Implementation of physical activity interventions in a community-based youth mental healthcare service : A case study of context, strategies, and outcomes

Journal article

Czosnek, Louise, Rosenbaum, Simon, Rankin, Nicole M., Zopf, Eva M., Cormie, Prue, Herbert, Brittany and Richards, Justin. (2023). Implementation of physical activity interventions in a community-based youth mental healthcare service : A case study of context, strategies, and outcomes. Early Intervention in Psychiatry. 17(2), pp. 212-222. https://doi.org/10.1111/eip.13324
AuthorsCzosnek, Louise, Rosenbaum, Simon, Rankin, Nicole M., Zopf, Eva M., Cormie, Prue, Herbert, Brittany and Richards, Justin
Abstract

Aims
Physical activity interventions are recommended for community-based youth mental health services to prevent physical health disparities. Implementation is challenging, and studies focusing on the methods to achieve change are needed. This study aims to identify the context, implementation strategies, and implementation outcomes that illustrate how physical activity interventions were implemented within an early intervention service in Australia.

Methods
A theoretically informed case study was undertaken. Data from a community-based youth mental health service that delivers an early psychosis programme were collected between July and November 2020. Three data sources were accessed (1) interviews with service managers, mental health clinicians and exercise physiologists; (2) document review of organizational policies and procedures; and (3) survey using the Program Sustainability Assessment Tool. The implementation outcomes investigated were acceptability, fidelity, penetration, and sustainability. Framework analysis was used, and a logic model developed guided by an established template, to interpret findings.

Results
Forty-three contextual factors and 43 implementation strategies were identified. The data suggests that creating a new clinical team and auditing and feedback are critical for implementation. High levels of acceptability and sustainability were described, while fidelity of implementation was difficult to establish, and penetration was low.

Conclusions
The relationship between constructs suggests several mechanisms underpinned implementation. These include changing professional beliefs, establishing new organizational norms, augmenting existing work processes, and aligning physical activity with priorities of the mental healthcare system and existing work tasks. This case study provides direction for future health service planning of physical activity interventions in community-based youth mental health service.

Keywordsevaluation; implementation outcome; implementation strategy; physical activity; youth mental health
Year2023
JournalEarly Intervention in Psychiatry
Journal citation17 (2), pp. 212-222
PublisherJohn Wiley & Sons Australia, Ltd
ISSN1751-7885
Digital Object Identifier (DOI)https://doi.org/10.1111/eip.13324
PubMed ID35766548
Scopus EID2-s2.0-85132997059
Open accessPublished as ‘gold’ (paid) open access
Page range212-222
FunderNational Health and Medical Research Council (NHMRC)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online29 Jun 2022
Publication process dates
Accepted29 May 2022
Deposited01 Dec 2022
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Earp, Jacob E., Newton, Robert U., Cormie, Prue and Blazevich, Anthony J.. (2015). Inhomogeneous quadriceps femoris hypertrophy in response to strength and power training. Medicine and Science in Sports and Exercise. 47(11), pp. 2389 - 2397. https://doi.org/10.1249/MSS.0000000000000669
Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer
Hamilton, Kyra, Chambers, Suzanne K., Legg, M, Oliffe, John L. and Cormie, Prue. (2015). Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer. Supportive Care in Cancer. 23(1), pp. 133 - 142. https://doi.org/10.1007/s00520-014-2327-8
Exercise-induced natural killer cell activation is driven by epigenetic modifications
Zimmer, Philipp, Bloch, Wilhelm, Schenk, Alexander, Zopf, Eva M., Hildebrandt, U., Streckmann, F., Beulertz, J., Koliamitra, C., Schollmayer, Friederike and Baumann, F.. (2015). Exercise-induced natural killer cell activation is driven by epigenetic modifications. International Journal of Sports Medicine. 36(6), pp. 510 - 515. https://doi.org/10.1055/s-0034-1398531
