End user evaluation of the Canadian Spinal Cord Injury Physical Activity Guidelines: Barriers and facilitators to uptake and dissemination in the United States

Objective: To engage U.S. end users to (1) gather information on facilitators and barriers to awareness and adoption of the Canadian Spinal Cord Injury (SCI) Physical Activity (PA) guidelines; (2) inform potential adaptations to the presentation and messaging of the guidelines; and (3) develop recommendations for targeted dissemination strategies to promote awareness in the United States. Design: Multi-method. Setting: Working groups conducted remotely via Zoom and online surveys. Participants: Individuals with lived SCI experience (n = 5), providers/clinical researchers (n = 7), and members of SCI professional or community organisations (n = 6). Interventions: N/A. Outcome Measures: N/A. Results: Participants highlighted the need for centralised, credible sources of information on PA. While participants generally viewed the guidelines as appropriate, useable, and acceptable, some questioned their credibility, as they were developed explicitly for Canadians with SCI rather than Americans. To enhance reach and effectiveness, participants suggested dissemination strategies that target specific audiences (i.e. level of functioning, level of injury, current level of PA). They also recommended collaborations with existing trusted community SCI organisations. Conclusion: Findings underscore the need for accessible, centralised, and credible information sources on PA tailored to the needs of the SCI community. Findings also suggest that while the guidelines do not require redevelopment for a U.S. context, they do need customised presentation, such as removing Canadian symbols from the materials, to better suit U.S. audiences. Effective dissemination will benefit from targeted strategies that leverage trusted organisations to reach and engage specific groups, ultimately supporting greater guideline awareness, acceptance, and application across the SCI population.