Dissemination and implementation strategies for physical activity guidelines among adults with disability, chronic conditions, and pregnancy: A systematic scoping review

Abstract

Physical activity guidelines have been developed for adults with disability, chronic conditions, and pregnancy (i.e., specific populations) to provide recommendations for safe and appropriate engagement in physical activity. However, specific populations are consistently less physically active than the general population, leaving a substantial knowledge-to-practice gap. Given the high rates of poor health outcomes reported among specific populations, it is important to examine what dissemination and implementation strategies have previously been successful. This systematic scoping review identified and evaluated strategies used to disseminate and implement physical activity guidelines for specific populations (i.e., persons with spinal cord injury, cancer, multiple sclerosis, osteoporosis, diabetes, Parkinson's disease, Alzheimer's disease, and pregnancy) and/or their stakeholders in Canada. Five search approaches were used (peer-reviewed literature, grey literature, custom Google searches, targeted web-based searches, and content expert consultation) to identify records reporting and/or evaluating dissemination and implementation strategies for a predetermined list of guidelines. Record selection, screening, and data extraction followed established systematic and scoping review protocols. Eighty-one records reported dissemination (n = 42) or implementation strategies (n = 28), or both (n = 11). Twenty-two studies reported 29 evaluated strategies, identifying "formative research" and "education" as favourable strategies for dissemination and "counselling", "skills training", "planning tools", and "stakeholder training" as favourable strategies for implementation. All studies were deemed "serious" or "high" risk of bias. Findings can guide future physical activity guideline dissemination and implementation efforts among specific populations and/or their stakeholders and may inform similar efforts among the general population or in countries similar to Canada.

Acknowledgments: This research was made possible through funding from the Public Health Agency of Canada, the Canadian Society for Exercise Physiology, and the Ontario Graduate Scholarship.