{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:12:06Z","timestamp":1747149126884,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031198","name":"Department of Health, Government of Western Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031198","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009317","name":"Faculty of Health and Medical Sciences, University of Western Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009317","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Prom J of Aust"],"published-print":{"date-parts":[[2024,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The ComEx3 community\u2010based extended maintenance pulmonary rehabilitation (PR) randomised controlled trial (RCT) aimed to determine the optimal strategy for maintaining the benefits of exercise for people with chronic obstructive pulmonary disease (COPD). We conducted a process evaluation of this RCT to determine if the trial was implemented per protocol, and to explore the barriers and facilitators of the trial, and mechanisms of impact.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a mixed methods study consisting of analysis of PR class records, study diaries and interviews of those involved in the trial. We developed a reporting framework from available literature and performed a content analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>Eleven of the 12 participants in the intervention group attended \u226570% of available classes before the trial was terminated due to the COVID\u201019 pandemic. Analysis of the study diaries found that adherence to the home exercise program was higher in the intervention than the control group. Analyses of interviews (n\u2009=\u200921) highlighted the complexity of standardising the processes across multiple sites, but revealed behaviour change amongst class physiotherapists who were able to conform with the required processes. Facilitators of participation included the desire to improve function and quality of life, while barriers included illnesses and lack of motivation. Mechanisms of impact included confidence in exercising and benefits from the education sessions.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The ComEx3 RCT was implemented as planned largely due to commitment by the research team and the desire by patients to improve their quality of life by attending a PR program that they are familiar with. Successful implementation of PR RCTs requires good organisational skills, clear and consistent trial documentation, broad understanding of participant needs while being conscious of challenges experienced by people with COPD, and dedication by everyone involved in the RCT.<\/jats:p><\/jats:sec>So What?<\/jats:title>This article shows the importance of running a process evaluation alongside an RCT. Although this RCT did not progress to completion, this process evaluation which was guided by a robust framework, will provide guidance for future interventions in this area.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hpja.860","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T08:14:02Z","timestamp":1712564042000},"page":"1263-1273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Process evaluation of a maintenance pulmonary rehabilitation trial for people with chronic obstructive pulmonary disease"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0677-0420","authenticated-orcid":false,"given":"Derrick","family":"Lopez","sequence":"first","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Jenkins","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"},{"name":"Physiotherapy Department Sir Charles Gairdner Hospital Nedlands Western Australia Australia"},{"name":"Institute for Respiratory Health Perth Western Australia Australia"},{"name":"School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nola","family":"Cecins","sequence":"additional","affiliation":[{"name":"Physiotherapy Department Sir Charles Gairdner Hospital Nedlands Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8163-9612","authenticated-orcid":false,"given":"Cecily","family":"Strange","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Cockram","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"},{"name":"Community Physiotherapy Services Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Collins","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"},{"name":"Community Physiotherapy Services Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Landers","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"},{"name":"North Metropolitan Health Services Nedlands Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5125-2820","authenticated-orcid":false,"given":"Barbara","family":"Nattabi","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia Crawley Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,8]]},"reference":[{"volume-title":"Chronic obstructive pulmonary disease: COPD","year":"2023","author":"Australian Institute of Health and 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