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Transl Behav Med. 2017 Sep;7(3):603-614. doi: 10.1007/s13142-017-0526-9.

A multilevel modeling approach to examining the implementation-effectiveness relationship of a behavior change intervention for health care professional trainees.

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School of Kinesiology & Health Studies, Queen's University, 28 Division Street, Kingston, Ontario, Canada.
Department of Kinesiology & Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec, Canada.
Abilities Centre, 55 Gordon Street, Whitby, Ontario, Canada.
School of Health and Exercise Sciences, University of British Columbia, Arts Building ART339, 1147 Research Road, Kelowna, British Columbia, Canada.


Changing Minds, Changing Lives, a seminar-mediated behavior change intervention, aims to enhance health care professionals' (HCPs') social cognitions for discussing leisure-time physical activity (LTPA) with patients with physical disabilities. This study examines which seminar implementation variables (presenter characteristics, delivery components) predict effectiveness using multilevel modeling. HCP trainees (n = 564) attended 24 seminars and completed Theory of Planned Behavior-based measures for discussing LTPA at pre-, post-, 1-month post-, and 6-months post-seminar. Implementation variables were extracted from presenter-completed questionnaires/checklists. Seminars presented by a HCP predicted positive changes in all cognitions pre-post but negative changes in attitudes and perceived behavioral control (PBC) over follow-up (ps < .05). The number of seminars the presenter had delivered predicted negative changes in attitudes and PBC during follow-up (ps < .001). Inclusion of audiovisual components predicted positive changes in attitudes pre-post (p < .001). Presenter characteristics may be "key ingredients" to educational interventions for HCPs; however, future studies should examine additional implementation variables.


Educational intervention; Health care professional trainees; Implementation-effectiveness relationship; Multilevel modeling; Theory of planned behavior

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