Recommendations for assessment methods for exercise trials with cancer patients
Scharhag-Rosenberger, F., Becker, T., Streckmann, F., Schmidt, K., Berling, A., Bernardi, A., Engeroff, T., Exner, A. K., Gutekunst, K., Hofmeister, D., Jensen, W., Kähnert, H., Kneis, S., Limbach, M., Mau-Möller, A., Röcker, K., Schmidt, M. E., Schmidt, T., Stöckel, T., ... Karen, Steindorf. (2014). Recommendations for assessment methods for exercise trials with cancer patients. Deutsche Zeitschrift fur Sportmedizin. 65(11), pp. 304 - 313. https://doi.org/10.5960/dzsm.2014.148
The relationship between BPAQ-derived physical activity and bone density of middle-aged and older men
Bolam, Kate, Beck, B. R., Adlard, K. N., Skinner, T. L., Cormie, Prue, Galvao, Daniel A., Spry, Nigel A., Newton, Robert U. and Taaffe, Dennis R.. (2014). The relationship between BPAQ-derived physical activity and bone density of middle-aged and older men. Osteoporosis International. 25(11), pp. 2663 - 2668. https://doi.org/10.1007/s00198-014-2797-z
Leisure time physical activity and long-term cardiovascular and cancer outcomes: The Busselton Health Study
Gunnell, Anthony S., Knuiman, Matthew, Divitini, Mark L. and Cormie, Prue. (2014). Leisure time physical activity and long-term cardiovascular and cancer outcomes: The Busselton Health Study. European Journal of Epidemiology. 29(11), pp. 851 - 857. https://doi.org/10.1007/s10654-014-9963-7
Physical activity and exercise recommendations for cancer patients during rehabilitation
Zopf, Eva M., Baumann, Freerk T. and Pfeifer, K.. (2014). Physical activity and exercise recommendations for cancer patients during rehabilitation. Rehabilitation (Germany). 53(1), pp. 2 - 7. https://doi.org/10.1055/s-0033-1334916
A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TRoG 03.04 radar
Galvao, Daniel A., Spry, Nigel A., Denham, James, Taaffe, Dennis R., Cormie, Prue, Joseph, David, Lamb, David S., Chambers, Suzanne K. and Newton, Robert U.. (2014). A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TRoG 03.04 radar. European Urology. 65(5), pp. 856 - 864. https://doi.org/10.1016/j.eururo.2013.09.041
Improving sexual health in men with prostate cancer: Randomised controlled trial of exercise and psychosexual therapies
Cormie, Prue, Chambers, Suzanne K., Newton, Robert U., Gardiner, Robert Alexander, Spry, Nigel A., Taaffe, Dennis R., Joseph, David, Hamid, M. Akhil, Chong, Peter, Hughes, David, Hamilton, Kyra and Galvao, Daniel A.. (2014). Improving sexual health in men with prostate cancer: Randomised controlled trial of exercise and psychosexual therapies. BMC Cancer. 14(199), pp. 1 - 9. https://doi.org/10.1186/1471-2407-14-199
Exercise as medicine in the management of pancreatic cancer: A case study
Cormie, Prue, Spry, Nigel A., Jasas, Kevin, Johansson, Mikael, Yusoff, Ian F., Newton, Robert U. and Galvao, Daniel A.. (2014). Exercise as medicine in the management of pancreatic cancer: A case study. Medicine and Science in Sports and Exercise. 46(4), pp. 664 - 670. https://doi.org/10.1249/MSS.0000000000000160
Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: Longitudinal results of a pilot study
Cormie, Prue, Galvão, Daniel A., Spry, Nigel, Joseph, David, Taaffe, D. R. and Newton, Robert U.. (2014). Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: Longitudinal results of a pilot study. Supportive Care in Cancer. 22(6), pp. 1537 - 1548. https://doi.org/10.1007/s00520-013-2103-1
The influence of loading intensity on muscle-tendon unit behavior during maximal knee extensor stretch shortening cycle exercise
Earp, Jacob E., Newton, Robert U., Cormie, Prue and Blazevich, Anthony J.. (2014). The influence of loading intensity on muscle-tendon unit behavior during maximal knee extensor stretch shortening cycle exercise. European Journal of Applied Physiology. 114(1), pp. 59 - 69. https://doi.org/10.1007/s00421-013-2744-2
PROSCARE :  A psychological care model for men with prostate cancer
Chambers, Suzanne K., Dunn, Jeff, Lazenby, Mark, Clutton, Samantha, Newton, Robert U., Cormie, Prue, Lowe, Anthony, Sandoe, David and Gardiner, Frank. (2013). PROSCARE :  A psychological care model for men with prostate cancer Prostate Cancer Foundation of Australia.
