32 research outputs found
Understanding school travel behaviour : an application of the theory of planned behaviour and the construct of habit
Get PDFThe purpose of this thesis was to develop an understanding of active school travel and to investigate the effects of a school-based intervention within the context of an extension of the theory of planned behaviour (Ajzen, 1985, 1991). Specifically, the focus was on understanding the role of habit and cognition in guiding intention and behaviour. This focus was addressed in four studies. The first two studies addressed measurement issues in this area: Study 1 examining the validity and reliability of the Self Report Habit Index (SRHI; Verplanken & Orbell, 2003) as a measure of habit and study 2 examining the validity of a measure of active travel cognition. The third study examined the theory of planned behaviour and the role of habit in predicting active school travel intention and behaviour. Finally, the fourth study examined the effect of a school-based active travel intervention, the Travelling Green resource, at changing these constructs. The findings from the research in this thesis emphasised the importance of both cognition and habit in the prediction of behaviour. However, the ability to change these constructs through the Travelling Green resource was not demonstrated. The implications of these findings in terms of direction for future research and practice are discussed in the final chapter of this thesis.The purpose of this thesis was to develop an understanding of active school travel and to investigate the effects of a school-based intervention within the context of an extension of the theory of planned behaviour (Ajzen, 1985, 1991). Specifically, the focus was on understanding the role of habit and cognition in guiding intention and behaviour. This focus was addressed in four studies. The first two studies addressed measurement issues in this area: Study 1 examining the validity and reliability of the Self Report Habit Index (SRHI; Verplanken & Orbell, 2003) as a measure of habit and study 2 examining the validity of a measure of active travel cognition. The third study examined the theory of planned behaviour and the role of habit in predicting active school travel intention and behaviour. Finally, the fourth study examined the effect of a school-based active travel intervention, the Travelling Green resource, at changing these constructs. The findings from the research in this thesis emphasised the importance of both cognition and habit in the prediction of behaviour. However, the ability to change these constructs through the Travelling Green resource was not demonstrated. The implications of these findings in terms of direction for future research and practice are discussed in the final chapter of this thesis
Predicting active school travel : the role of planned behavior and habit strength
Get PDFDespite strong support for predictive validity of the theory of planned behavior (TPB) substantial variance in both intention and behavior is unaccounted for by the model's predictors. The present study tested the extent to which habit strength augments the predictive validity of the TPB in relation to a currently under-researched behavior that has important health implications, namely children's active school travel. Participants (N = 126 children aged 8-9 years; 59 % males) were sampled from five elementary schools in the west of Scotland and completed questionnaire measures of all TPB constructs in relation to walking to school and both walking and car/bus use habit. Over the subsequent week, commuting steps on school journeys were measured objectively using an accelerometer. Hierarchical multiple regressions were used to test the predictive utility of the TPB and habit strength in relation to both intention and subsequent behavior. The TPB accounted for 41 % and 10 % of the variance in intention and objectively measured behavior, respectively. Together, walking habit and car/bus habit significantly increased the proportion of explained variance in both intention and behavior by 6 %. Perceived behavioral control and both walking and car/bus habit independently predicted intention. Intention and car/bus habit independently predicted behavior. The TPB significantly predicts children's active school travel. However, habit strength augments the predictive validity of the model. The results indicate that school travel is controlled by both intentional and habitual processes. In practice, interventions could usefully decrease the habitual use of motorized transport for travel to school and increase children's intention to walk (via increases in perceived behavioral control and walking habit, and decreases in car/bus habit). Further research is needed to identify effective strategies for changing these antecedents of children's active school travel
Psychosocial factors related to children’s active school travel : A comparison of two European regions
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Quality, quality assurance and quality assured practitioners
Get PDFThe need for consumers to differentiate competing products on the grounds of quality has been around since ancient times and, over the centuries, various bodies have been formed with the aim of ensuring consumer confidence in the quality of the goods and services being traded. The goal of standardising the measurable quality of healthcare also has historical precedence and, in more recent times, the requirement for continuing medical education that has now evolved to continuing professional development, is recognised by healthcare professionals as an essential part of enhancing and maintaining their quality of practice. Physio First has continually expanded on this national requirement by championing evidence-based practice, initially through encouraging members to participate in data collection, and most recently in the option, through the analysis of this collected data, of obtaining the status of Quality Assured Practitioner (QAP)
Psychosocial factors related to children’s active school travel: A comparison of two European regions
