Evaluation of the Happy Child Program: a randomized study in 30 Brazilian municipalities. / Avaliação do Programa Criança Feliz: um estudo randomizado em 30 municípios brasileiros.

The Happy Child Program (Programa Criança Feliz - PCF, in Portuguese) reaches 1.4 million Brazilian children under three years of age with home visits aimed at promoting neuropsychomotor development. Based on a conceptual model, PCF implementation and impact were evaluated in a randomized study in 30 municipalities. A total of 3,242 children were allocated to the intervention (IG) or control (CG) group, 80.0% of whom were prospectively followed up from late 2018 to late 2021. Development was assessed by the Ages and Stages Questionnaire (ASQ3). During the three-year study period, visits were replaced by virtual contacts for an average of 12 months due to COVID-19. At the endline survey, intent-to-treat analyses showed mean scores of 203.3 in the IG and 201.3 in the CG. Additional analyses using instrumental variables and propensity scores matching also showed no effect, since the number of contacts with the program was not associated with ASQ3 scores. No impact was observed on stimulation, responsive interactions or psychological attributes of children. The implementation study revealed low coverage in the IG, contamination of the CG, deficiencies in management and low quality of visits in many municipalities. The study did not demonstrate an impact of PCF implemented under routine conditions, but provides elements for its improvement.

O Programa Criança Feliz (PCF) atinge 1,4 milhão de crianças brasileiras menores de três anos com visitas domiciliares visando o desenvolvimento neuropsicomotor. Com base em modelo conceitual, avaliou-se implementação e impacto do PCF em estudo randomizado, em 30 municípios. Ao todo 3.242 crianças foram alocadas para o grupo intervenção (GI) ou controle (GC), sendo 80,0% acompanhadas prospectivamente durante três anos. O desenvolvimento foi avaliado pelo Ages and Stages Questionnaire (ASQ3). Análises por intenção de tratar mostraram escores médios de 203,3 no GI e 201,3 no GC. Análises adicionais com variáveis instrumentais e emparelhamento por escores de propensão tampouco mostraram efeito, uma vez que o número de contatos recebidos não esteve associado aos escores ASQ3. Tampouco foi observado impacto sobre estimulação, interações responsivas ou atributos psicológicos das crianças. As visitas foram interrompidas durante 12 meses devido à COVID-19, sendo substituídas por contatos virtuais. O estudo de implementação revelou baixa cobertura no GI, contaminação do GC, deficiências na gestão e baixa qualidade das visitas em muitos municípios. O estudo não demonstrou impacto do PCF implementado sob condições de rotina e fornece elementos para seu aprimoramento.

First Year Outcomes: Program Evaluation of a Statewide Nurse Residency Program.

In New Jersey, a statewide nurse residency program was implemented using an apprenticeship model. The pandemic created disruption to registered nurse residency programs. This included rapid restructuring of program delivery to online methods and a need to adapt curricula to reflect changing practice and guidelines. As a result of the pandemic, new graduates had educational gaps and nurse leaders experienced staffing shortages. First year program outcomes demonstrated a 90% retention of new graduates and financial benefits for organizations participating in the statewide nurse residency program.

[Resilient Children: Evaluation of a Programme to Promote Resilience in Kindergarten and Elementary School]. / Resiliente Kinder: Evaluation eines Programms zur Förderung der Resilienz in der Elementar- und Primarpädagogik.

In the project "Resilient Children", a resilience promotion program for kindergartens and elementary schools was directly applied and evaluated during the COVID-19-crisis.The aim of the study was to strengthen the three sources of resilience according to Grotberg (1995) I HAVE, I AM and I CAN through targeted exercises and resilience-promoting communication (transfer to everyday life). Additionally, gender differences with regard to the effect of the programme were addressed. "Resilient Children" was evaluated at the impact level (pre-post design) and process level. Eight kindergartens and three elementary schools with 125 children participated. A total of 122 teachers and 70 parents provided information about the children. The results at the impact level showed that from the parent and teacher perspective, and from the self-perspective (children), the three sources of resilience were significantly strengthened. With regard to gender differences, the results from the perspective of teachers and parents showed that girls were characterised by greater changes than boys. Compared to the girls, the physical andmental well-being of the boys improved fromthe parents' point of view. The results of the process evaluation revealed a high level of motivation and enthusiasm for participation in the programme on the part of participating children and teachers. The success of "Resilient Children" depends on the identification of the teachers with the program.

