A multilevel modeling approach to examining the implementation-effectiveness relationship of a behavior change intervention for health care professional trainees

Transl Behav Med. 2017 Sep;7(3):603-614. doi: 10.1007/s13142-017-0526-9.


Changing Minds, Changing Lives, a seminar-mediated behavior change intervention, aims to enhance health care professionals' (HCPs') social cognitions for discussing leisure-time physical activity (LTPA) with patients with physical disabilities. This study examines which seminar implementation variables (presenter characteristics, delivery components) predict effectiveness using multilevel modeling. HCP trainees (n = 564) attended 24 seminars and completed Theory of Planned Behavior-based measures for discussing LTPA at pre-, post-, 1-month post-, and 6-months post-seminar. Implementation variables were extracted from presenter-completed questionnaires/checklists. Seminars presented by a HCP predicted positive changes in all cognitions pre-post but negative changes in attitudes and perceived behavioral control (PBC) over follow-up (ps < .05). The number of seminars the presenter had delivered predicted negative changes in attitudes and PBC during follow-up (ps < .001). Inclusion of audiovisual components predicted positive changes in attitudes pre-post (p < .001). Presenter characteristics may be "key ingredients" to educational interventions for HCPs; however, future studies should examine additional implementation variables.

Keywords: Educational intervention; Health care professional trainees; Implementation-effectiveness relationship; Multilevel modeling; Theory of planned behavior.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Audiovisual Aids
  • Cognition
  • Exercise
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Health Personnel* / education
  • Health Personnel* / psychology
  • Health Plan Implementation
  • Health Promotion* / methods
  • Humans
  • Leisure Activities
  • Male
  • Multilevel Analysis
  • Time Factors
  • Treatment Outcome
  • Young Adult