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Table 3 Mapping behaviour change techniques on key domains, proposed KT interventions and actions

From: Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention

Self-management-TDF barriers (BCTs) KT Intervention Actions
Knowledge
- Patients believe that they know enough about SMS
Behavioural change techniques:
Information regarding behaviour, outcome.
- Standardized materials as tools to introduce the concept of SMS - Context: the majority of patients believe that exercise is the core component of self-management strategies (SMS)
- Aim: to introduce and maximize the patients’ knowledge on SMS
- Opportunities:
• Distribute educational materials to patients summarizing the components of SMS, and emphasizing ways to initiate/sustain life style changes
• Webinar to provide information on SMS
• Provide information on SMS on social media (e.g. Facebook)
Environmental Context and Resources
- Lack of time to use self-management among patients
- Not receiving educational materials
Behavioural change techniques:
(Environmental Changes; Time management)
- Standardized electronic or printed materials as tools for facilitating the use of SMS
- Persuasive communication
- Context: Lack of time is a barrier to using SMS
- Aim: helping patients better manage their time to use SMS
- Opportunity:
• Encouraging patients to seek advice from clinicians/interns on ways to manage their time to be able to use SMS (before going to work/school, at lunch time, going to the gym …)
• Provide patients with educational materials (paper based and e-pamphlets) summarizing the key components of self-management
• Webinar and videos to provide information on SMS
Emotion
- Feeling of anxiety/ frustrating regarding use SMS
Behavioural change techniques:
(Stress Management, Social support (emotional); Coping strategies)
- Modeling, demonstration of behaviour by others - Context: patients stated that they have some anxiety and concern regarding performing therapeutic exercises improperly
- Aim: minimizing the anxiety among patients by providing them with materials summarizing the prescribed exercises
- Opportunities:
• Webinar and videos to provide information about the SMS and to demonstrate home exercises
• Having them speak to other patients who have been successful
create a patient video to share stories on successful strategies on how to integrate SMS into daily schedule
Memory, attention & decision making
- Few patients were not involved in the decision making
- Remembering to do SMS is challenging
Behavioural change techniques:
planning/implementation; Prompts/Triggers/Cues; Motivational Interviewing
- Persuasive communication and information regarding behavioural outcomes
- Provision of information
- Instructions
- Reminders
- Context: Some patients were not involved in the decision making process. Many patients have difficulty in remembering the SMS components
- Aim: to facilitate the involvement of patients in the decision making process, and to remind patients about the use of SMS
- Opportunities:
• Distribute educational/instructional materials to patients to facilitate the shared decision making
• Encourage patients to be actively involved in the decision making process by using the principles of BAP
• Webinar to provide suggestions on ways of implementing SMS
• Social media to provide information on SMS
• Send patients reminders to use SMS via:
▪ E-mail
▪ Phone call (ex. when confirming next appointment)
Behavioural Regulation
- Some patients don’t use SMS as much as they should
Behavioural change techniques:
planning/implementation; Prompts/Triggers/Cues
- Reminders
- Persuasive communication
- Context: Some patients do not use SMS as often as they should
- Aim: to understand why they don’t and motivate patients to use SMS more regularly
- Opportunities:
• Encourage clinicians/interns to help patients form a SMART plan to self-manage
• Encourage patients to put Post-it notes near their computer, automated recalls on their cell phone and/or lap-top
• Send patients reminders to use SMS via:
▪ E-mail
▪ Phone call
  1. BAP brief action planning, BCT behavioural change technique, KT knowledge translation, SMS self-management strategy