Benefits of participation in a community of practice focused on evaluation and programmatic improvement for environmental educators.

One of the biggest challenges environmental education (EE) practitioners face is having timely and systematically-collected evaluation data to inform the design and improvement of existing programs. One potential way to provide systematic evaluations of programs and build evaluation capacity for practitioners is through a facilitated community of practice (CoP). We developed a CoP involving 37 organizations who were pivoting to online EE programs within the United States due to the COVID-19 pandemic. Our goals were to build organizational capacity in evaluation and adaptive management to improve these organizations' online EE programs. We describe our CoP design, challenges associated with its implementation, and the benefits reported by participants in the CoP. Participants reported that they improved their evaluation skills and attitudes towards evaluation and developed social capital with a new network of colleagues. They also reported positive changes in practice, both individually and organizationally; considered new outcomes for their programs; and learned about using evaluation data to systematically improve programs. Educators shared their learning both within and outside of their organizations. Those who were more regularly involved in this community reported more positive benefits than others who were less involved. We share our reflections on the process and make suggestions for other evaluators to consider in similar CoP designs.

Valuing adaptive programming: A study of resilience processes and outcomes.

Recent decades have seen a growth in theoretical frameworks focusing on systems, context and the dynamic interplay of multiple variables, stimulating interest in complementary research and programme evaluation methods. With resilience theory now emphasising the complex and dynamic nature of resilience capacities, processes and outcomes, resilience programming stands to benefit from approaches such as design-based research and realist research/evaluation. The aim of this collaborative (researcher/practitioner) study was to explore how such benefits can be achieved when programme theory spans individual, community and institutional outcomes, with a focus on the reciprocal processes involved in effecting change across the social system. The context of the research was a regional (Middle East and North Africa) project operating in contexts with an escalated risk of marginalised young people being drawn into illegal/harmful activity. The project's youth engagement and development approach combined participatory learning, skills training, and collective social action, adapted for diverse localities and during the COVID-19 crisis. Quantitative measures of individual and collective resilience were at the centre of a set of realist analyses evidencing systemic connections in changes to individual, collective and community resilience. Findings demonstrated the value, challenges and limitations of the applied research approach for adaptive, contextualised programming.

MCH Leadership Training Program: An Innovative Application of an Implementation Science Framework.

INTRODUCTION: MCH training programs in schools of public health provide specialized training to develop culturally competent and skilled MCH leaders who will play key roles in public health infrastructure. Previous literature has reported on the effectiveness of MCH training programs (e.g., number of trainees, improvement in knowledge/skills); less attention has been devoted to understanding factors influencing program implementation during times of rapid change, while considering internal and external contexts (e.g., global pandemic, social unrest, uncertainty of funding, mental health issues, and other crises). PURPOSE: This article describes a graduate-level MCH leadership training program and illustrates how an implementation science framework can inform the identification of determinants and lessons learned during one year of implementation of a multi-year program. ASSESSMENT: Findings reveal how CFIR can be applicable to a MCH training program and highlight how constructs across domains can interact and represent determinants that serve as both a barrier and facilitator. Key lessons learned included the value of accountability, flexibility, learner-centeredness, and partnerships. CONCLUSION: Findings may apply to other programs and settings and could advance innovative training efforts that necessitate attention to the multi-level stakeholder needs (e.g., student, program, institution, community, and local/regional/national levels). Applying CFIR could be useful when interpreting process and outcome evaluation data and transferring findings and lessons learned to other organizations and settings. Integrating implementation science specifically into MCH training programs could contribute to the rigor, adaptability, and dissemination efforts that are critical when learning and sharing best practices to expand leadership capacity efforts that aim to eliminate MCH disparities across systems.

An Early Evaluation of Remote Site Visits for ACGME Program Applications.

