Abstract
Background: Exercise is highly beneficial for managing multiple sclerosis (MS) symptoms and disease progression. Healthcare providers (HCPs) are well-positioned to promote exercise to MS patients, yet exercise prescription is not routine. Addressing this requires further professional development, as many allied HCPs want advanced evidence-based training to promote exercise behaviour in MS.
Objective: The aim of this study was to evaluate the effectiveness of a co-designed educational programme (BASE-HCP) for improving HCP confidence, knowledge, and attitudes towards remote exercise delivery for individuals with MS. In addition, we aimed to establish the acceptability, appropriateness and feasibility of the education programme for clinical usage.
Methods: We conducted a one-year study to assess the BASE-HCP programme. Evaluations were done at baseline, post-theoretical learning, post-application with MS clients, and at 12-month follow-up. Primary outcomes included professional quality of life, confidence, and knowledge about exercise in MS care. Secondary outcomes were implementation measures. Primary outcomes were analysed using general linear mixed models, with secondary outcomes evaluated as counts and qualitative themes.
Results: Of 40 practitioners who provided baseline data, 24 completed the theoretical programme, and 16 completed the applied programme. Self-confidence improved significantly (|βs| ⩾ 1.272, SEs ⩽ 0.308, |ts| ⩾ 5.282, ps < 0.001), with large effect sizes (percentage change: 72.0-82.6%). Some TDF-based domains improved, such as beliefs about skills to prescribe. Practitioners expressed high satisfaction with the programme, and all showed increased delivery of implementation behaviour change strategies.
Conclusion: An online evidence-based education programme for MS care improved practitioners' self-confidence and beliefs about physical activity, but high attrition suggests healthcare system barriers. Identifying barriers and enablers for HCPS to receive evidence-based education programmes will help facilitate implementation of exercise to all persons with MS.