Physical literacy and the participant perspective: Exploring the value of physical literacy according to individuals experiencing disability through composite narratives.

Background: Physical literacy (PL) is essential to the holistic human experience, emphasizing embodied capability and affording opportunities for inclusive engagement. Despite its recent use as a core programming element, PL from the experiential point of view of individuals experiencing disability has yet to be explored. Excluding these perspectives promotes a culture of ableism, one that devalues the embodied capabilities of those experiencing the world differently. The purpose of this study was to highlight the participant perspective related to PL and explore the value individuals experiencing disability attribute to PL and its development. Methods: Using the communities of practice theoretical model of knowledge as a conceptual framework, 13 participants experiencing disability participated in two focus groups. Participants' experiences were thematized via the use of thematic analysis, and voices were portrayed through composite narratives, highlighting the shared participant experience and value associated with PL. Results: Three themes emerged: (1) imagine the possibilities, (2) dance like nobody's watching, and (3) no wrong way to move. Composite narratives reflect PL as a valued means of exploration and learning, personal growth, and opportunity related to physical activity and social interaction. Participant value was considered to be enhanced via a learning climate affording opportunities for developing autonomy and a sense of belonging. Conclusion: This research provides an authentic understanding of PL within the context of disability, and what might be used to facilitate its development in such an environment. Individuals experiencing disability contributed to this knowledge and must be continually involved to ensure PL development is inclusive to all.

Research and Healthcare Priorities of Individuals Living with COPD.

This study describes the research and healthcare priorities of individuals living with COPD. On an online survey, individuals living with COPD assigned a percentage of funding to 22 research priorities and a percentage of time spent communicating with a healthcare provider to 24 healthcare priorities, indicating which topics were most important. For each research and healthcare priority, we examined the selection frequency of the priority and used chi-square analyses to examine differences in priority selection by quartiles of airflow obstruction (percent predicted forced expiratory volume in 1-sec (FEV1%predicted)) and breathlessness burden and exacerbation risk. Based on participants' responses (N = 148, 47% women; Mean ± Standard Deviation age = 68 ± 9 yrs) relief of breathlessness was the most often selected research (76% of respondents) and healthcare priority (61% of respondents). It was selected most often, regardless of disease severity or breathlessness burden and exacerbation risk. We found differences for disease severity and breathlessness burden and exacerbation risk in some research priorities (e.g., to improve the maximal amount of exercise of adults living with COPD in and out of the home (χ2(3) = 9.97, Cramer's V =.28) and healthcare priorities (e.g., increase your ability to exercise (χ2(3) = 9.72, Cramer's V =.27)). This study provides empirical evidence that relief of breathlessness is a top research and healthcare priority for individuals living with COPD. Future healthcare and research activities should align with the priorities of individuals with COPD to improve their care by minimizing disease/symptom burden and optimizing health-related quality of life.

Description of Participation in Daily and Social Activities for Individuals with COPD.

This study described the participation in daily and social activities and the perceived barriers and facilitators to participation of individuals with chronic obstructive pulmonary disease (COPD). Individuals, recruited from outpatient clinics, responded to a survey on their participation in, and barriers and facilitators towards, 26 daily and social activities, divided into 3 categories: (1) physical activity and movement (PAM); (2) self-care; and (3) social engagement. For each activity, chi-square analyses were used to examine participation differences by individuals': quartiles of airflow obstruction [percent predicted forced expiratory volume in 1 second (FEV1%predicted)] and breathlessness burden and exacerbation risk. Of the 200 participants (47% women; mean ± standard deviation age = 68 ± 9 years), most wanted to increase their participation in PAM activities (range 21-75%) and significant differences were found in 5/10 PAM activities for individuals' breathlessness burden and exacerbation risk (e.g., more individuals than expected in group A (modified Medical Research Council breathlessness score <2 and 0-1 exacerbations in past 12 months) participated in regular exercise as much as they wanted (χ(9)2=20.43, Cramer's V=.23)). Regardless of the degree of airflow obstruction or breathlessness burden and exacerbation risk, the most common barrier to participation was breathlessness (p<.001, η2p=.86) and the most common facilitator was engaging as part of their routine (p<.001, η2p=.75). Individuals with COPD want to increase their participation in daily and social activities but are limited by breathlessness. Strategies to alleviate breathlessness should be identified/prioritized and incorporated into individuals' daily routines to meet their self-reported participation objectives in daily and social activities.

RE-AIMing conferences: evaluating the adoption, implementation and maintenance of the Rick Hansen Institute's Praxis 2016.

