Title: “Translating knowledge to action: creation of the evidence-based Exercise and Depression Toolkit for health care providers working with individuals with depression”
Supervisory Committee: Dr. Guy Faulkner (Research Supervisor), Dr. Erin Michalak; Dr. Heather Gainforth
University Examiners: Dr. Linda Li, Dr. Alan Kingstone
External Examiner: Dr. Diane Crone (Cardiff Metropolitan University)
Chair: TBD
Abstract: The purpose of this dissertation was to 1) use a systematic and phased process to develop an evidence-based resource (toolkit) about exercise and depression for health care providers working with adults with depression in Canada (based on treatment guidelines) and 2) provide a step by step guide for translating knowledge into action for health care interventions. This dissertation was guided by the Knowledge to Action Framework and the AGREE II (Appraisal of Guidelines for Research & Evaluation) instrument. Study 1 was a scoping review to identify the barriers and facilitators to engagement in physical activity (PA) and exercise for adults with depression. A behavioural analysis informed by the Theoretical Domains Framework (TDF) determined that future intervention should target the emotion and social influences domains. Study 2 was a scoping review to identify the barriers and facilitators to PA promotion by health care providers (HCP) working with individuals with mental illness. The most prominent barriers and facilitators were within the domains of beliefs about the consequences and environmental context & resources. Study 3 was a qualitative study to guide toolkit development. Interviews were conducted with adults with lived experience with depression (AWD) and HCP. Study 4 described the systematic and phased process used to develop the evidence-based ‘Exercise and Depression Toolkit’ for HCP working with AWD. The four phases included: reviews of relevant literature, formative interviews, an expert panel meeting, and final toolkit development. Various stakeholders were involved throughout the process including HCP, AWD, researchers, and exercise professionals. Study 5 evaluated the ‘Exercise and Depression Toolkit’ in practice by HCP working with AWD and attained feedback on the toolkit to inform national dissemination and uptake. The toolkit was found to be acceptable and have positive innovation attributes. Concerns about effort and time to use it in practice informed dissemination plans and selection of end users. Together, the studies in this dissertation have resulted in the first evidence-based resource, the ‘Exercise and Depression Toolkit’, to help health care providers and individuals with depression collaboratively consider exercise as a treatment.