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Feasibility of Training Physical Therapists to Deliver the Theory-Based Self-Management of Osteoarthritis and Low Back Pain Through Activity and Skills (SOLAS) Intervention Within a Trial.

Feasibility of Training Physical Therapists to Deliver the Theory-Based Self-Management of Osteoarthritis and Low Back Pain Through Activity and Skills (SOLAS) Intervention Within a Trial.

Phys Ther. 2017 Oct 23;:

Authors: Keogh A, Matthews J, Segurado R, Hurley DA

Abstract
Background: Provider training programs are frequently under evaluated leading to ambiguity surrounding effective intervention components.
Objective: To assess the effectiveness of a training program in guiding physical therapists to deliver the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) group education and exercise intervention (ISRCTN49875385) using a communication style underpinned by self-determination theory (SDT).
Design: Assessment of the intervention arm training program using quantitative methods.
Methods: Thirteen physical therapists were trained using mixed methods to deliver the SOLAS intervention. Training was evaluated using the Kirkpatrick model: (1) Reaction- physical therapists’ satisfaction with training, (2) Learning -therapists’ confidence in and knowledge of the SDT-based communication strategies and intervention content and their skills in applying the strategies during training), and (3) Behavior -8 therapists were audio-recorded delivering all 6 SOLAS intervention classes (n = 48), and 2 raters independently coded 50% of recordings (n = 24) using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention-specific measure.
Results: Reaction : Physical therapists reacted well to training (median [IRQ]; min-max = 4.7; [0.5]; 3.7-5.0). Learning : Therapists’ confidence in the SDT-based communication strategies and knowledge of some intervention content components significantly improved. Behavior: Therapists delivered the intervention in a needs-supportive manner (median HCCQ = 5.3 [1.4]; 3.9-6.0; median CCBS = 6.6 ([0.5]; 6.1-6.8; median intervention specific measure = 4.0 [1.2]; 3.2-4.9). However, “goal-setting” was delivered below acceptable levels by all therapists (median 2.9 [0.9]; 2.0-4.0).
Limitations: The intervention group only was assessed as part of the process evaluation of the feasibility trial.
Conclusions: Training effectively guided physical therapists to be needs-supportive during delivery of the SOLAS intervention. Refinements were outlined to improve future similar training programs, including greater emphasis on goal-setting.

PMID: 29088437 [PubMed – as supplied by publisher]

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