Feasibility of an isometric maximal voluntary contraction test in hematological cancer patients during thrombocytopenia
Zimmer, Philipp, Baumann, Freerk T., Ebel, Janis, Zopf, Eva Maria, Bloch, Wilhelm and Elter, Thomas. (2013). Feasibility of an isometric maximal voluntary contraction test in hematological cancer patients during thrombocytopenia. Journal of Sports Medicine. 2013(Article ID 470489), pp. 1-6. https://doi.org/10.1155/2013/470489
Knee angle-specific EMG normalization: The use of polynomial based EMG-angle relationships
Earp, Jacob E., Newton, Robert U., Cormie, Prue and Blazevich, Anthony. (2013). Knee angle-specific EMG normalization: The use of polynomial based EMG-angle relationships. Journal of Electromyography and Kinesiology. 23(1), pp. 238 - 244. https://doi.org/10.1016/j.jelekin.2012.08.015
Neither heavy nor light load resistance exercise acutely exacerbates lymphedema in breast cancer survivor
Cormie, Prue, Galvao, Daniel A., Spry, Nigel A. and Newton, Robert U.. (2013). Neither heavy nor light load resistance exercise acutely exacerbates lymphedema in breast cancer survivor. Integrative Cancer Therapies. 12(5), pp. 423 - 432. https://doi.org/10.1177/1534735413477194
Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases
Cormie, P., Newton, R. U., Spry, N., Joseph, D., Taaffe, D. R. and Galvaõ, D. A.. (2013). Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer and Prostatic Diseases. 16(4), pp. 328-335. https://doi.org/10.1038/pcan.2013.22
Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: A randomised controlled trial
Cormie, Prue, Pumpa, Kate, Galvao, Daniel A., Turner, Elizabeth, Spry, Nigel A., Saunders, Christobel, Zissiadis, Yvonne and Newton, Robert U.. (2013). Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: A randomised controlled trial. Journal of Cancer Survivorship. 7(3), pp. 413 - 424. https://doi.org/10.1007/s11764-013-0284-8
Exercise therapy for sexual dysfunction after prostate cancer
Cormie, Prue, Newton, Robert U., Taaffe, Dennis R., Spry, Nigel A. and Galvao, Daniel A.. (2013). Exercise therapy for sexual dysfunction after prostate cancer. Nature Reviews Urology. 10(12), pp. 731 - 736. https://doi.org/10.1038/nrurol.2013.206
Clinical exercise interventions in prostate cancer patients-a systematic review of randomized controlled trials
Baumann, Freerk T., Zopf, Eva M. and Bloch, Wilhelm. (2012). Clinical exercise interventions in prostate cancer patients-a systematic review of randomized controlled trials. Supportive Care in Cancer. 20(2), pp. 221 - 233. https://doi.org/10.1007/s00520-011-1271-0
Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation?
