Exploration of training as an implementation strategy to promote physical activity within community settings: research, theory, and practice
The prevalence of inactivity remains high, with more than 80 percent of adults failing to meet physical activity guidelines. Numerous evidence-based interventions for physical activity promotion have been developed and tested to address this need, but are typically not scaled-up and sustained in the intended practice setting. Many of these physical activity promotion programs suggest community-based delivery, often requiring researchers to train delivery personnel on intervention components. However, there is a paucity of detail on for whom, under what conditions, and how training mechanism are effective in practice.
The purpose of this research was to explore the questions related to the research, theory, and practice of training. For research, a mixed-methods exploration of delivery personnel characteristics and perceived barriers and facilitators before and after program delivery or non-delivery was conducted. For theory, a systematic review of physical activity trainings for community-based delivery personnel was conducted in the literature to determine the characteristics of those who were trained, the structural and mechanistic components of said trainings, and the effectiveness of these trainings. For practice, a case-study of existing training in a community based setting was conducted to determine training processes that are likely to be successful in the real world and to evaluate the feasibility of an observational tool for physical activity trainings.
The results of this dissertation show that delivery personnel characteristics and skillset may impact the acceptability, appropriateness, and effectiveness of training. They also provide preliminary support for the inclusion and importance of peer support within physical activity trainings to increase the number and representativeness of people trained and increase comfort with the training material. Further, descriptions of training for in-person physical activity programs in community settings are vague and inadequate making them difficult to replicate. Taken together, these studies provide avenues for future research and practice to develop an evidence-base for training mechanisms.