Date of Award
Fall 11-2-2026
Document Type
Dissertation
Degree Name
Doctor of Kinesiology (EdD)
Department
Kinesiology
First Advisor
Andrew Mock
Second Advisor
Thomas Hammett
Third Advisor
Sheila Hautbois
Abstract
This action research study examined implementation of a clinician-led framework for identifying adults not participating in safe, structured, progressive resistance training; assessing readiness; addressing barriers; and referring appropriate patients to qualified medical fitness professionals. The intervention integrated the Transtheoretical Model, Motivational Interviewing, and COM-B and used a decision tree, barriers guide, referral procedures, logs, reflection meetings, and surveys. Ten clinicians, seven physicians and three nurse practitioners, implemented the framework across varied practice settings during a 12-week intervention with three action research cycles. Quantitative data were analyzed descriptively, and qualitative data were examined using descriptive thematic analysis. Clinicians documented 338 patient interactions and 35 referrals (10.4%); 20 referred patients agreed to an initial consultation (57.1% follow-through). Implementation varied: readiness was not always classified specifically for progressive resistance training, barrier documentation was incomplete, and tool and referral use was inconsistent. Cross-cycle findings showed that practice context and workflow burden shaped fidelity; clinicians sometimes reverted to usual care; referral required more than a recommendation; and training, technology, infrastructure, and experience were important supports. The findings provided implementation and feasibility evidence rather than proof of effectiveness. A supported Assess-Prescribe-Refer framework was proposed, embedding behavior-specific assessment, stage-appropriate communication, training, trackable referral, follow-up, and bidirectional communication throughout the process.