreditation bodies and higher education providers is how to best translate this information to allied health practitioners to ensure they are providing the best evidence-based practice to their clients. One in three community dwelling older people over the age of 65 years fall every year and this figure increases to one in two people over the age of 80 years. As a profession, exercise physiologists (EPs) are responsible for providing exercise for the prevention, maintenance and treatment of chronic disease and complex medical conditions, including prescribing exercise for falls prevention. The incidence of falls, chronic disease and complex medical conditions increases with age and as Australia moves towards an ever ageing population, the cost burden of health care for older people and falls is exploding. Exercise physiology and exercise science professionals have an opportunity to become champions of exercise for falls prevention and assist in ameliorating the ever increasing burden of falls in Australia. By targeting the exercise physiology profession and providing methods to translate the research evidence, there is great potential to build workforce capacity to deliver falls prevention exercise programs. But how best to target the profession of exercise physiology? Advances can be made by targeting undergraduate and post-graduate university programs or as part of mandated professional continuing education programs which focuses on both the future and current exercise physiology workforce respectively. A scoping study conducted across two States in Australia (New South Wales and Victoria) established that at the time, the current level of knowledge of undergraduate human movement and exercise and sports science students and post graduate exercise rehabilitation/exercise physiology students, was inadequate with regard to falls risk and exercise prescription for fall prevention in older people. These results highlighted the need for the development and widespread implementation of an evidence-based “exercise for falls prevention” curriculum for future exercise professionals. The UniFPEP curriculum was developed to provide evidence-based teaching and learning resource materials to enhance learning beyond current levels by translating the latest research evidence regarding falls risk and exercises for falls prevention to produce a discipline leading curriculum. The curriculum was designed to enhance exercise science and exercise rehabilitation students’ learning outcomes through the provision of online lectures and learning materials to supplement and strengthen the delivery of face-to-face lectures, practical classes and self-directed learning tasks. The UniFPEP curriculum was implemented at the University of Ballarat and following completion students’ knowledge outcomes and self-reported confidence to prescribe exercise for older people and for falls prevention were significantly increased. The results indicated that a significant change in knowledge and confidence can be achieved during a 2-3 week educational period during a normal university semester. More importantly, these changes were retained 13 weeks after completion of the UniFPEP curriculum. Following evaluation of the UniFPEP the curriculum was reviewed and prepared as a workforce continuing education program (CEP) (Fit+Fall=Free). This was implemented and evaluated as a clustered controlled trial to compare two different delivery modes: face-to-face and online, to a control group of exercise physiology professionals. The Fit+Fall=Free CEP showed significant improvements in the knowledge and confidence of EPs in prescribing exercise for older people and exercise prescription for falls prevention for both the face-to-face (F2F) and Online delivery modes. The F2F delivery of the Fit+Fall=Free CEP provided the greatest long-term impact with the increases being maintained at a significant level six months post workshop.
- Description: Doctor of Philosophy
- Authors: Pascoe, Deborah
- Date: 2015
- Type: Text , Thesis , PhD
- Full Text:
- Description: There is a wealth of evidence supporting the positive effects of exercise for falls prevention. The problem that faces researchers, policy makers, accreditation bodies and higher education providers is how to best translate this information to allied health practitioners to ensure they are providing the best evidence-based practice to their clients. One in three community dwelling older people over the age of 65 years fall every year and this figure increases to one in two people over the age of 80 years. As a profession, exercise physiologists (EPs) are responsible for providing exercise for the prevention, maintenance and treatment of chronic disease and complex medical conditions, including prescribing exercise for falls prevention. The incidence of falls, chronic disease and complex medical conditions increases with age and as Australia moves towards an ever ageing population, the cost burden of health care for older people and falls is exploding. Exercise physiology and exercise science professionals have an opportunity to become champions of exercise for falls prevention and assist in ameliorating the ever increasing burden of falls in Australia. By targeting the exercise physiology profession and providing methods to translate the research evidence, there is great potential to build workforce capacity to deliver falls prevention exercise programs. But how best to target the profession of exercise physiology? Advances can be made by targeting undergraduate and post-graduate university programs or as part of mandated professional continuing education programs which focuses on both the future and current exercise physiology workforce respectively. A scoping study conducted across two States in Australia (New South Wales and Victoria) established that at the time, the current level of knowledge of undergraduate human movement and exercise and sports science students and post graduate exercise rehabilitation/exercise physiology students, was inadequate with regard to falls risk and exercise prescription for fall prevention in older people. These results highlighted the need for the development and widespread implementation of an evidence-based “exercise for falls prevention” curriculum for future exercise professionals. The UniFPEP curriculum was developed to provide evidence-based teaching and learning resource materials to enhance learning beyond current levels by translating the latest research evidence regarding falls risk and exercises for falls prevention to produce a discipline leading curriculum. The curriculum was designed to enhance exercise science and exercise rehabilitation students’ learning outcomes through the provision of online lectures and learning materials to supplement and strengthen the delivery of face-to-face lectures, practical classes and self-directed learning tasks. The UniFPEP curriculum was implemented at the University of Ballarat and following completion students’ knowledge outcomes and self-reported confidence to prescribe exercise for older people and for falls prevention were significantly increased. The results indicated that a significant change in knowledge and confidence can be achieved during a 2-3 week educational period during a normal university semester. More importantly, these changes were retained 13 weeks after completion of the UniFPEP curriculum. Following evaluation of the UniFPEP the curriculum was reviewed and prepared as a workforce continuing education program (CEP) (Fit+Fall=Free). This was implemented and evaluated as a clustered controlled trial to compare two different delivery modes: face-to-face and online, to a control group of exercise physiology professionals. The Fit+Fall=Free CEP showed significant improvements in the knowledge and confidence of EPs in prescribing exercise for older people and exercise prescription for falls prevention for both the face-to-face (F2F) and Online delivery modes. The F2F delivery of the Fit+Fall=Free CEP provided the greatest long-term impact with the increases being maintained at a significant level six months post workshop.