Newton, Robert U., Taaffe, Dennis R., Spry, Nigel A., Cormie, Prue, Chambers, Suzanne K., Gardiner, Robert Alexander, Shum, David H. K., Joseph, David and Galvao, Daniel A.. (2012). Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation? BMC Cancer. 12(432), pp. 1 - 8. https://doi.org/10.1186/1471-2407-12-432
Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: Study protocol of the ProRehab Study
Zopf, Eva M., Braun, Moritz, Machtens, Stefan, Zumbé, Jürgen, Bloch, Wilhelm and Baumann, Freerk T.. (2012). Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: Study protocol of the ProRehab Study. BMC Cancer. 12(312), pp. 1 - 7. https://doi.org/10.1186/1471-2407-12-312
Changes in strength over a 2-year period in professional Rugby Union players
Appleby, Brendyn, Newton, Robert U. and Cormie, Prue. (2012). Changes in strength over a 2-year period in professional Rugby Union players. Journal of Strength and Conditioning Research. 26(9), pp. 2538 - 2546. https://doi.org/10.1519/JSC.0b013e31823f8b86
The relationship between isometric force-time curve characteristics and club head speed in recreational golfers
Leary, Brian K., Statler, Jason, Hopkins, Britton, Fitzwater, Rachael, Kesling, Tucker, Lyon, Jacob, Phillips, Brett, Bryner, Randell W., Cormie, Prue and Haff, Gregory G.. (2012). The relationship between isometric force-time curve characteristics and club head speed in recreational golfers. Journal of Strength and Conditioning Research. 26(10), pp. 2685 - 2697. https://doi.org/10.1519/JSC.0b013e31826791bf
Principles of athlete testing
Newton, Robert U., Cormie, Prue and Cardinale, Marco. (2011). Principles of athlete testing. In In Cardinale, Marco, Newton, Rob and Nosaka, Kazunori (Ed.). Strength and conditioning : Biological principles and practical applications pp. 255-270 Wiley-Blackwell.
Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: Benefits of a moderate exercise intervention
Baumann, Freerk T., Zopf, Eva M., Nykamp, Eike, Kraut, Ludwig, Schüle, Klaus, Elter, Thomas, Fauser, Axel A. and Bloch, Wilhelm. (2011). Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: Benefits of a moderate exercise intervention. European Journal of Haematology. 87(2), pp. 148 - 156. https://doi.org/10.1111/j.1600-0609.2011.01640.x
Influence of muscle-tendon unit structure on rate of force development during the squat, countermovement, and drop jumps
Earp, Jacob E., Kraemer, William J., Cormie, Prue, Volek, Jeffery S., Maresh, Carl M., Joseph, Michael and Newton, Robert U.. (2011). Influence of muscle-tendon unit structure on rate of force development during the squat, countermovement, and drop jumps. Journal of Strength and Conditioning Research. 25(2), pp. 340 - 347. https://doi.org/10.1519/JSC.0b013e3182052d78
Developing maximal neuromuscular power: Part 1 - Biological basis of maximal power production
Cormie, Prue, McGuigan, Michael R. and Newton, Robert U.. (2011). Developing maximal neuromuscular power: Part 1 - Biological basis of maximal power production. Sports Medicine. 41(1), pp. 17 - 38. https://doi.org/10.2165/11537690-000000000-00000
Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: a randomized controlled trial
Galvao, Daniel, Taaffe, D R, Cormie, P, Spry, Nigel, Chambers, Suzanne, Peddle-McIntyre, C, Baker, Michael, Denham, James, Joseph, David and Groom, Geoff. (2011). Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: a randomized controlled trial. BMC Cancer. 11(13), pp. 517 - 523. https://doi.org/10.1186/1471-2407-11-517
Developing maximal neuromuscular power: Part 2 training considerations for improving maximal power production
Cormie, Prue, McGuigan, Michael R. and Newton, Robert U.. (2011). Developing maximal neuromuscular power: Part 2 training considerations for improving maximal power production. Sports Medicine. 41(2), pp. 125 - 146. https://doi.org/10.2165/11538500-000000000-00000
Influence of strength on magnitude and mechanisms of adaptation to power training
