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Table 3 Summary of theoretical domains identified from two focus groups (n = 12) as not relevant to adherence to LBP radiography guidelines and LBP imaging ordering behaviours (including overarching themes and belief statements)

From: Exploring factors influencing chiropractors’ adherence to radiographic guidelines for low back pain using the Theoretical Domains Framework

Domain Overarching theme Example belief statements
Beliefs about capabilities Confidence and control of LBP imaging ordering behaviours. (Enabler) I am confident that I can manage LBP without X-rays
I feel that I have control over the decision to manage LBP with or without X-rays
It is easy for me to decide if I should order an X-ray or not
Lack of confidence in the patient’s case presentation. (Barrier) When I am not confident, I am more likely to refer for X-rays
Optimism None identified None
Reinforcement Previous clinical experiences help to reduce use of imaging for LBP. (Enabler) My previous experiences with diagnosing pathology does not influence my decision to always use X-ray with future patients with LBP
My previous experiences with patients not needing X-ray influences my decision to NOT always use an X-ray for patients with LBP
My previous clinical experiences help with deciding whether or not a patient requires an X-ray
Intentions Positive intentions to managing LBP without imaging. (Enabler) I want to manage patients with LBP without imaging
Goals Imaging is low priority for management of patients with LBP. (Enabler) Taking X-rays is low priority compared to taking a history and conducting a physical examination
Environmental context and resources Many available resources (e.g., time, patient’s previous imaging) to help manage LBP without imaging. (Enabler) Most patients have had X-rays that I can have access to
My decision to take an X-ray is not influenced by time constraints
There are clinical resources available to help manage LBP without X-rays
Social influences Not influenced by others’ views on imaging for LBP. (Enabler) I am not influenced by patients wanting X-rays for their LBP
My decision to take an X-ray is not influenced by my colleagues
I am not influenced by campaigns supporting reducing unnecessary imaging (and would still take an X-ray if necessary)
My decision to take an X-ray is not influenced by patients in lots of pain
Emotion Not influenced by fear or worry. (Enabler) Fear does not influence my decision to take an X-ray
Not using imaging does not make me worried that I missed a diagnosis
Feel comforted with having ability to order X-rays if needed. (Barrier) It gives me comfort knowing that I can take an X-ray if I need to
  1. LBP low back pain