Background: Prior to the COVID-19 pandemic, accreditation site visit interviews occurred in-person. In response to the pandemic, the Accreditation Council for Graduate Medical Education (ACGME) developed a remote site visit protocol. Objective: To perform an early assessment of the remote accreditation site visits for programs applying for initial ACGME accreditation. Methods: A cohort of residency and fellowship programs that had remote site visits was evaluated from June to August 2020. Surveys were sent to program personnel, ACGME accreditation field representatives, and executive directors following the site visits. Comparison of accreditation decisions (Initial Accreditation or Accreditation Withheld) was completed for matched residency or fellowship programs having in-person site visits in 2019. Results: Surveys were sent to all program personnel from the 58 residency and fellowship programs that had remote site visits for new program applications, as well as the accreditation field representatives who performed the remote visits. The survey response rate was 58% (352 of 607). Ninety-one percent of all respondents were extremely or very confident that remote site visits provided a thorough assessment of proposed residency or fellowship programs. Fifty-four programs having remote site visits were matched by specialty to programs having had in-person program application site visits in 2019. Forty-six programs that had remote site visits received Initial Accreditation, and 52 programs that had in-person site visits in 2019 received Initial Accreditation (P=.093, 95% CI 0.91-22.38). Conclusions: Most program personnel and accreditation field representatives were confident that remote site visits conducted for program applications provided fair and thorough assessments of the program.

D.A.R.E./keepin' it REAL elementary curriculum: Substance use outcomes.

In response to a need to implement an evidence-based prevention program, D.A.R.E. America adopted keepin' it REAL. The program was previously developed and tested in middle school settings. As part of its adoption, an elementary version of the program was developed. This study tests the effectiveness of keepin' it REAL when delivered to fifth graders. The intervention was delivered to two cohorts of students, the first in the 2019-2020 school year, the second in the 2020-2021 school year. Pretest surveys were completed by 6,122 students. The COVID-19 pandemic interfered with posttest and follow-up data collection. At immediate posttest, 2,049 students (33.5%) completed analyzable posttest surveys. One year after the pretest, 1,486 (24.3%) students completed usable follow-up surveys. We used algorithmically generated cases (virtual controls) that use treatment cases' pretest psychosocial scores to assess program effectiveness. When compared to virtual control cases, the program had identifiable improvements in both a key psychosocial measure and in terms of deterring the onset of 30-day alcohol use, drunkenness, and vaping. Outcomes suggest that the delivery of elementary school keepin' it REAL by D.A.R.E. officers is having a positive effect in terms of deterring the onset of alcohol use and vaping.

Lessons learnt from a scientific peer-review training programme designed to support research capacity and professional development in a global community.

High-quality peer-reviewer training open to researchers across the globe has the potential to improve the published literature, however, this type of training is not widely available. In this paper, we describe an online peer-reviewer training programme, highlight its effectiveness in building peer review and writing skills, and discuss challenges and lessons learnt. This training programme, open to researchers across the globe, acquaints participants with challenges to and inequities in publishing and educates them about writing effective peer reviews. A focal point is how to provide specific and respectful feedback to help authors get accepted for peer review at an academic journal. Forty-nine participants from or residing in six continents completed the training. All programme evaluation respondents agreed that the orientation helped them gain a better understanding of their role as a peer reviewer at Pre-Publication Support Service. Most agreed that the training was helpful in improving their peer-review skills, and that the training was helpful in improving their writing skills. Participants wanted more networking and collaboration opportunities with other peer reviewers, inclusion of a qualitatively researched example paper and improved communication about the required time commitment. Our online programme with multiple time options was geographically inclusive but internet connectivity was challenging for some participants. Peer-reviewer training programmes can help researchers build their peer review and writing skills and enhance participants' understanding of disparities in publishing. Integrating a geographically diverse group of researchers has the potential to enrich the discussions and learning in such a programme.

Evaluation of a COVID-19 rapid antigen testing program among student athletes in a public high school district.

PURPOSE: The purpose of this study is to evaluate a COVID-19 rapid antigen testing program among high school athletes through testing data and qualitative analysis from key stakeholders. METHODS: Testing data was obtained by the partnering school district. Testing staff, coaches, and parents participated in a focus group using a semi-structured focus group guide. Transcripts were analyzed using a grounded theory approach to produce the themes of the study. RESULTS: Rapid antigen tests quickly identified a COVID-19-positive student athlete, which allowed for quick isolation and zero transmission to teammates. Focus groups with parents, testing staff, and coaches indicated the testing program improved perceived safety and demonstrated the ability for school staff to implement a widespread COVID-19 screening program with minimal training. CONCLUSIONS: As schools continue to respond to various waves of COVID-19 infections, targeted testing for high-risk activities in school settings such as sports programs may help prevent school outbreaks during times of high community transmission rates. This evaluation adds to a body of literature that will aid schools and policy makers in their decision on how to best keep student athletes and school communities safe for future waves of COVID-19 infection and other pandemics.