Cormie, Prue, McGuigan, Michael and Newton, Robert U.. (2010). Influence of strength on magnitude and mechanisms of adaptation to power training. Medicine and Science in Sports and Exercise. 42(8), pp. 1566 - 1581. https://doi.org/10.1249/MSS.0b013e3181cf818d
Changes in the eccentric phase contribute to improved stretch-shorten cycle performance after training
Cormie, Prue, McGuigan, Michael and Newton, Robert U.. (2010). Changes in the eccentric phase contribute to improved stretch-shorten cycle performance after training. Medicine and Science in Sports and Exercise. 42(9), pp. 1731 - 1744. https://doi.org/10.1249/MSS.0b013e3181d392e8
Adaptations in athletic performance after ballistic power versus strength training
Cormie, Prue, McGuigan, Michael and Newton, Robert U.. (2010). Adaptations in athletic performance after ballistic power versus strength training. Medicine and Science in Sports and Exercise. 42(8), pp. 1582 - 1598. https://doi.org/10.1249/MSS.0b013e3181d2013a
Muscle deoxygenation during repeated sprint running: Effect of active vs. Passive recovery
Buchheit, M., Cormie, Prue, Abbiss, Chris R., Ahmaidi, S., Nosaka, K and Laursen, P B.. (2009). Muscle deoxygenation during repeated sprint running: Effect of active vs. Passive recovery. International Journal of Sports Medicine. 30(6), pp. 418 - 425. https://doi.org/10.1055/s-0028-1105933
Power-time, force-time, and velocity-time curve analysis of the countermovement jump: Impact of training
Cormie, Prue, McBride, Jeffrey M. and McCaulley, Grant O.. (2009). Power-time, force-time, and velocity-time curve analysis of the countermovement jump: Impact of training. Journal of Strength and Conditioning Research. 23(1), pp. 177 - 186. https://doi.org/10.1519/JSC.0b013e3181889324
Acute hormonal and neuromuscular responses to hypertrophy, strength and power type resistane exercise
McCaulley, Grant O., McBride, Jeffrey M., Cormie, Prue, Hudson, Matthew B., Nuzzo, James L., Quindry, John C. and Triplett, N. Travis. (2009). Acute hormonal and neuromuscular responses to hypertrophy, strength and power type resistane exercise. European Journal of Applied Physiology. 105(5), pp. 695 - 704. https://doi.org/10.1007/s00421-008-0951-z
Comparison of methods to quantify volume during resistance exercise
McBride, Jeffrey M., McCaulley, Grant O., Cormie, Prue, Nuzzo, James L., Cavill, Michael J. and Triplett, N. Travis. (2009). Comparison of methods to quantify volume during resistance exercise. Journal of Strength and Conditioning Research. 23(1), pp. 106 - 110. https://doi.org/10.1519/JSC.0b013e31818efdfe
Does an optimal load exist for power training?
Cormie, Prue and Flanagan, Sean P.. (2008). Does an optimal load exist for power training? Strength and Conditioning Journal. 30(2), pp. 67 - 69. https://doi.org/10.1519/SSC.0b013e31816a8776
Trunk muscle activity during stability ball and free weight exercises
Nuzzo, James L., McCaulley, Grant O., Cormie, Prue, Cavill, Michael J. and McBride, Jeffrey M.. (2008). Trunk muscle activity during stability ball and free weight exercises. Journal of Strength and Conditioning Research. 22(1), pp. 95 - 102. https://doi.org/10.1519/JSC.0b013e31815ef8cd
Influence of preactivity and eccentric muscle activity on concentric performance during vertical jumping
McBride, Jeffrey M., McCaulley, Grant O. and Cormie, Prue. (2008). Influence of preactivity and eccentric muscle activity on concentric performance during vertical jumping. Journal of Strength and Conditioning Research. 22(3), pp. 750 - 757. https://doi.org/10.1519/JSC.0b013e31816a83ef
Relationship between countermovement jump performance and multijoint isometric and dynamic tests of strength
Nuzzo, James L., McBride, Jeffrey M., Cormie, Prue and McCaulley, Grant O.. (2008). Relationship between countermovement jump performance and multijoint isometric and dynamic tests of strength. Journal of Strength and Conditioning Research. 22(3), pp. 699 - 707. https://doi.org/10.1519/JSC.0b013e31816d5eda
