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IntroductionStrategic knowledge mobilization efforts are needed to enhance uptake and use of the Canadian 24-Hour Movement Guidelines (24HMG), which describe optimal amounts of physical activity, sedentary behaviour and sleep each day for overall health. The Whole Day Matters Toolkit for Primary Care is an evidence-informed resource to help primary care providers (PCPs) disseminate the 24HMGs. The purpose of this study was to describe gaining consensus on toolkit components through iterative revisions to improve its utility in preparation for the September 2022 launch, and to summarize early dissemination efforts. MethodsA multidisciplinary expert working group planned three modified Delphi surveys to assess PCPs’ level of agreement with toolkit components on 7-point Likert scales with follow-up prompts for ratings of 4 or less. Consensus was defined a priori as a mean of 6 or higher out of 7 and 60% or more of PCPs selecting at least “somewhat agree.” Items on which consensus was reached were removed from subsequent surveys unless they were revised. ResultsTwenty PCPs completed surveys 1 and 2; 15 completed survey 3. Consensus was reached on 5% (4/83), 17% (14/83) and 55% (38/69) of the items in surveys 1, 2 and 3, respectively. The number of qualitative comments decreased from 26 to 19 to 12, further indicating increasing consensus. ConclusionItems on which consensus was not gained may reflect differences in provider characteristics or settings. A coproduced dissemination strategy was enacted. Toolkit reach was evaluated at launch and 4 months later.

IntroductionDes efforts stratégiques de mobilisation des connaissances sont nécessaires pour améliorer l’adoption et l’utilisation des Directives canadiennes en matière de mouvement sur 24 heures (DM24H), qui présentent la durée quotidienne optimale d’activité physique, de comportement sédentaire et de sommeil pour favoriser une bonne santé générale. La trousse « Profitez au maximum de votre journée » pour les prestataires de soins primaires est une ressource fondée sur des données probantes visant à aider les prestataires de soins primaires à faire connaître les DM24H. Le but de cette étude était de décrire comment un consensus a été obtenu sur les éléments de la trousse au moyen de révisions itératives afin d’améliorer son utilité en vue de sa publication en septembre 2022 ainsi que de résumer les premiers efforts de diffusion. MethodsUn groupe multidisciplinaire d’experts a planifié trois sondages par méthode Delphi modifiée pour évaluer, sur une échelle de Likert à 7 points comprenant des messages de suivi pour les cotes de 4 ou moins, dans quelle mesure les prestataires de soins primaires approuvaient les éléments de la trousse. Le consensus a été défini a priori comme une moyenne de 6 ou plus sur 7 aux questions où 60 % des prestataires de soins primaires ou plus avaient répondu au moins « plutôt d’accord ». Les éléments sur lesquels un consensus a été atteint ont été retirés des sondages suivants, sauf s’ils avaient été révisés. ResultsVingt prestataires de soins primaires ont répondu aux sondages 1 et 2 et 15 ont répondu au sondage 3. Un consensus a été atteint sur 5 % (4/83) des éléments du sondage 1, 17 % (14/83) du sondage 2 et 55 % (38/69) du sondage 3. Le nombre de commentaires qualitatifs est passé de 26 à 19, puis à 12, autre indication de la hausse du consensus. ConclusionLes éléments sur lesquels le consensus n’a pas été obtenu sont sans doute le reflet de différences dans les caractéristiques des prestataires ou dans le milieu dans lequel ils exercent. Une stratégie de diffusion élaborée conjointement a été mise en oeuvre. La portée de la trousse d’outils a été évaluée au moment de sa publication ainsi que quatre mois plus tard.

