General movements assessment training and implementation in clinical practice: key insights from a mixed-methods study.

Abstract

To support early detection of cerebral palsy, capacity for General Movements Assessment (GMA) needs to be built in Denmark. This study aimed to evaluate the training and implementation of GMA across Danish hospitals. Objectives [1]: to develop a GMA training intervention [2]; to evaluate implementation [3]; to identify key factors for successful implementation. In this multicenter mixed-methods study, physiotherapists participated in GMA courses, in-person workshops, dialogue meetings, and online workshops from May 2023 to November 2024. Data was collected through surveys, field notes, and focus group interviews. Descriptive statistics and thematic analysis were used within the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). (Clinicaltrials.gov NCT05835674). Reach was high across training components. Effectiveness showed high post-training competencies, with median group scores of 70-80 on a 0-100 scale. Adoption was strong, driven by clinical relevance and interdisciplinary recognition. After 18 months, all participants working with infants aged 3-4 months used GMA in clinical practice. Maintenance was supported by a national GMA network. Key factors for sustainable use included video storage, peer-based training, and expert feedback. GMA capacity was successfully built and implemented in clinical practice. Structural support and collaboration were essential for maintenance.