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)

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