A multilevel modeling approach to examining the implementation-effectiveness relationship of a behavior change intervention for health care professional trainees.

Abstract

Changing Minds, Changing Lives, a seminar-mediated behavior change intervention, aims to enhance health care professionals' (HCPs') social cognitions for discussing leisure-time physical activity (LTPA) with patients with physical disabilities. This study examines which seminar implementation variables (presenter characteristics, delivery components) predict effectiveness using multilevel modeling. HCP trainees (n=564) attended 24 seminars and completed Theory of Planned Behavior-based measures for discussing LTPA at pre-, post-, 1-month post-, and 6-months post-seminar. Implementation variables were extracted from presenter-completed questionnaires/checklists. Seminars presented by a HCP predicted positive changes in all cognitions pre-post but negative changes in attitudes and perceived behavioral control (PBC) over follow-up (ps<.05). The number of seminars the presenter had delivered predicted negative changes in attitudes and PBC during follow-up (ps<.001). Inclusion of audiovisual components predicted positive changes in attitudes pre-post (p<.001). Presenter characteristics may be "key ingredients" to educational interventions for HCPs; however, future studies should examine additional implementation variables.