Study of the Naturalistic Dissemination Process of an Evidence-based Program

描述（由申请人提供）：公共卫生从业人员使用循证体力活动计划的数量很少，尽管广泛了解推荐使用这些计划的指南。公共卫生组织仅代表一个可以传播这种循证计划的部门;其他部门包括健身中心，工作场所和医疗中心。据我们所知，没有任何研究审查过这类方案在部门和组织一级的传播和执行情况。《每天积极生活》（ALED）是一个以实证为基础的体力活动计划，由体力活动领域的领先出版商Human Kinetics（HK）积极传播到四个主要行业。在这个回顾性的观察项目中，我们建议检查这些过程中ALED的传播：1）部门和组织的影响，决定采用ALED和2）组织的影响，实施和适应ALED。这些过程的基础上的创新扩散模型的理论预测将进行测试。我们将评估部门层面的影响（即部门规范、领头组织的行动以及部门内与其他组织的沟通）和组织影响（即ALED和其他体力活动计划的知识，组织价值观，决策过程，感知创新特征，和采用的潜在障碍）作为病例对照研究（n=120例病例和480例对照）中ALED采用的预测因子。我们还将评估与计划实施相关的组织变量（即意见领导，组织决策，上下文支持，感知创新，与现有计划的兼容性，采用其他体育活动计划），并描述在观察性后测研究中对ALED的适应。我们将分析目前使用ALED的组织和那些以前实施过该计划但已停止使用的组织（即，病例对照研究中的病例;仅后测研究中的病例数n=120。数据将从（a）香港数据库中获得，包括推广工作、促进者培训、购买和使用ALED材料和在线资源，（B）对组织负责人的调查，以及（c）对采用组织的负责人的后续采访。该项目将提高对传播的理论理解，并为改进循证预防方案的传播战略提供经验信息。

DESCRIPTION (provided by applicant): The use of evidence-based physical activity programs by public health practitioners is small, despite widespread knowledge of guidelines recommending their use. Public health organizations represent only one sector where such evidence-based programs may be disseminated; other sectors include fitness centers, worksites, and medical centers. To our knowledge, no study has examined the dissemination and implementation of such programs at the sector and organizational level. Active Living Every Day (ALED) is an evidence-based physical activity program that has been actively disseminated to four major sectors by Human Kinetics (HK), a leading publisher in the physical activity field. In this retrospective observational project, we propose to examine these processes in the dissemination of ALED: 1) sector and organization influences on decisions to adopt ALED and 2) organization influences on implementation and adaptation of ALED. Theoretical predictions about these processes based on the Diffusion of Innovations Model will be tested. We will assess sector-level influences (i.e. sector norms, actions by bellwether organizations, and intra-sector communication with other organizations) and organizational influences (i.e. knowledge of ALED and other physical activity programs, organizational values, decision-making processes, perceived innovation characteristics, and potential barriers to adoption) as predictors of ALED adoption in a case- control study (n=120 cases and 480 controls). We will also evaluate organization variables (i.e. opinion leadership, organizational decision-making, contextual supports, perceived innovation, compatibility with existing programs, adoption of other physical activity programs) associated with program implementation and describe adaptations made to ALED in an observational posttest-only study. We will analyze organizations that currently use ALED and those that have previously implemented the program but have discontinued using it (i.e., the cases in the case-control study; n=120) in the posttest-only study. Data will be obtained from (a) HK databases on promotional efforts, facilitator training, and purchase and use of ALED materials and online resources, (b) a survey of organization directors, and (c) follow-up interviews with directors at adopting organizations. The project will improve theoretical understanding of dissemination and provide empirical information for improving dissemination strategies for evidence-based prevention programs.