Usability of a new digital walking program for older adults: a pilot study.

BACKGROUND: Walking has been emphasized as an important solution for preventing isolation among older adults, especially given the coronavirus disease 2019 (COVID-19) pandemic, and various methods are being proposed to promote walking in this population. In this study, a walking exercise program for the elderly was developed using various latest technologies, and the effectiveness and influencing factors of the program were evaluated. METHOD: The walking program for older adults was designed using mHealth devices, social media application, and gamified elements to prevent isolation. Twelve participants were recruited via an online community of retired individuals. This one-year study involved a one-group repeated measures experimental design; an online questionnaire was conducted four times along with a focus group interview. RESULT: The results showed that the e-health literacy of the 12 participants increased, while Wearable Device App Literacy/Usability, digital health self-efficacy, and walking program evaluation showed a decline. In the focus group interview, participants expressed their appreciation for this program, ways to overcome its limitations, and expectations for the next program. CONCLUSION: This study confirmed the positive effect of the online walking program for retired older adults, indicating that an online-offline convergence program suitable for the "COVID-19 era" will be necessary in the future.

Evaluation of a workplace suicide prevention program in the Australian manufacturing industry: protocol for a cluster-randomised trial of MATES in manufacturing.

Males are at higher risk of death by suicide than females in Australia, and among men, blue-collar males are at higher risk compared to other working males. In response, MATES in Construction developed a workplace suicide prevention program for the construction sector in 2007 that has been widely implemented in Australia. In the current project, this program is being adapted and trialled in the manufacturing sector. The common aims of MATES programs are to improve suicide prevention literacy, help-seeking intentions, and helping behaviours. The program will be evaluated using a cluster randomised-controlled trial design with waitlist controls across up to 12 manufacturing worksites in Australia. We hypothesise that after 8 months of the MATES in Manufacturing program, there will be significantly greater improvements in help-seeking intentions (primary outcome) compared to waitlist controls. The project is led by Deakin University in collaboration with the University of Melbourne, and in partnership with MATES in Construction and a joint labour-management Steering Group.Trial registration: The trial was registered retrospectively with the Australian New Zealand Clinical Trials Registry on 25 January 2022 (ACTRN12622000122752).Protocol version: 2.0, November 2022.

Evaluation of eHealth assistance in-hospital care for improved quality of life in patients.

Health conditions contribute significantly to patients' quality of life. Healthcare infrastructure and healthcare services, including their accessibility, belong to objective factors influencing their perception of their health. The growing disparity between supply and demand for specialized inpatient facilities due to the aging population calls for new solutions, including eHealth technologies. Automatized activities could be taken over by eHealth technologies that do not require a constant presence of staff. We tested whether eHealth technical solutions reduce patients' health risks on a sample of 61 patients on the covid-19 unit in Tomas Bata hospital in Zlin. We have applied the randomized control trial to select patients for the treatment and the control groups. Moreover, we tested eHealth technologies and their help to staff in the hospital. Due to the severity of the covid-19 disease and its rapid course and the size of the sample in our research, we did not demonstrate a statistically significant impact of eHealth technologies on patient health. The evaluation results confirm that even the limited number of technologies deployed proves to be an effective help for staff in critical situations like the pandemic. The main issue is psychological support to staff in hospitals and relieving stressful work.

Parental decision-making on summer program enrollment: A mixed methods Covid-19 impact study.

BACKGROUND: The closure of childcare organizations (e.g. schools, childcare centers, afterschool programs, summer camps) during the Covid-19 pandemic impacted the health and wellbeing of families. Despite their reopening, parents may be reluctant to enroll their children in summer programming. Knowledge of the beliefs that underlie parental concerns will inform best practices for organizations that serve children. METHODS: Parents (n = 17) participated in qualitative interviews (October 2020) to discuss Covid-19 risk perceptions and summer program enrollment intentions. Based on interview responses to perceived Covid-19 risk, two groups emerged for analysis- "Elevated Risk (ER)" and "Conditional Risk (CR)". Themes were identified utilizing independent coding and constant-comparison analysis. Follow-up interviews (n = 12) in the Spring of 2021 evaluated the impact of vaccine availability on parent risk perceptions. Additionally, parents (n = 17) completed the Covid-19 Impact survey to assess perceived exposure (Range: 0-25) and household impact (Range: 2-60) of the pandemic. Scores were summed and averaged for the sample and by risk classification group. RESULTS: Parents overwhelmingly supported the operation of summer programming during the pandemic due to perceived child benefits. Parent willingness to enroll their children in summer programming evolved with time and was contingent upon the successful implementation of safety precautions (e.g. outdoor activities, increased handwashing/sanitizing of surfaces). Interestingly, parents indicated low exposure (ER: Avg. 6.3 ± 3.1 Range [2-12], CR: Avg. 7.5 ± 3.6 Range [1-14]) and moderate family impact (ER: Avg. 27.1 ± 6.9 Range [20-36], CR: Avg. 33.7 ± 11.4 Range [9-48]) on the impact survey. CONCLUSION: Childcare organizations should mandate and evaluate the implementation of desired Covid-19 safety precautions for their patrons.

