Co-creating and Implementing a Community-Based Peer-Assisted Physical Activity Program to Promote Exercise and Sport Participation after Moderate-to-Severe Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of death and disability around the world, and moderate-to-severe TBI may result in long-term or lifelong sequelae that prevent individuals from returning to a pre-injury way of functioning. Physical activity (PA; e.g., exercise and sport) demonstrates the potential to alleviate some of this burden through meaningful health-improving activities that are positive for mood, community participation, and quality of life after moderate-to-severe TBI. However, adults with moderate-to-severe TBI do not participate in recommended amounts of PA. Therefore, establishing best-practice methods to support PA participation in the community after moderate-to-severe TBI is warranted for the purpose of improving long-term outcomes. This doctoral dissertation addresses that gap with (1) a scoping review of the current literature about community-based PA interventions after moderate-to-severe TBI, (2) an exploratory case study of an existing peer-based PA program being piloted in a YMCA fitness centre, (3) an interpretive case study of co-creating a tailored peer-based PA program with key stakeholders, and (4) an interpretative phenomenological analysis of COVID-19’s impact on program participants and their PA. Results showed (1) community-based PA interventions can lead to significant improvements in health-related outcomes after moderate-to-severe TBI, but further research is needed with sex and gender considerations, telehealth applications, and better intervention reporting; (2) the inner mechanisms of a peer-based PA program from the perspective of multiple stakeholders and the autonomy-supportive approaches needed to tailor the intervention for future users; (3) how the participation in and co-creation of a new optimized community-based peer-assisted program can increase PA autonomy, reduce PA barriers, and lead to important biopsychosocial benefits; and (4) the profound impact of COVID-19 and necessary considerations to support PA in a pandemic after moderate-to-severe TBI. Findings of this dissertation include implications for the rehabilitation sciences and literature. Integrated knowledge transfer approaches to co-creating a peer-based PA program in the community can lead to the co-production of knowledge between researchers and users, who benefit from health promotion opportunities that further their participation in society. Peer-based PA programs can transcend rehabilitation to the community context with positive health behaviours that extend beyond a formal intervention.

Department dc:contributor.department

Rehabilitation Science

Year dc:date.issued

2023

Author dc:creator

• Quilico, Enrico L.

Advisors dc:contributor.advisor

• Colantonio, Angela
• Swaine, Bonnie

• Community
• Exercise
• Peer
• Physical Activty
• Sport
• Traumatic Brain Injury

Statement dc:rights

• Attribution-NonCommercial-NoDerivatives 4.0 International

Licence dc:rights.uri

• http://creativecommons.org/licenses/by-nc-nd/4.0/

Handle dc:identifier.uri

http://hdl.handle.net/1807/127917

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/127917