No full textPsychosocial factors related to children’s active school travel: a comparison of two European regionsInequalities in health behaviors exist between regions of Europe, along a North West/South East axis. This study investigated whether prevalence of walking to school and associated psychosocial antecedents differed between these two European regions. Participants were 1,263 children aged 7-11 years, from five countries. Children from North West Europe (n = 641) and South East Europe (n = 622) completed a school travel questionnaire that measured demographics, school commuting mode, travel companion, feelings about their local area, and Theory of Planned Behavior (TPB) variables related to walking to school. Multivariate analysis of variance was used to investigate differences in TBP variables between children from the two regions of Europe. More children from South East Europe walked to school (70.8%) compared to those in the North West (47%). For the TPB variables, a significant multivariate main effect for region was found (Wilks’ λ=.94, F (4, 1201)=20.55, pp. Inequalities in walking to school exist between European regions. Children from South East Europe walk to school more than their counterparts from the North West. However children from North West Europe display higher scores on TPB variables, suggesting that psychosocial constructs related to walking to school may not explain rates of engagement in this behaviour.Ye
Psychosocial factors related to children’s active school travel: A comparison of two European regions
Get PDFPsychosocial factors related to children’s active school travel: a comparison of two European regionsInequalities in health behaviors exist between regions of Europe, along a North West/South East axis. This study investigated whether prevalence of walking to school and associated psychosocial antecedents differed between these two European regions. Participants were 1,263 children aged 7-11 years, from five countries. Children from North West Europe (n = 641) and South East Europe (n = 622) completed a school travel questionnaire that measured demographics, school commuting mode, travel companion, feelings about their local area, and Theory of Planned Behavior (TPB) variables related to walking to school. Multivariate analysis of variance was used to investigate differences in TBP variables between children from the two regions of Europe. More children from South East Europe walked to school (70.8%) compared to those in the North West (47%). For the TPB variables, a significant multivariate main effect for region was found (Wilks’ λ=.94, F (4, 1201)=20.55, pp. Inequalities in walking to school exist between European regions. Children from South East Europe walk to school more than their counterparts from the North West. However children from North West Europe display higher scores on TPB variables, suggesting that psychosocial constructs related to walking to school may not explain rates of engagement in this behaviour.Ye
Physiotherapy Outcomes Are Associated With Shorter Waiting Times, More Treatment Sessions and Younger Age:Analysis of a Clinical Database
Get PDFBackground: Musculoskeletal (MSK) conditions affect over 20.3 million people in the UK, presenting a substantial economic impact on health and social services. Physiotherapy can alleviate MSK conditions, especially if delivered in the acute or sub-acute period. However, patients often present after significant waiting times. Objectives: Our analysis examined how waiting times and the number of treatments influenced physiotherapy outcomes for MSK conditions. Design: Retrospective analysis of the Data for Impact, Physio First dataset. Methods: Logistic regression models assessed the effects of symptom duration, treatment frequency, and other variables on pain, Patient-Specific Functional Scores (PSFSs), and Goal Achievement (GA). Results: Analysis of 15,624 patient records showed that patients treated within two weeks of symptom onset were more likely to have favourable outcomes in pain (odds ratio [OR] = 2.01, 95% Confidence Interval [95% CI] = 1.65–2.45), PSFS (OR = 1.80, 95% CI = 1.55–2.08), and GA (OR = 1.74, 95% CI = 1.51–2.01) compared to those treated after longer durations. Receiving four or more treatment sessions significantly improved outcomes compared with only one session (pain: OR = 4.64, PSFS: OR = 5.72, GA: OR = 1.94, all p's < 0.001), with no additional benefits beyond four sessions. Younger age was associated with better outcomes (approximately OR = 0.99 per year age difference). Other findings included better outcomes in males and in those with fewer previous episodes of the condition. Conclusions: Shorter waiting times, a greater number of treatments, and younger patient age are associated with better physiotherapy outcomes for MSK conditions.</p
Are combined conservative interventions effective in reducing pain, disability and/or global rating of pain in people with sciatica with known neuropathic pain mechanisms?
No full textPurposeNational Clinical Guidelines recommend an integrated combination of conservative management strategies for sciatica. However, the efficacy of such combinations have not been established. The purpose of this systemic review with meta-analysis was to determine the efficacy of combined conservative (non-pharmacological) compared to single interventions for people with sciatica with a confirmed neuropathic mechanism.MethodsThe systematic review was registered on PROSPERO CRD42023464011. The databases included were the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Embase, PubMed, Scopus, APA PsycINFO, and grey literature sources from inception until January 2024. Inclusion criteria were randomized controlled trials that assessed the effectiveness of combined non-pharmacological interventions in comparison to a control intervention among individuals with sciatica of a neuropathic origin identified using diagnostic or clinical tests. Primary outcomes were back pain, leg pain, and disability. The secondary outcome was global rating of change. Study selection, data extraction and risk of bias assessment (using Cochrane ROB2) were assessed by two reviewers. Meta-analysis was performed with a random effects model with inverse variance weighting used for the metanalysis using SPSS v 29.Results3,370 articles were identified, of which 6 were included. Risk of bias was high in one study and had some concerns in the remaining 5 studies for each outcome measure. There was evidence of efficacy for combined interventions for back pain in the short-and long-term (SMD − 0.56 (95% CI -0.91, -0.22, p = 0.01, I2 = 0.2; SMD − 0.44 (95% CI -0.79, -0.1, p = 0.03, I2 = 0.00), and for disability in the short term (SMD − 0.48 (95% CI -0.92, -0.04, p = 0.04, I2 = 0.72). There was no evidence of efficacy for leg pain at any time point (( short term SMD − 0.45 (95% CI -0.91, 0.02, p = 0.06, I2 = 0.65), medium term (SMD − 0.29 (95% CI -1.12, 0.54, p = 0.35, I2 = 0.82), long term (SMD − 0.40 (95% CI -1.23, 0.44, p = 0.18, I2 = 0.57).Certainty of evidence ranged from very low to moderate.ConclusionThere are few studies that have combined conservative (non-pharmacological) interventions for the management of sciatica with a neuropathic component pain mechanism, as recommended by National Clinical Guidelines. This review indicates that combining conservative (no-pharmacological) management strategies appeared more effective than single interventions for the outcomes of low back pain in the short and long term, and for disability in the short term, but not for leg pain at any time point. The overall low certainty of evidence, suggests that future studies with more robust methodologies are needed
