Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 31, 2020
Date Accepted: Oct 13, 2020
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Improving Physical Activity in Adults admitted to Surgery, Internal Medicine or Cardiology hospital wards: Protocol for Intervention Development and Implementation in Co-Creation.
ABSTRACT
Background:
Admission to a hospital has often been associated with hospital-associated disabilities. Improving physical activity (PA) during hospitalization is considered to be effective to counteract hospital-associated disabilities, whereas many studies report on very low PA levels. Gradually developing and implementing interventions in co-creation with patients and healthcare professionals rather than implementing pre-defined interventions may be more effective in creating sustainable changes in everyday clinical practice. However, no studies have reported on the use of co-creation in the development and implementation of interventions aimed at improving PA.
Objective:
To investigate if interventions, which will be developed and implemented in co-creation, improve PA in patients on Surgery, Internal Medicine and Cardiology hospital wards. Secondary aims are to investigate the effectiveness on the reduction of time patients spent in bed, length of hospital stay and the proportion of patients going home after discharge.
Methods:
The Better By Moving study takes place for 12 months at five different wards of an university hospital: two Gastrointestinal- & Oncology Surgery, one Internal Medicine Hematology, one Internal Medicine Infectious Diseases and one Cardiology. The step-by-step implementation model of Grol and Wensing is used, while all interventions are developed and implemented in co-creation with healthcare professionals and patients. Outcome evaluation is performed across the different hospital wards and for each hospital ward individually. Primary outcome: amount of PA in minutes with the Physical Activity Monitor AM400 accelerometer in three individual groups of patients (n=110 pre-implementation, n=110 6 months after the start of the implementation and n=110 13 months after start of the implementation). Secondary outcomes: time spent in bed measured using behavioral mapping protocols, and length of stay and discharge destinations using organizational data. A process evaluation using semi-structured interviews and surveys used to evaluate the implementation, mechanisms of impact, context and perceived barriers and enablers.
Results:
This study is ongoing. The first participant was enrolled in January 2018. The last outcome evaluation and process evaluation are planned for June 2020.
Conclusions:
This study will provide information about the effectiveness of developing and implementing interventions in co-creation with regard to improving PA in different subgroups of hospitalized patients in a university hospital. By following a step-by-step implementation and by performing a process evaluation, we identify barriers and enablers for implementation and describe the effect of new interventions on improving physical activity of hospitalized patients. Clinical Trial: Netherlands Trial Register NL8480
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