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Table 4 The key TDF domains and proposed KT intervention

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 Description Proposed KT intervention
- Patients believe that they know enough about SMS
- Context: the majority of patients believe that exercise is the core component of self-management strategies (SMS) • 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
- Lack of time was a barrier to using SMS • Encourage 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
- Feeling of anxiety/ frustration regarding use SMS
- Patients stated that they have some anxiety and concern regarding performing therapeutic exercises adequately • Webinar and videos to provide information about the SMS and to demonstrate home exercises
• Have patients 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
- Some patients were not involved in the decision making process. Many patients had difficulty in remembering the SMS components • 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
- Some patients did not use SMS as often as they should • 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