Factors That Predict Adoption and Implementation of an Evidence-based Physical Activity Program

PURPOSE:There is increasing emphasis by funding agencies for evidence-based research to be translated and disseminated into practice. However, little is known about what factors predict whether an organization will adopt an evidence-based physical activity program, or what factors predict implementation of the program, once the program has been adopted. METHODS:Using Diffusion of Innovations Theory constructs, a case-control survey examining organizational and sector-level decision making to adopt and implement Active Living Every Day (ALED), a lifestyle physical activity program has been concluded. RESULTS: The total number of organizations invited to complete the survey included 154 cases; 319 controls who had contacted the publisher expressing interest; and 328 controls who had been marketed to but who did not express interest. The overall response rate was 57.6% with a higher response rate for cases compared with either type of control. The Wilcoxon Signed Ranks test indicated that cases ranked 5 of 20 factors higher than controls: 1) clients would benefit from the program (p<0.001); 2) the program matched the organization mission and goals (p=0.008); 3) facilitator training prepared the staff (p=0.016); 4) ease of implementation (p=0.029); and 5) staff was able to learn the program (p=0.007). Of the 97 cases that were classified as adopters of ALED, 54.2% said they had ever implemented the program and 45.8% said they had never implemented the program. Chi-Square or Fisher's Exact Test indicated two factors differed between implementers and non-implementers of ALED cases; 1) ease of implementation (p=0.04) and 2) belief that employees and clients could understand the program (p=0.009). CONCLUSIONS: These data provide future directions for implementation research of evidence-based physical activity programs targeting strategies that overcome barriers related to ease of use and understanding of the program.