Evaluation of a Trauma-Informed Parenting Program for Resource Parents.

Child maltreatment impacts many young people involved in the child welfare system, and it is important that the resource parents supporting these youth have knowledge and skills in trauma-informed care. The current study is a preliminary evaluation of the Resource Parent Curriculum (RPC), an in-service, 8-module, group-based parenting program developed by the National Child Traumatic Stress Network. Youth and caregiver outcomes were examined by way of a quasi-experimental design that included 22 resource parents in the experimental group and 21 in the waitlist control group and involved baseline, post-program, and 2-month follow-up assessments. For learning outcomes, RPC resulted in improvements in resource parents' knowledge and beliefs about trauma-informed parenting. While not statistically significant, potential effects included improvements in resource parents' tolerance of challenging youth behaviors and parenting self-efficacy. For behavioral outcomes, several non-significant potential effects were noted, including improvements in resource parents' attachment relationships with their youth and increased social supports. This study was the first to evaluate RPC using a quasi-experimental design within a Canadian context and through a virtual delivery. Findings highlighted several benefits of the program and resource parents' ongoing training needs.

Effects of the ECHO tele-mentoring program on HIV/TB service delivery in health facilities in Zambia: a mixed-methods, retrospective program evaluation.

BACKGROUND: In the quest to ensure that quality healthcare is provided to all citizens through building healthcare worker capacity and extending reach for expert services, Zambia's Ministry of Health (MoH) in collaboration with its partners PEPFAR through the CDC and HRSA, began to implement the Extension for Community Healthcare Outcomes (ECHO) tele-mentoring program across the country through the Health Workers for the 21st Century (HW21) Project and University Teaching Hospital HIV/AIDS Project (UTH-HAP). This ECHO tele-mentoring approach was deemed pivotal in helping to improve the human immunodeficiency virus (HIV) service delivery capacity of health care workers. METHOD: The study used a mixed method, retrospective program evaluation to examine ECHO participants' performance in the management of HIV/AIDS patients in all the 10 provinces of Zambia. CASE PRESENTATION: A phenomenological design was applied in order to elicit common experiences of ECHO users through focus group discussions using semi-structured facilitation guides in four provinces (Eastern, Lusaka, Southern and Western) implementing ECHO tele-mentoring approach. These provinces were purposively selected for this study. From which, only participants that had a monthly frequency of ECHO attendance of ten (10) and above were selected. The participants were purposively selected based on the type of cadre as well as facility type so that the final sample consisted of Doctors, Nurses, Midwives, Clinical Officers, Medical Licentiates, Pharmacy and Laboratory Personnel. All sessions were audio recorded and transcribed by the data collectors. A thematic content analysis approach was adopted for analyzing content of the interview's transcripts. RESULTS: Enhanced knowledge and skills of participants on HIV/TB improved by 46/70 (65.7%) in all provinces, while 47/70 (67.1%) of the participants reported that ECHO improved their clinical practice. Further, 12/70 (17.1%) of participants in all provinces reported that presenter/presentation characteristics facilitated ECHO implementation and participation. While, 15/70(21.4%) of the participants reported that ownership of the program had contributed to ECHO implementation and participation. Coordination, another enabler accounted for 14/70 (20%). Inclusiveness was reported as a barrier by 16/70 (22.8%) of the participants while 6/70 (8.6%) of them reported attitudes as a barrier (8.6%) to ECHO participation. In addition, 34/70 (48.6%) reported poor connectivity as a barrier to ECHO implementation and participation while 8/70 (11.5%) of the participants reported that the lack of ownership of the ECHO program was a barrier. 22/70 (31.4%) reported that increased workload was also a barrier to the program's implementation. CONCLUSION: Consistent with its logical pathway model, healthcare providers' participation in ECHO sessions and onsite mentorship contributed to improved knowledge on HIV/TB among health care providers and patient health outcomes. In addition, barriers to ECHO implementation were intrinsic to the program its self, such as coordination, presenter and presentation characteristics other barriers were extrinsic to the program such as poor connectivity, poor infrastructure in health facilities and negative attitudes towards ECHO. Improving on intrinsic factors and mitigating extrinsic factors may help improve ECHO outcomes and scale-up plans.

