Specialists in the area of geriatric physiotherapy and remedial therapy will be asked to supply contact information for therapists who might be interested in the study.
The professional organisations of geriatric physiotherapists and remedial therapists will be asked to supply addresses of therapists who might be eligible and interested in the study. Furthermore, addresses of eligible therapists will be obtained from the internet and physiotherapists in the TNO network will be contacted. These will mainly be physiotherapists who have participated in previous studies of training for the elderly.
All therapists will receive an e-mail containing global information about the study. Those therapists who express interest will be contacted by phone and will receive detailed information about the FTE programme, the training and the study protocol. Therapists will be contacted until 15 therapists are found who are eligible to participate in this study. Other interested therapists will be placed on a reserve list.
Strategy 1: training for therapists
The training for the therapists will consist of three components linked to the determinant analyses in Phase 1: FTE principles and how to provide group training for the elderly, recruitment of elderly, and providing FTE in a financially sustainable way. Each topic is described in more detail below.
a) Training in FTE principles
A critical conclusion of our determinant analysis was that therapists need to learn about the FTE approach. Therapists will therefore be taught the principles underlying FTE. The education module incorporates cooperative learning, and feedback and evaluation. FTE principles will be taught first. This includes the theoretical background, as well as the planning of group progress, documentation of individual progress and the use of clinimetric measures to document changes and plan progress. Secondly, the use of FTE will be demonstrated by teachers with 10 or more years of experienced. Thirdly, the therapists will practise FTE skills and using FTE themselves. The therapists will receive feedback from the teachers about their performance. During the training, the therapists will also be made aware of the importance of giving their participants a range of options to remain active after the FTE programme such as joining social, hobby or activity groups that match the personal needs of the participants and encourage them to stay active.
The determinant analysis showed that it was necessary to train knowledge and skills relating to the target population of elderly people because specific skills are required when addressing the problems faced by older people. The training will therefore focus on social, communicational, motivational and safety issues. Therapists will also learn how to provide group training for the elderly. In line with the determinant analysis, the FTE programme will be adapted to the needs of the participants and the circumstances of the therapists’ local settings. However, key activities and the FTE principles in the programme will not be changed.
b) Recruitment of elderly participants
Therapists will receive training and guidance in building community networks for contacting and recruiting the elderly for FTE. Therapists will be made aware of the different ways of contacting the elderly: through GPs, home care, the community, private care, media and so on. The therapists will learn how to develop a network strategy that is adapted to their local situation. After the training, the network strategy will be immediately applicable and ready to use.
c) Business case
It is important for the FTE programme to be delivered in a way that is financially sustainable for both therapists and the elderly. Financial sustainability was found to be a critical determinant reported by the elderly and the therapists: the programme will not be provided routinely if the costs are too high. The therapists will learn how to draw up a business case (a detailed plan of how to implement FTE, including the expected time, costs, financing, and risks) specifically for their own practice. This means that the business case will be immediately applicable and ready to use during and after the training.
Four teachers will be responsible for the training. Each teacher has his/her own specialty, i.e. FTE principles and application, building community networks, business case development, and group training for elderly. The therapists will receive 20 hours of training over three days. Homework assignments relating to each topic covered by the course will be given and the assignments will be discussed on the next day of training. Therapists will spend an average of 20 hours on homework assignments.
Meetings will be at two-week intervals so that therapists have enough time for the assignments and to familiarise themselves with the FTE principles. At the same time, an online forum will be available for asking questions and sharing information. Therapists will receive support during the implementation process to enhance the likelihood of successful implementation.