BACKGROUND: In April 2016, the Rick Hansen Institute (RHI) hosted an innovative, 2-day conference called Praxis 2016. RHI aimed to bring together a diverse group of stakeholders to develop solutions for overcoming the challenges of translating spinal cord injury (SCI) research into practice. To understand the impact of Praxis, RHI funded an independent team to evaluate Praxis at the individual and setting level using the RE-AIM framework. Individual-level findings are published elsewhere. The aim of this evaluation is to report on the impact of Praxis at the setting level in terms of its adoption, implementation and maintenance. METHODS: Data sources included interviews with attendees (n = 13) and organisers (n = 9), a fidelity assessment conducted at the conference, and observation notes provided by the evaluation team. RESULTS: Main findings indicated that the Praxis model was adopted by organisers and attendees, implemented by RHI as intended, and has the potential for long-term maintenance. Lessons learned highlighted the importance of including SCI community members throughout the entire process from development to post-conference activities as well as in the research process, the value of facilitation and fostering interactive problem solving, and the need to identify leadership and funds to foster long-term efforts. CONCLUSIONS: Developing and implementing a solutions-focused conference that brings together a diverse group of SCI stakeholders was challenging and rewarding for attendees and organisers. Other domains could learn from, adopt and build on the Praxis 2016 approach to address research-to-practice gaps.

Spinal Cord Injury Peer Mentorship: Applying Self-Determination Theory to Explain Quality of Life and Participation.

OBJECTIVES: To investigate the role of spinal cord injury (SCI) peer mentorship on quality of life (QoL)/participation, and test a self-determination theory model that explains the role of SCI peer mentorship on these outcomes. DESIGN: A static group comparison design. SETTING: Community. PARTICIPANTS: A convenience sample of mentees (individuals receiving peer mentorship) (n=68) and nonmentees (n=63) who had an SCI, were older than 18 years, and spoke either English or French. INTERVENTIONS: Mentees: at least 4 peer mentorship sessions over the past 5 years; nonpeer mentees: 0 or 1 brief introductory session. MAIN OUTCOME MEASURES: QoL (ie, life satisfaction and positive and negative affect), participation (eg, autonomous indoor; family role), and the psychological needs of autonomy, competence, and relatedness. RESULTS: No group differences were found, but years since injury was a moderator indicating that, generally, peer mentees living with SCI for longer (∼30y) appear to benefit more from peer mentorship interactions compared with nonmentees and mentees living with SCI for approximately 6 years. Competence and relatedness mediated the peer mentorship-outcome relationship for QoL and some participation variables, indicating that peer mentorship predicted competence and relatedness, which in turn were related to the outcomes. CONCLUSIONS: Satisfaction of competence and relatedness needs requires greater attention in SCI peer mentorship. Years since injury modified the relationship between peer mentorship and outcomes, which provided new insights on the role of SCI peer mentorship. Further studies are needed to determine SCI peer mentorship-specific outcomes that are important across the years-since-injury spectrum.

Understanding the Effects of Message Framing on Physical Activity Action Planning: the Role of Risk Perception and Elaboration.

PURPOSE: This study aimed to determine the effects of action planning, risk perception, and message elaboration on the creation and quality of physical activity action plans. Risk perception was hypothesized as a potential moderator and elaboration as a potential mediator of the message framing-action planning relationship. METHOD: Inactive adults (N = 180; 44% women; Mage = 29.7, SD = 9.92) were randomized to one of two framed action planning messages and responded to an online questionnaire pre- and post-message. Participants were asked about two types of risk perception towards action planning: emotional and plan creation risk perception. Post-message participants were asked about their elaboration regarding the message and presented with the opportunity to create action plans, which were scored for quality. A moderation model and a moderated mediation model were tested. RESULTS: Emotional risk perception moderated the message framing-action plan creation relationship. Individuals with increased emotional risk perception, as opposed to increased plan creation risk perception, were more likely to create an action plan when given a gain-framed message, as opposed to a loss-framed message. The moderated mediation model was not significant, but message elaboration predicted action plan creation. Individuals with greater message elaboration were more likely to create an action plan, regardless of the message frame. CONCLUSION: Gain-framed messages may be more effective than loss-framed messages at promoting action plan creation in individuals with greater emotional risk perception. One's elaboration of an action planning message may increase their likelihood of creating a physical activity action plan.

Using mixed methods and partnership to develop a program evaluation toolkit for organizations that provide physical activity programs for persons with disabilities.

BACKGROUND: The purpose of this paper is to report on the process for developing an online RE-AIM evaluation toolkit in partnership with organizations that provide physical activity programming for persons with disabilities. METHODS: A community-university partnership was established and guided by an integrated knowledge translation approach. The four-step development process included: (1) identify, review, and select knowledge (literature review and two rounds of Delphi consensus-building), (2) adapt knowledge to local context (rating feasibility of outcomes and integration into online platform), (3) assess barriers and facilitators (think-aloud interviews), and (4) select, tailor, implement (collaborative dissemination plan). RESULTS: Step 1: Fifteen RE-AIM papers relevant to community programming were identified during the literature review. Two rounds of Delphi refined indicators for the toolkit related to reach, effectiveness, adoption, implementation, and maintenance. Step 2: At least one measure was linked with each indicator. Ten research and community partners participated in assessing the feasibility of measures, resulting in a total of 85 measures. Step 3: Interviews resulted in several recommendations for the online platform and toolkit. Step 4: Project partners developed a dissemination plan, including an information package, webinars, and publications. DISCUSSION: This project demonstrates that community and university partners can collaborate to develop a useful, evidence-informed evaluation resource for both audiences. We identified several strategies for partnership when creating a toolkit, including using a set of expectations, engaging research users from the outset, using consensus methods, recruiting users through networks, and mentorship of trainees. The toolkit can be found at et.cdpp.ca. Next steps include disseminating (e.g., through webinars, conferences) and evaluating the toolkit to improve its use for diverse contexts (e.g., universal PA programming).

