The Telephysiotherapy for Older People (TOP-UP) program for improving mobility in people receiving aged care: a hybrid type 1 effectiveness-implementation randomised controlled trial.

Objectives: To assess the effectiveness and implementation of a telephysiotherapy program for improving mobility, mobility goal attainment, and quality of life of people receiving at-home or residential aged care.

Study Design: Hybrid type 1 effectiveness-implementation randomised controlled trial.

Setting, Participants: People aged 65 years or older who were receiving community or residential aged care services in Australia, 1 September 2021 - 30 November 2023.

Supported implementation of tailored multicomponent fall prevention interventions in hospital: a feasibility study.

Background: Falls in hospital remain a complex patient safety issue for health systems. Multicomponent fall prevention interventions can reduce patient falls in hospitals; however, the implementation of these approaches in routine practice can be challenging and inconsistent. Quality improvement (QI) education and clinical facilitation may support the implementation of hospital fall prevention interventions.

The long road back to physical activity: the experience of people with moderate-to-severe traumatic brain injury.

Purpose: People with moderate-to-severe traumatic brain injury (TBI) are frequently inactive with increased risk of higher rates of chronic health conditions, mortality and economic burden than peers without TBI. Understanding how this population experience physical activity participation may help us develop better pathways and supports to community-based physical activity.

Materials And Methods: Using an interpretive description approach, we conducted a secondary analysis of focus group and interview data.

Promotion of Physical Activity by Health Professionals (PROMOTE-PA): protocol for effectiveness outcomes in a hybrid type I effectiveness-implementation cluster randomised controlled trial.

Promotion of physical activity by health professionals can increase physical activity participation among patients, however, implementing physical activity promotion within hospital systems is lacking. The Promotion of Physical Activity by Health Professionals (PROMOTE-PA) study is a hybrid type I effectiveness-implementation cluster randomised controlled trial evaluating the effectiveness of support for physical activity promotion by health professionals on physical activity participation of patients. Health professionals delivering outpatient healthcare services within four local health districts and one specialty health network in New South Wales, Australia will be included.

Features of effective hospital fall prevention trials: an intervention component analysis.

Background: Falls in hospitals continue to burden patients, staff, and health systems. Prevention approaches are varied, as well as their success at preventing falls. Intervention component analysis (ICA) is useful in indicating important features associated with successful interventions in sets of trial with high heterogeneity.

Considerations across multiple stakeholder groups when implementing fall prevention programs in the acute hospital setting: a qualitative study.

Background: Falls in hospital remain a common and costly patient safety issue internationally. There is evidence that falls in hospitals can be prevented by multifactorial programs and by education for patients and staff, but these are often not routinely or effectively implemented in practice. Perspectives of multiple key stakeholder groups could inform implementation of fall prevention strategies.

True inclusion: evaluation protocol for an approach to increase meaningful participation of children with disability in athletics.

Children with disability face many barriers to participating in community sports. Little Athletics Australia aims to increase fair and meaningful inclusion via a new structure which will enable all children to take part in the same contest by competing for their 'personal best' score. Named the True Inclusion Method (TIM), this new structure will be piloted in 13 sites across six states.

Health professionals' involvement in volunteering their professional skills: a scoping review.

Background: Volunteering positively affects overall health of both volunteers and recipients through social interaction, support and physical activity. Health professionals' volunteering has considerable potential to improve health outcomes in communities.

Objectives: This study aimed to summarize published scientific literature regarding volunteering by health professionals.

Effective fall prevention exercise in residential aged care: an intervention component analysis from an updated systematic review.

Objective: The effect of fall prevention exercise programmes in residential aged care (RAC) is uncertain. This paper reports on an intervention component analysis (ICA) of randomised controlled trials (RCTs), from an update of a Cochrane review, to develop a theory of features of successful fall prevention exercise in RAC.

Methods: Trial characteristics were extracted from RCTs testing exercise interventions in RAC identified from an update of a Cochrane review to December 2022 (n=32).

Physiotherapy-led telehealth and exercise intervention to improve mobility in older people receiving aged care services (TOP UP): protocol for a randomised controlled type 1 hybrid effectiveness-implementation trial.

Introduction: Deteriorating mobility and falls reduce independence and quality of life for older people receiving aged care services. This trial aims to establish effectiveness on the mobility of older people, and explore cost-effectiveness and implementation of a telehealth physiotherapy programme.

Method And Analysis: This type 1 hybrid effectiveness-implementation randomised controlled trial will involve 240 people aged 65+ years receiving aged care services in community or residential settings.

Rethinking Barriers and Enablers in Qualitative Health Research: Limitations, Alternatives, and Enhancements.

Explorations of barriers and enablers (or barriers and facilitators) to a desired health practice, implementation process, or intervention outcome have become so prevalent that they seem to be a default in much health services and public health research. In this article, we argue that decisions to frame research questions or analyses using barriers and enablers (B&Es) should not be default. Contrary to the strengths of qualitative research, the B&Es approach often bypasses critical reflexivity and can lead to shallow research findings with poor understanding of the phenomena of interest.

Experiences of Older Adults, Physiotherapists, and Aged Care Staff in the TOP UP Telephysiotherapy Program: Interview Study of the TOP UP Interventions.

Background: Telehealth provides opportunities for older adults to access health care. However, limited research exists on the use of telehealth within aged care services, particularly regarding physiotherapy-led fall prevention and mobility programs. Understanding the experiences and interactions of older adults, physiotherapists, and aged care service providers is crucial for the scale-up and sustainability of such essential programs.

