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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:

â–ª E-mail

â–ª 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:

â–ª E-mail

â–ª Phone call

  1. BAP brief action planning, BCT behavioural change technique, KT knowledge translation, SMS self-management strategy