Power-time, force-time, and velocity-time curve analysis during the jump squat: Impact of load
Cormie, Prue, McBride, Jeffrey M. and McCaulley, Grant O.. (2008). Power-time, force-time, and velocity-time curve analysis during the jump squat: Impact of load. Journal of Applied Biomechanics. 24(2), pp. 112 - 120. https://doi.org/10.1123/jab.24.2.112
Neuromuscular and endocrine responses of elite players during an Australian rules football season
Cormack, Stuart John, Newton, Robert U., McGuigan, Michael R. and Cormie, Prue. (2008). Neuromuscular and endocrine responses of elite players during an Australian rules football season. International Journal of Sports Physiology and Performance. 3(4), pp. 439 - 453. https://doi.org/10.1123/ijspp.3.4.439
The influence of body mass on calculation of power during lower-body resistance exercises
Cormie, Prue, McBride, Jeffrey M. and McCaulley, Grant O.. (2007). The influence of body mass on calculation of power during lower-body resistance exercises. Journal of Strength and Conditioning Research. 21(4), pp. 1042 - 1049. https://doi.org/10.1519/R-21636.1
Mechanical efficiency during repetitive vertical jumping
McCaulley, Grant O., Cormie, Prue, Cavill, Michael J., Nuzzo, James L., Urbiztondo, Zea G. and McBride, Jeffrey M.. (2007). Mechanical efficiency during repetitive vertical jumping. European Journal of Applied Physiology. 101(1), pp. 115 - 123. https://doi.org/10.1007/s00421-007-0480-1
Optimal loading for maximal power output during lower-body resistance exercises
Cormie, Prue, McCaulley, Grant O., Triplett, N. Travis and McBride, Jeffrey M.. (2007). Optimal loading for maximal power output during lower-body resistance exercises. Medicine and Science in Sports and Exercise. 39(2), pp. 340 - 349. https://doi.org/10.1249/01.mss.0000246993.71599.bf
Methodological concerns for determining power output in the jump squat
Cormie, Prue, Deane, Russell and McBride, Jeffrey M.. (2007). Methodological concerns for determining power output in the jump squat. Journal of Strength and Conditioning Research. 21(2), pp. 424 - 430. https://doi.org/10.1519/R-19605.1
Power versus strength-power jump squat training: Influence on the load-power relationship
Cormie, Prue, McCaulley, Grant O. and McBride, Jeffrey M.. (2007). Power versus strength-power jump squat training: Influence on the load-power relationship. Medicine and Science in Sports and Exercise. 39(6), pp. 996 - 1003. https://doi.org/10.1097/mss.0b013e3180408e0c
Validation of power measurement techniques in dynamic lower body resistance exercises
Cormie, Prue, McBride, Jeffrey M. and McCaulley, Grant O.. (2007). Validation of power measurement techniques in dynamic lower body resistance exercises. Journal of Applied Biomechanics. 23(2), pp. 103 - 118. https://doi.org/10.1123/jab.23.2.103
Acute effects of whole-body vibration on muscle activity, strength, and power
Cormie, Prue, Deane, Russell, Triplett, N. Travis and McBride, Jeffrey M.. (2006). Acute effects of whole-body vibration on muscle activity, strength, and power. Journal of Strength and Conditioning Research. 20(2), pp. 257 - 261. https://doi.org/10.1519/R-17835.1
Isometric squat force output and muscle activity in stable and unstable conditions
McBride, Jeffrey M., Cormie, Prue and Deane, Russell. (2006). Isometric squat force output and muscle activity in stable and unstable conditions. Journal of Strength and Conditioning Research. 20(4), pp. 915 - 918. https://doi.org/10.1519/R-19305.1
Anthropometric and physical abilities profiles: US National Skeleton Team.
Sands, William A., Smith, L. Sarah L., Kivi, Derek M. R., McNeal, Jeni R., Dorman, Jason, Stone, Michael H. and Cormie, Prue. (2005). Anthropometric and physical abilities profiles: US National Skeleton Team. Sports Biomechanics. 4(2), pp. 197 - 214. https://doi.org/10.1080/14763140508522863