"It doesn't feel like exercise": a realist process evaluation of factors that support long-term attendance at dance classes designed for healthy ageing.

Introduction: Dance can positively impact older people's health and wellbeing across cultures and socioeconomic groups, countering age-related physical, sensorimotor and cognitive decline.

Background/objectives: The RIPE (Really Is Possible for Everyone) Dance program aims to improve older people's physical, mental, cognitive and social wellbeing by integrating engaging dance sequences with evidence-based fall prevention exercises. We sought to identify what mechanisms support observed long-term participation in this program, including by people living with challenging health conditions.

'My words become my hands': Yoga instructors' experiences of adapting teleyoga in the SAGE fall prevention trial-A qualitative analysis.

Objective: This research identifies practical lessons regarding the delivery of teleyoga. Our objectives are to (1) describe challenges and opportunities experienced by yoga instructors when moving the Successful AGEing (SAGE) yoga programme online, and (2) describe how yoga instructors adapted to manage the challenges and leverage opportunities presented by teleyoga.

Methods: This study is a secondary analysis of the data from a previous realist process evaluation of the SAGE yoga trial.

Promotion of physical activity by health professionals in a sample of six public hospitals: A cross sectional study.

Issue Addressed: Despite strong evidence of physical and mental health benefits from physical activity, participation is low. Physical activity promotion by health professionals can effectively increase physical activity participation. This study aimed to explore the frequency of physical activity promotion by health professionals in public hospitals with a focus on community-based structured exercise; and facilitators and barriers to such promotion.

Output-orientated policy engagement: a model for advancing the use of epidemiological evidence in health policy.

Background: Use of epidemiological research in policy and practice is suboptimal, contributing to significant preventable morbidity and mortality. Barriers to the use of research evidence in policy include lack of research-policy engagement, lack of policy-relevant research, differences in policymaker and researcher practice norms, time constraints, difficulties in coordination, and divergent languages and reward systems.

Approach And Outcomes: In order to increase policy-relevant research and research uptake, we developed the output-orientated policy engagement (OOPE) model, in Australia.

"I wouldn't have joined if it wasn't online": understanding older people's engagement with teleyoga classes for fall prevention.

Background: Yoga-based exercise is a promising strategy for promoting healthy ageing, with the potential to reduce falls and increase physical, cognitive and psychological wellbeing. Teleyoga (real-time yoga provided via interactive videoconferencing) can deliver yoga programs at scale, potentially reducing costs, increasing convenience, and reaching people who cannot attend studio-based classes. But better understanding of how older people perceive and engage with teleyoga is needed to optimise its design, implementation and promotion.

Designing physical activity interventions for women aged 50+: a qualitative study of participant perspectives.

Background: The Active Women over 50 trial tested a scalable program for increasing physical activity among women aged 50+. The program included information, activity tracker and email support. This study sought to describe the participant perspectives of the Active Women over 50 program and considerations for designing physical activity interventions for this demographic.

Developing a systems thinking guide for enhancing knowledge mobilisation in prevention research.

Knowledge mobilisation aims to increase research impact in policy and practice. 'Mobilising' knowledge implies a social interaction and involves an iterative, collaborative process. We argue that this process is strengthened when underpinned by systems thinking.

The Value of Mind-Body Connection in Physical Activity for Older People.

Exercise that targets balance and strength is proven to prevent falls in older age. The Successful AGEing yoga trial is the first large randomized controlled trial to assess the impact of yoga on falls in people aged ≥60 years. We conducted a realist process evaluation to explain the strong participant engagement observed using interviews (21 participants and three yoga instructors) and focus groups (12 participants and four yoga instructors).

Brief physical activity counselling by physiotherapists (BEHAVIOUR): protocol for an effectiveness-implementation hybrid type II cluster randomised controlled trial.

Background: Physical inactivity is a leading risk factor for chronic disease. Brief physical activity counselling delivered within healthcare systems has been shown to increase physical activity levels; however, implementation efforts have mostly targeted primary healthcare and uptake has been sub-optimal. The Brief Physical Activity Counselling by Physiotherapists (BEHAVIOUR) trial aims to address this evidence-practice gap by evaluating (i) the effectiveness of a multi-faceted implementation strategy, relative to usual practice for improving the proportion of patients receiving brief physical activity counselling as part of their routine hospital-based physiotherapy care and (ii) effectiveness of brief physical activity counselling embedded in routine physiotherapy care, relative to routine physiotherapy care, at improving physical activity levels among patients receiving physiotherapy care.

What helps older people persevere with yoga classes? A realist process evaluation of a COVID-19-affected yoga program for fall prevention.

Background: Falls among older people are a major global health concern. This process evaluation investigates the experience of participants aged 60+ in a yoga program aimed at preventing falls which transitioned from studio-based classes to online classes in response to COVID-19 restrictions. We sought to understand how the Successful AGEing (SAGE) yoga program functioned in both settings and as a hybrid program, and to explain why it worked well for most participants.

Planning implementation and scale-up of physical activity interventions for people with walking difficulties: study protocol for the process evaluation of the ComeBACK trial.

Background: There is currently little evidence of planning for real-world implementation of physical activity interventions. We are undertaking the ComeBACK (Coaching and Exercise for Better Walking) study, a 3-arm hybrid Type 1 randomised controlled trial evaluating a health coaching intervention and a text messaging intervention. We used an implementation planning framework, the PRACTical planning for Implementation and Scale-up (PRACTIS), to guide the process evaluation for the trial.