Journal
DISABILITY AND REHABILITATION
Volume 42, Issue 24, Pages 3516-3524Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2019.1597178
Keywords
Behaviour change; cerebrovascular disorders; intensity; physiotherapy; occupational therapy
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Funding
- West Moreton early career research excellence award, West Moreton Hospital and Health Service
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Purpose: An evidence-practice gap exists between the amount of active practice recommended and the amount completed by stroke inpatients. The aim of this paper is to describe steps in the design of a participatory, theoretically tailored staff behaviour change intervention to help staff use strategies to increase active practice by stroke inpatients. Methods: A staff behaviour change intervention was developed in one rehabilitation unit in Queensland, Australia using a six-step process guided by the Behaviour Change Wheel framework. Mixed methods were used including direct observation (behavioural mapping), and focus groups to identify barriers and facilitators to implementation. Barriers and facilitators were mapped to the behaviour change techniques, and a behaviour change intervention developed in participation with rehabilitation staff. Results: Staff chose to implement ward-based practice books. Barriers included patient factors (including low motivation and severity of stroke), environmental segregation and limited skills for motivating patients. Staff belief in increasing active practice was a facilitator to implementation. The staff intervention included a training programme about motivation, environmental restructuring, audit, and feedback. Conclusions: This example of collaborative implementation research can be used and adapted by clinicians and researchers in other rehabilitation services.
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