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    PHYSICAL ACTIVITY PROMOTION IN MEXICAN HEALTHCARE SETTINGS: FROM KNOWLEDGE TO ACTION

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    Date
    2014-07-31
    Author
    Galaviz Arredondo, Karla Ivette
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    Abstract
    The rising burden of physical inactivity among Mexican adults warrants

    population wide intervention strategies. The healthcare setting has been recognized as an

    appropriate place to implement such strategies. Although physician-delivered strategies

    have been shown to improve patient physical activity (PA), physician counselling,

    prescription and referral rates remain low. Guided by the Knowledge-to-Action

    framework, the purpose of this dissertation was to identify gaps in Mexican physician PA

    prescription practices, to identify a counselling tool for addressing this gap and to

    implement an intervention for improving physician counselling practices.

    In study 1, the PA prescription behaviour of Mexican primary care physicians

    (N=633) and the psychosocial factors influencing this behaviour were explored. Findings

    showed that only 6% of physicians regularly prescribe PA and that their perceived ability

    to prescribe, as well as their own PA behaviour, explain this practice.

    In study 2, the informational (e.g. signage), educational (e.g. posters) and

    instrumental (e.g. stairs) environments of 40 primary care clinics/hospitals in Guadalajara

    were assessed for their potential to promote PA. The Healthcare Environment

    Assessment Tool was developed to assess these environments (kappa=.81). Findings

    showed that the instrumental environment is encouraging, but the informational and

    educational environments could be improved.

    In study 3, a theory-based training intervention to improve PA counselling

    practices among primary care physicians was developed and evaluated using the RE-AIM

    framework. The training strategy reached 305 primary care physicians (52% female,

    mean age 40 years), was effective for improving physicians’ psychosocial constructs in

    iii

    the short term and PA counselling practices in the long term, was successfully adopted

    and consistently implemented across the state of Jalisco and was institutionalized by the

    Jalisco Secretary of Health.

    This dissertation demonstrates that knowledge translation efforts in Mexican

    healthcare settings are feasible and promising for promoting evidence-based PA

    promotion practices. This dissertation represents the first step in that direction and sheds

    light on potential approaches for facilitating such efforts.
    URI
    http://hdl.handle.net/1974/12342
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    • Queen's Graduate Theses and Dissertations
    • School of Kinesiology & Health Studies Graduate Theses
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