abstract: 'Recommendations suggest a multicomponent exercise for people with

  osteoporosis. We identified rehabilitation professionals'' barriers and

  facilitators to implementing exercise recommendations with people with

  osteoporosis, and used those to make suggestions for targeted knowledge

  translation interventions. Future work will report on development and

  evaluation of the interventions informed by our study.

  Purpose Rehabilitation professionals can help people with osteoporosis

  to engage in a multicomponent exercise program and perform activities of

  daily living safely. However, rehabilitation professional face barriers

  to implementing exercise evidence, especially for specific disease

  conditions like osteoporosis. We performed a behavioural analysis and

  identified rehabilitation professionals'' barriers to and facilitators of

  implementing disease-specific physical activity and exercise

  recommendations (Too Fit to Fracture recommendations), and used the

  Behaviour Change Wheel to select interventions.

  Methods Semi-structured interviews and focus groups were conducted with

  rehabilitation professionals, including physical therapists,

  kinesiologists, and occupational therapists, and transcribed verbatim.

  Two researchers coded data and identified emerging themes. Using the

  Behaviour Change Wheel framework, themes were categorized into

  capability, opportunity, and motivation, and relevant interventions were

  identified.

  Results Ninety-four rehabilitation professionals (mean age 40.5 years,

  88.3\% female) participated. Identified barriers were as follows:

  capability-lack of training in behaviour change, how to modify

  recommendations for physical and cognitive impairments; opportunity-lack

  of resources, time, and team work; motivation-lack of trust between

  providers, fear in providing interventions that may cause harm.

  Interventions selected were as follows: education, training, enablement,

  modelling and persuasion. Policy categories are communication/marketing,

  guidelines, service provision and environmental/social planning.

  Conclusions Key barriers to implementing the recommendations are

  rehabilitation professionals'' ability to use behaviour change

  techniques, to modify the recommendations for physical and cognitive

  limitations and to feel comfortable with delivering challenging but safe

  interventions for people with osteoporosis, and lacking trust and team

  work across sectors. Future work will report on development and

  evaluation of knowledge translation interventions informed by our study.'
affiliation: 'McArthur, C (Corresponding Author), Univ Waterloo, Dept Kinesiol, 200
  Univ Ave West, Waterloo, ON N2L 3G1, Canada.

  McArthur, C (Corresponding Author), Geriatr Educ \& Res Aging Sci Ctr, Hamilton,
  ON, Canada.

  McArthur, C (Corresponding Author), McMaster Univ, Hamilton, ON, Canada.

  McArthur, Caitlin; Ziebart, Christina; Giangregorio, Lora M., Univ Waterloo, Dept
  Kinesiol, 200 Univ Ave West, Waterloo, ON N2L 3G1, Canada.

  McArthur, Caitlin; Papaioannou, Alexandra; Giangregorio, Lora M., Geriatr Educ \&
  Res Aging Sci Ctr, Hamilton, ON, Canada.

  McArthur, Caitlin; Papaioannou, Alexandra, McMaster Univ, Hamilton, ON, Canada.

  Cheung, Angela M.; Laprade, Judi, Univ Toronto, Toronto, ON, Canada.

  Laprade, Judi; Jain, Ravi, Ontario Osteoporosis Strategy \& Osteoporosis Cana, Toronto,
  ON, Canada.

  Lee, Linda, Ctr Family Med, Kitchener, ON, Canada.

  Giangregorio, Lora M., Univ Hlth Network, Toronto Rehabil Inst, Toronto, ON, Canada.

  Giangregorio, Lora M., Schlegel UW Res Inst Aging, Waterloo, ON, Canada.'
article-number: '7'
author: McArthur, Caitlin and Ziebart, Christina and Papaioannou, Alexandra and Cheung,
  Angela M. and Laprade, Judi and Lee, Linda and Jain, Ravi and Giangregorio, Lora
  M.
author-email: cmcarthur@uwaterloo.ca
author_list:
- family: McArthur
  given: Caitlin
- family: Ziebart
  given: Christina
- family: Papaioannou
  given: Alexandra
- family: Cheung
  given: Angela M.
- family: Laprade
  given: Judi
- family: Lee
  given: Linda
- family: Jain
  given: Ravi
- family: Giangregorio
  given: Lora M.
da: '2023-09-28'
doi: 10.1007/s11657-018-0419-7
eissn: 1862-3514
files: []
issn: 1862-3522
journal: ARCHIVES OF OSTEOPOROSIS
keywords: 'Physical activity; Physical therapy; Osteoporosis; Health care provider;

  Guidelines; Knowledge translation; Implementation science'
keywords-plus: 'LOW-BACK-PAIN; PHYSICAL-ACTIVITY; ALLIED HEALTH; IMPLEMENTATION;

  OSTEOPOROSIS; MANAGEMENT; DIAGNOSIS; BELIEFS; PHYSIOTHERAPISTS;

  GUIDELINE'
language: English
month: JAN 25
number: '1'
number-of-cited-references: '46'
orcid-numbers: 'Giangregorio, Lora/0000-0002-3739-1805

  McArthur, Caitlin/0000-0001-9985-2796

  Cheung, Angela M./0000-0001-8332-0744'
papis_id: 17c98b06e24abc7e18e1c694e1928d8b
ref: Mcarthur2018weget
researcherid-numbers: 'Ziebart, Christina/AAT-3639-2020

  '
times-cited: '6'
title: '``We get them up, moving, and out the door. How do we get them to do what
  is recommended?″ Using behaviour change theory to put exercise evidence into action
  for rehabilitation professionals'
type: article
unique-id: WOS:000423477700001
usage-count-last-180-days: '0'
usage-count-since-2013: '11'
volume: '13'
web-of-science-categories: Endocrinology \& Metabolism; Orthopedics
year: '2018'