Table 4 The key TDF domains and proposed KT intervention

Knowledge

- 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

Emotion

- 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