Translation of the Otago Exercise Program for adoption and implementation in the United States

Abstract

Background: The Otago Exercise Program (OEP) is an evidence-based fall prevention program developed, evaluated, and disseminated in New Zealand. The program was designed for delivery in the home by physical therapists (PTs). It was not known if American PTs would require additional training and resources to adopt the OEP. This article describes the process of translating the OEP for dissemination in the US. Processes included reviewing and piloting the New Zealand training materials to identify implementation challenges, updating trainingmaterials to be consistentwith American physical therapy practices, piloting the updated training materials in an online format, and determining if the online format reached the target PT audience. Methods - Process Activities: The New Zealandmanual was reviewed by expert American PTs and a trainingwebinarwas pilotedwith 56 American PTs. Feedback suggested that the program itself was understood by PTs, but training materials required modification related to documentation and reimbursement policies. Additional content was developed and integrated into an online training module. The online training was piloted and then deemed adequate by seven PT subject matter experts. The online training was launched in March 2013. Demographic and practice data were collected to characterize the PTs attending the online training as well as perceived barriers and facilitators to implementation (n =522). Perceived facilitators include the effectiveness of the OEP to facilitate adoption, but the lack of agency support, billing and reimbursement challenges pose a significant barrier to OEP implementation. Conclusion: The OEP required additional information to facilitate adoption by American PTs. Online training that specifically targets PTs appears to effectively reach the target audience and be well received by participants. More research is required to determine the impact of online training on a PT's adoption and implementation of this material into their practice.