The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study

ReSpAct-group, Femke Hoekstra*, Trynke Hoekstra, Cees P. van der Schans, Florentina J. Hettinga, Lucas H.V. van der Woude, Rienk Dekker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
8 Downloads (Pure)


Purpose: This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients’ physical activity outcomes. Methods: This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients’ physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. Results: 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. Conclusion: After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity).Implications for rehabilitation Physical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities. Establishing “Physical Activity Counseling Centers” is a promising “disability-overarching” strategy to promote physical activity after rehabilitation. Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes. The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice.

Original languageEnglish
Pages (from-to)1710-1721
Number of pages12
JournalDisability and Rehabilitation
Issue number12
Early online date17 Oct 2019
Publication statusPublished - 1 Dec 2021
Externally publishedYes


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