The relationship between the implementation and effectiveness of a nationwide physical activity telephone counseling service for adults with spinal cord injury

Abstract

Purpose: Get in Motion (GIM) is an evidence-based telephone counseling service that promotes leisure-time physical activity (LTPA) among Canadian adults with spinal cord injury (SCI). The first phase of GIM sustained intentions for, and increased participation in, LTPA; however, it is unclear how GIM led to these outcomes. The purpose of this study was to explore the implementation correlates of change in LTPA intentions and behavior in the second phase of GIM.

Methods: The frequency, duration, and content of counseling sessions were tailored to meet clients’ (N = 46; 50.0% male; 50.0% paraplegia; 51.46 (SD 12.36) years old) needs and preferences. Intervention dose and content were monitored using Counseling Session Checklists. Clients self-reported their intentions for and actual aerobic and strength-training LTPA participation at baseline, 2-, 4-, and 6-months, and their perceptions of service quality at 6-months.

Results: The second phase of GIM effectively sustained LTPA intentions and increased time spent on moderate-to-vigorous strength-training and total LTPA. Increases in clients’ moderate-to-vigorous aerobic LTPA were significantly positively related to intervention dose, intervention content (both informational and behavioral strategies), and clients’ perceptions of service credibility.

Conclusions: This study identified intervention dose and content as key implementation variables for an LTPA telephone counseling service for adults with SCI.

Implications for Rehabilitation

• An evidence- and theory-based telephone counseling service can effectively sustain LTPA intentions and increase LTPA behavior among adults with SCI.

• The first two months of the service are a critical period for enhancing LTPA participation and for minimizing dropouts.

• The provision of both informational and behavioral strategies is important for increasing aerobic LTPA levels among adults with SCI.

Keywords:

• Knowledge translation
• knowledge-to-action framework
• leisure-time physical activity
• exercise
• physical disability

Acknowledgements

The authors would like to acknowledge: SCI Ontario and SCI British Columbia for their assistance with promoting the GIM service; Clement Lau, Krystina Malakovski, Krystn Orr, Christine Palisoc, Maryam Somo, Jessie Stapleton, and Matthew Stork for their assistance with data collection and management; Bryce Donald for implementing the counseling sessions; and Brittany McEachern for her assistance with manuscript formatting.

Disclosure statement

The authors alone are responsible for the content and writing of this article.

Additional information

Funding

Funding for the second phase of the GIM service was provided by the Rick Hansen Institute and the Ontario Neurotrauma Foundation. This work was supported by an Ontario Neurotrauma Foundation and Rick Hansen Institute Mentor-Trainee Capacity Building Award in Knowledge Mobilization awarded to JRT and KMG. ALC holds a Tier 2 Canada Research Chair in physical activity promotion and disability from the Canadian Institutes of Health Research. KAN, ALC, and KMG conducted the randomized controlled trials upon which the Get in Motion service is based, and all four authors conducted the evaluation of the first phase of the service.