Organizations that provide sport and exercise programming for people with disabilities need to evaluate their programs to understand what works, secure funding, and make improvements. However, these programs can be difficult to evaluate due to lack of evidence-informed tools, low capacity, and few resources (e.g., money, time). For this project, we aimed to close the evaluation gap by creating an online, evidence-informed toolkit that helps organizations evaluate physical activity programs for individuals with disabilities. The toolkit development process was guided by a community-university partnership and used a systematic four-step approach. Step one included reviewing the literature and building consensus among partners and potential users about indicators related to the success of community-based programs. Step two involved linking indicators with at least one measure for assessment. Step three involved interviews with partners who provided several recommendations for the online toolkit. Step four included the co-creation of a collaborative plan to distribute the toolkit for academic and non-academic audiences. Our comprehensive toolkit includes indicators for the reach, effectiveness, adoption, implementation, and maintenance of physical activity programs for individuals with disabilities. This paper provides a template for making toolkits in partnership with research users, offers strategies for community-university partnerships, and resulted in the co-creation of an evidence-informed evaluation resource to physical activity organizations. Users can find the toolkit at et.cdpp.ca.

RE-AIMing conferences: a reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute's Praxis 2016.

This article reported on the reach, effectiveness, and maintenance dimensions of a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) analysis to evaluate Praxis 2016, a conference aimed to develop solutions to overcome challenges to translating research into practice in the spinal cord injury (SCI) community. Reach indicators were collected from the Praxis 2016 organizing committee. For effectiveness and maintenance, attendees (n = 106) completed a questionnaire pre-, post-, and 9-month post-Praxis 2016 assessing (a) capability (e.g., knowledge), (b) motivation, (c) opportunities, and (d) the groups they currently, need to, and/or plan to work with to develop solutions to overcome the challenges of translating SCI research into practice. They also reported their satisfaction with Praxis 2016. Qualitative interviews with attendees and organizers post-Praxis 2016 were conducted. Praxis 2016 reached 28% of their intended audience. For effectiveness, attendees' knowledge significantly increased (t(59)= 3.83, p < .001), they reported a greater need to work with members within the SCI community from pre- to post-Praxis 2016, and were generally satisfied with Praxis 2016. Regarding maintenance, more attendees reported needing to work with researchers, clinicians and SCI community organizations at 9-month post-Praxis 2016. The interviewees reported increased knowledge and capacity to network with the SCI community, but highlighted concerns for the long-term impact of Praxis 2016. Praxis 2016 was an effective approach to create short-term change in knowledge, and to expand knowledge translation networks. Further efforts could build on Praxis 2016 to foster long-term success in overcoming the challenges in translating SCI research into practice.

Motivation and participation in daily and social activities among adults with spinal cord injury: Applying self-determination theory.

BACKGROUND: Individuals with a spinal cord injury (SCI) report decreased participation in daily and social activities. Self-determination theory (SDT) posits that individuals' need satisfaction and frustration predicts participation in health-related behaviours and this relationship is mediated by their motivation. OBJECTIVES: This study explored the role of psychological needs and motivation in relation to participation in daily and social activities among adults with SCI. It was hypothesized that: a) need satisfaction and need frustration were positively associated with autonomous and controlled motivation, respectively, which, positively and negatively predicted participation in daily and social activities; b) autonomous and controlled motivation mediated the need satisfaction/frustration and participation relationship, respectively; and c) need frustration was positively related to amotivation, with no relationship between amotivation and activity participation. METHODS: In this cross-sectional study, adults with SCI (N = 131) completed a questionnaire regarding their need satisfaction/frustration, autonomous and controlled motivation, amotivation, and participation in daily and social activities. RESULTS: Need satisfaction was positively related to autonomous motivation (ß = 0.29, 95%bias-corrected confidence interval (bCI): [0.04, 0.67]) and need frustration to controlled motivation (ß = 0.28, 95%bCI: [0.09, 0.55]). Autonomous motivation was positively associated with six participation categories: autonomous indoor, autonomous outdoor, family role, health, social life, and work/education. Autonomous motivation also mediated the relationship between need satisfaction and all six participation categories; whereas, neither controlled motivation nor amotivation mediated the relationship between need frustration and participation. CONCLUSIONS: This study found that SDT provides a meaningful framework for understanding participation among adults with SCI.