- Description: Doctor of Philosophy
Enhancing the implementation of injury prevention exercise programs in professional soccer
- Authors: O’Brien, James
- Date: 2016
- Type: Text , Thesis , PhD
- Full Text:
- Description: Recently, injury prevention exercise programs (IPEPs) for soccer have received considerable attention and their efficacy has been demonstrated in large-scale trials. However, the ultimate impact of IPEPs will depend not only on their efficacy under controlled conditions, but also on the extent to which they are successfully implemented under real-world conditions. Despite increasing recognition of the challenges involved in successfully implementing IPEPs, there is a paucity of research addressing these challenges. The first aim of this thesis was to systematically review published IPEP trial reports, from an implementation perspective, in both soccer and other team ball sports. To achieve this, an established health-promotion framework, called the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, was employed. The subsequent phases of the thesis aimed to identify IPEP implementation barriers and facilitators in the specific context of professional soccer. Two cross-sectional surveys explored the perceptions of IPEP users in professional teams and a prospective observational study assessed IPEP use, over one playing season, in a professional youth soccer academy. Evaluation of the published literature against the RE-AIM framework revealed major gaps in the reporting of specific IPEP implementation aspects, particularly relating to program adoption and maintenance. In professional soccer teams, multiple IPEP implementation barriers and facilitators were identified. These factors related either to the content and nature of the IPEPs themselves (e.g. variation, progression and soccer-specificity), or the delivery and support of programs (e.g. communication and team work) at different levels of the professional soccer ecology. In summary, there are major gaps in the reporting of implementation aspects in team ball sport trials. To enhance the implementation of IPEPs in professional soccer settings, the content and delivery of programs require significant tailoring to the specific implementation context.
- Description: Doctor of Philosophy
- Authors: O’Brien, James
- Date: 2016
- Type: Text , Thesis , PhD
- Full Text:
- Description: Recently, injury prevention exercise programs (IPEPs) for soccer have received considerable attention and their efficacy has been demonstrated in large-scale trials. However, the ultimate impact of IPEPs will depend not only on their efficacy under controlled conditions, but also on the extent to which they are successfully implemented under real-world conditions. Despite increasing recognition of the challenges involved in successfully implementing IPEPs, there is a paucity of research addressing these challenges. The first aim of this thesis was to systematically review published IPEP trial reports, from an implementation perspective, in both soccer and other team ball sports. To achieve this, an established health-promotion framework, called the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, was employed. The subsequent phases of the thesis aimed to identify IPEP implementation barriers and facilitators in the specific context of professional soccer. Two cross-sectional surveys explored the perceptions of IPEP users in professional teams and a prospective observational study assessed IPEP use, over one playing season, in a professional youth soccer academy. Evaluation of the published literature against the RE-AIM framework revealed major gaps in the reporting of specific IPEP implementation aspects, particularly relating to program adoption and maintenance. In professional soccer teams, multiple IPEP implementation barriers and facilitators were identified. These factors related either to the content and nature of the IPEPs themselves (e.g. variation, progression and soccer-specificity), or the delivery and support of programs (e.g. communication and team work) at different levels of the professional soccer ecology. In summary, there are major gaps in the reporting of implementation aspects in team ball sport trials. To enhance the implementation of IPEPs in professional soccer settings, the content and delivery of programs require significant tailoring to the specific implementation context.
- Description: Doctor of Philosophy
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