What Does It Take: The Roles, Responsibilities, and Fidelity to Implement a Physical Activity in Public HealthTraining

Abstract

Cooperative Extension Service (Extension) Agents are tasked with incorporating physical activity promotion in their work. Physical activity training interventions rarely report specific structures (dose, content) and measures (fidelity, resource cost). The study’s purpose was to evaluate the feasibility and resource costs of Physical Activity in Cooperative Extension (PACE), a training to increase physical activity in public health competency. PACE is a virtual, 9-week, 18-hour general capacity-building training based on the Interactive Systems Framework. Fidelity was calculated as the proportion of objectives delivered as intended and total time to deliver core components. Resource cost was calculated as the time spent on each implementation strategy and responsibility and total time spent delivering PACE. Fidelity was 93% (39/42 planned objectives delivered as intended). PACE required 183 hours to implement, with session delivery (45 hours) and participant communication (40 hours) requiring the most time. Overall, time spent included 37 hours per delivery team member and 18 hours per PACE participant. The personnel time spent was within the standard time spent on other Extension training protocols and perceived as feasible. Fidelity to session components was high and easy to track. Future work should determine the scalability and sustainability of PACE within Extension nationally.