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

描述(由申请人提供)：公共卫生从业者对循证体力活动计划的使用很少，尽管广泛了解推荐使用的指南。公共卫生组织只代表可能传播这种循证计划的一个部门；其他部门包括健身中心、工作场所和医疗中心。据我们所知，没有研究审查在部门和组织一级传播和执行这类方案的情况。每日积极生活(ALED)是一项以证据为基础的身体活动计划，已由身体活动领域的领先出版商人类动力学(HK)积极传播到四个主要领域。在这个回溯性的观察性项目中，我们建议研究ALED传播中的这些过程：1)部门和组织对采用ALED的决策的影响；2)组织对ALED实施和适应的影响。基于创新扩散模型的关于这些过程的理论预测将得到检验。在病例对照研究中，我们将评估部门层面的影响(即部门规范、领头羊组织的行动以及部门内与其他组织的沟通)和组织影响(即对ALED和其他体力活动计划、组织价值观、决策过程、感知到的创新特征和采用的潜在障碍的了解)，作为采用ALED的预测因素(n=120个病例和480个对照)。我们还将评估与计划实施相关的组织变量(即意见领导力、组织决策、背景支持、感知创新、与现有计划的兼容性、采用其他体力活动计划)，并描述在仅限观察性后测研究中对ALED的适应情况。在仅限后测的研究中，我们将分析目前使用ALED的组织以及那些以前实施了该计划但已停止使用的组织(即，病例对照研究中的病例；n=120)。数据将来自(A)关于推广工作、促进者培训、购买和使用ALED材料和在线资源的香港数据库，(B)对组织主任的调查，以及(C)对收养组织的董事的后续访谈。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.