Evaluating the long-term sustainability of the ENCOURAGE (ENhancing primary care COUnseling and Referrals to community-based physical Activity opportunities for sustained lifestyle chanGE) project utilizing methods to determine external validity

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Chapman, Soyun
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Primary care based physical activity interventions have been shown to be efficacious when delivered under controlled research conditions, over the short-term. However, few studies have evaluated the long-term sustainability of these health interventions utilizing methods to determine external validity. Our own research group conducted the ENCOURAGE project, which enabled previously sedentary individuals (Age, 51 ± 1 years; BMI, 35.2 ± 0.8) to increase their total physical activity by 104 minutes a week. Although the ENCOURAGE project has now ended, a number of stakeholders are utilizing project outcomes to inform best practice within their respective organizations. The purpose of this thesis project was to use the RE-AIM framework to evaluate the external validity of the ENCOURAGE project, and to describe the stakeholders’ perceptions regarding the long-term sustainability of the project utilizing methods from a stakeholder analysis assessment. Results from the RE-AIM evaluation suggest that three of the five dimensions of the framework were met, notably: Reach, Adoption and Implementation. Therefore, the ENCOURAGE project generated a moderate level of public health impact. Semi-structured interviews were conducted with eight key stakeholders who were involved with the design, development or implementation of the project. Although the ENCOURAGE project was not adopted into the health care system, it left notable implications on the recognition of physical activity in primary care, and the delivery of physical activity services in primary care. Furthermore, the project was able to influence the primary care providers’ perceptions about physical activity, community-based programing and health policy. These positive changes observed at the individual, organizational and system-level are sustainable over the long-term.
Physical activity, Primary care, Exercise counseling, Sustainability, Health promotion, External validity, RE-AIM