Pilot evaluation of a virtual training program for child injury prevention.

Unintentional injuries are a leading cause of child death. The present study evaluated the effectiveness of a behavioral injury prevention program for children aged 3-18 years and their caregivers. To accommodate families during the Coronavirus-19 pandemic, training was modified to be delivered virtually. Forty-one children aged 3-18 years and 14 parents/caregivers of children aged 3-5 years attended one of several 4-hour online injury prevention training sessions directed toward residents of Washington state. Training was targeted to three different developmental stages (ages 3-5, 6-12 and 13-18 years). Study outcomes included knowledge about injury prevention strategies, perceived vulnerability for injury, self-efficacy to engage in safety behaviors and behavioral intentions to be safe. Following training, participants showed improved self-efficacy to stay safe, excellent knowledge about the learned material and increased behavioral intention to engage safely. There was minimal change in perceived vulnerability to injury among children; caregivers of young children felt their children were somewhat less vulnerable to injury following the training. Almost all participants said they would recommend the program to others. Results suggest that a virtual behavioral training program delivered remotely is feasible and may be effective to create behavior change and reduce child injury risk. Given its scalability and reach, such programs are recommended for further study, refinement and, if demonstrated effective in larger-scale controlled trials, dissemination to address the leading cause of child mortality in the United States, unintentional injury.

Adapting Geriatric Day Hospital Care From an In-House to Outreach Process.

Outpatient programs have been challenged to find ways to deliver services while adhering to coronavirus disease protocols. Our Geriatric Day Hospital (GDH) Falls Clinic changed from a 6-week in-house program to an outreach program incorporating telephone assessments and home visits. We evaluated whether the outreach program was effective in improving patient outcomes in 23 serially enrolled clients. Statistically significant gains were achieved with falls, Berg Balance Scale scores, functional reach measurements, and pain management scores. Access to social support from family or friends led to higher implementation of recommendations. There was an inability to predict which clients would improve from an outreach program, but it was evident that the program benefited some clients and provided a viable alternative to an in-person program. [Journal of Gerontological Nursing, 49(4), 33-38.].

Utilising telehealth to support exercise and physical activity in people with Parkinson disease: a program evaluation using mixed methods.

BACKGROUND: Physical activity and exercise play a key role in managing Parkinson disease. This study aimed to: 1) determine if physiotherapy supported by telehealth helped people with Parkinson disease (PwP) to adhere to a home-based exercise program and maintain their physical activity; and 2) understand their experiences of using telehealth during the COVID-19 pandemic. METHODS: A mixed methods program evaluation involving a retrospective file audit from a student-run physiotherapy clinic and semi-structured interviews exploring participants' experiences of telehealth. Ninety-six people with mild to moderate disease received home-based telehealth physiotherapy for 21 weeks. The primary outcome was adherence to the prescribed exercise program. Secondary outcomes were measures of physical activity. Interviews were conducted with 13 clients and seven students and analysed thematically. RESULTS: Adherence to the prescribed exercise program was high. The mean (SD) proportion of prescribed sessions completed was 108% (46%). On average clients spent 29 (12) minutes per session, and 101 (55) minutes per week exercising. Physical activity levels were maintained, with clients taking 11,226 (4,832) steps per day on entry to telehealth, and 11,305 (4,390) steps per day on exit from telehealth. The semi-structured interviews identified important features of a telehealth service required to support exercise; a flexible approach of clients and therapists, empowerment, feedback, a therapeutic relationship, and mode of delivery. CONCLUSIONS: PwP were able to continue exercising at home and maintain their physical activity when physiotherapy was provided via telehealth. The flexible approach of both the client and the service was imperative.