Abstract Background Health care providers have reported low knowledge, skill, and confidence for discussing movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), which may be improved with the use of tools to guide movement behaviour discussions in their practice. Past reviews have examined the psychometric properties, scoring, and behavioural outcomes of physical activity discussion tools. However, the features, perceptions, and effectiveness of discussion tools for physical activity, sedentary behaviour, and/or sleep have not yet been synthesized. The aim of this review was to report and appraise tools for movement behaviour discussions between health care providers and adults 18 + years in a primary care context within Canada or analogous countries. Methods An integrated knowledge translation approach guided this review, whereby a working group of experts in medicine, knowledge translation, communications, kinesiology, and health promotion was engaged from research question formation to interpretation of findings. Three search approaches were used (i.e., peer-reviewed, grey literature, and forward searches) to identify studies reporting on perceptions and/or effectiveness of tools for physical activity, sedentary behaviour, and/or sleep. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Results In total, 135 studies reporting on 61 tools (i.e., 51 on physical activity, one on sleep, and nine combining two movement behaviours) met inclusion criteria. Included tools served the purposes of assessment (n = 57), counselling (n = 50), prescription (n = 18), and/or referral (n = 12) of one or more movement behaviour. Most tools were used or intended for use by physicians, followed by nurses/nurse practitioners (n = 11), and adults accessing care (n = 10). Most tools were also used or intended to be used with adults without chronic conditions aged 18–64 years (n = 34), followed by adults with chronic conditions (n = 18). The quality of the 116 studies that evaluated tool effectiveness varied. Conclusions Many tools were positively perceived and were deemed effective at enhancing knowledge of, confidence for, ability in, and frequency of movement behaviour discussions. Future tools should guide discussions of all movement behaviours in an integrated manner in line with the 24-Hour Movement Guidelines. Practically, this review offers seven evidence-based recommendations that may guide future tool development and implementation.

Abstract Background Canada’s 24-Hour Movement Guidelines for Adults have shifted the focus from considering movement behaviours (i.e., physical activity, sedentary behaviour, and sleep) separately to a 24-h paradigm, which considers how they are integrated. Accordingly, primary care providers (PCPs) have the opportunity to improve their practice to promote all movement behaviours cohesively. However, PCPs have faced barriers to discussing physical activity alone (e.g., time, competing priorities, inadequate training), leading to low frequency of physical activity discussions. Consequently, discussing three movement behaviours may seem challenging. Tools to facilitate primary care discussions about physical activity have been developed and used; however, few have undergone usability testing and none have integrated all movement behaviours. Following a synthesis of physical activity, sedentary behaviour, and sleep tools for PCPs, we developed the Whole Day Matters Tool and User Guide that incorporate all movement behaviours. The present study aimed to explore PCPs’ perceptions on the usability, acceptability, and future implementation of the Whole Day Matters Tool and User Guide to improve their relevancy among PCPs. Methods Twenty-six PCPs were observed and audio–video recorded while using the Tool and User Guide in a think-aloud procedure, then in a near-live encounter with a mock service-user. A debriefing interview using a guide informed by Normalization Process Theory followed. Recordings were transcribed verbatim and analysed using content analysis and a critical friend to enhance rigour. Results PCPs valued aspects of the Tool and User Guide including their structure, user-friendliness, visual appeal, and multi-behaviour focus and suggested modifications to improve usability and acceptability. Findings are further discussed in the context of Normalization Process Theory and previous literature. Conclusions The Tool and User Guide were revised, including adding plain language, reordering and renaming sections, reducing text, and clarifying instructions. Results also informed the addition of a Preamble and a Handout for adults accessing care (i.e., patients/clients/service-users) to explain the evidence underpinning the 24-Hour Movement Guidelines for Adults and support a person-centered approach. These four resources (i.e., Tool, User Guide, Preamble, Handout) have since undergone a consensus building process to arrive at their final versions before being disseminated into primary care practice.

Abstract Effective physical activity messaging plays an important role in the pathway towards changing physical activity behaviour at a population level. The Physical Activity Messaging Framework (PAMF) and Checklist (PAMC) are outputs from a recent modified Delphi study. This sought consensus from an international expert panel on how to aid the creation and evaluation of physical activity messages. In this paper, we (1) present an overview of the various concepts within the PAMF and PAMC, (2) discuss in detail how the PAMF and PAMC can be used to create physical activity messages, plan evaluation of messages, and aid understanding and categorisation of existing messages, and (3) highlight areas for future development and research. If adopted, we propose that the PAMF and PAMC could improve physical activity messaging practice by encouraging evidence-based and target population-focused messages with clearly stated aims and consideration of potential working pathways. They could also enhance the physical activity messaging research base by harmonising key messaging terminologies, improving quality of reporting, and aiding collation and synthesis of the evidence.