The development of the Quality Assured Practitioner (QAP) Scheme in Private Physiotherapy Practice in the UK
No full textBackground: Quality assurance in health care has become a priority for health care providers. In the UK, Physiotherapists are required to renew their registration every two years and confirm they meet the standard set by the health professions regulator in the UK, the Health and Care Professions Council (HCPC). Within this standard is the requirement that physiotherapists must be able to assure the quality of their practice. Since 2005, Physio First (the Organisation for Chartered Physiotherapists in Private Practice in the UK) have worked in collaboration with the University of Brighton on the Data for Impact (DfI) project to provide private practitioners with the opportunity to participate in an online standardised data collection project gathering data for patients with musculoskeletal conditions. Although quality assurance has been set out in the HCPC standards, the issue has not yet been addressed in a formalised way on a national level. That, in addition with the increasing need for physiotherapists to evidence their quality within a competitive healthcare marketplace, has highlighted the need for an appropriate quality assurance scheme to be developed for private physiotherapists in the UK.Purpose: To provide private physiotherapists a means of benchmarking their patient outcomes and demonstrating quality through the development of an ongoing Quality Assured Practitioner (QAP) scheme. Methods: Draft standards for how quality would be defined and measured were proposed by Physio First. Discussions between Physio First and the University allowed for further development and refinement of the QAP scheme. Results: Five criteria were agreed on as indicators of the QAP scheme including waiting time, change in outcome scores pre/post treatment, average number treatments, goal achievement at discharge, and outcome of referral on discharge. Descriptive statistical analyses of the national data was performed based on a non-weighted mean of practitioners who had collected 50+ data. Data for each of the criteria was normally distributed. The lower and/or upper limits were calculated for each criterion representing a value that is one standard deviation below and one standard deviation above the mean. Eligibility of QAP status would be based on practitioners meeting a minimum of three of the five criteria based on their data collected over a twelve month period. Data would be analysed independently by researchers at the University.Conclusions: The development of the scheme provides private physiotherapists the opportunity to verify the quality of their own practice with objective evidence collected nationally through the DfI project. One of the main challenges of such initiatives is the selection of appropriate indicators of quality. Ongoing feedback from stakeholders of the scheme may be used to amend the criteria if the need arises. Further amendments in the form of introducing an online patient-reported outcome measure alongside the practitioner-reported outcomes will strengthen the scheme and alleviate bias. Implications: The ability to demonstrate quality enables practitioners to effectively position themselves in an increasingly competitive marketplace. The scheme also serves to highlight to practitioners areas of focus for CPD and areas of improvement. <br/
How does the use of standardised data collection inform the educational needs of physiotherapists working in private practice?
No full textPurpose: Working as a physiotherapist in private practice can be an isolating experience. Practitioners are under pressure to make their businesses pay and often work as sole practitioners, whilst also being accountable for delivering a quality service to patients. Maintaining high standards of practice requires regular continuing professional development (CPD) as well as the possibility of comparing and discussing practice with others. Standardised data collection is a tool which can enable and inform these needs. This qualitative research aims to explore how standardised data collection influences the practice of physiotherapists working in private practice, specifically focussing on whether it can help to inform their educational needs.Methods: This study was undertaken as part of a larger data collection project involving more than 500 physiotherapists working in private practice. Semi-structured telephone interviews were carried out with 12 physiotherapists working in private practice, all of whom had used standardised data collection. Interviews were recorded and transcribed verbatim. Data was analysed using inductive thematic analysis.Results: 10 females and 2 males participated in the interviews (median years qualified 30.5, range 20–46 years). Five were sole practitioners. Analysis revealed two main themes; ‘the practitioner’ and ‘connectedness to others’. For the practitioner, the use of standardised data collection prompted reflection and highlighted areas for CPD. Connectedness to others was supported by the constructs of ‘benchmarking practice’ and ‘communicating with others’.Conclusion(s): Standardised data collection showed participants ‘where participants were in the pecking order’, provided feed back like a manager (particularly useful for sole practitioners) and gave reassurance about the currency of practice, as well as stimulating discussion with colleagues thus helping to inform their practice. A limitation of this study is that participants were selected for interview depending on their availability within a short time period so it may not be representative of the wider population of private practitioners. Further research into whether standardised data collection informs educational needs with other groups of physiotherapy practitioners, for example those with less experience, is warranted.Impact: This research supports the use of standardised data collection (practitioner and patient reported data) by physiotherapists working in the private sector to help inform the education needs of physiotherapists, and the potential for better clinical outcomes
