Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study
Abstract Background Low back pain is still the leading cause of disability and societal burden, with 619 million prevalent cases worldwide in 2020. Most countries produce clinical guidelines to support healthcare professionals in evidence-based care regarding low back pain. However, several studies...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
|
| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-024-00568-x |
| _version_ | 1797219831262478336 |
|---|---|
| author | Maja Husted Hubeishy Camilla Blach Rossen Petra Dannapfel Kristin Thomas Tue Secher Jensen Thomas Maribo Nanna Rolving |
| author_facet | Maja Husted Hubeishy Camilla Blach Rossen Petra Dannapfel Kristin Thomas Tue Secher Jensen Thomas Maribo Nanna Rolving |
| author_sort | Maja Husted Hubeishy |
| collection | DOAJ |
| description | Abstract Background Low back pain is still the leading cause of disability and societal burden, with 619 million prevalent cases worldwide in 2020. Most countries produce clinical guidelines to support healthcare professionals in evidence-based care regarding low back pain. However, several studies have identified relatively poor uptake of guidelines. Tailored strategies to facilitate the implementation of guidelines have been argued to increase uptake. This study aimed to develop a contextually tailored implementation programme to enhance evidence-based low back pain care among Danish physiotherapists and chiropractors in primary care. Methods A theory-driven implementation programme development study was conducted using the Behaviour Change Wheel, with high healthcare professional involvement. Data collection included four workshops with seven physiotherapists and six chiropractors from primary care clinics. The development process consisted of [1] establishing a theoretical frame, [2] involving participants, [3] understanding the behaviour, [4] designing the implementation programme, and [5] final implementation programme. Results The target behaviours selected (guideline recommendations) for the implementation programme were (i) screening of psychosocial risk factors and (ii) offering patient education. The barriers and facilitators for the selected behaviours were described and linked to intervention functions and behavioural techniques. Finally, the implementation programme comprised five strategies: webinars, e-learning videos, communication exercises, peer learning, and group dialogue meetings. In addition, the programme consisted of implementation support: champions, a physical material folder, a weekly email reminder, a specially designed website and a visit from an implementation consultant. An essential element of the overall programme was that it was designed as a step-by-step implementation process consisting of 16 h of education and training distributed over 16 weeks. Conclusions A programme for implementing low back pain guideline recommendations was developed based on behaviour change theory and four co-design workshops involving healthcare professionals to overcome the contextually identified barriers. A theory-driven approach involving healthcare professionals was useful in identifying relevant target behaviours and tailoring the programme to consider contextual barriers and facilitators for implementation. The effectiveness of the final implementation programme will be evaluated in the project’s next phase. Trial registration Central Denmark Region, Registered November 11, 2021, act no. 1-16-02-93-19. |
| first_indexed | 2024-04-24T12:39:53Z |
| format | Article |
| id | doaj.art-e01fc6a100574f408fecc26c9ce08576 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-04-24T12:39:53Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-e01fc6a100574f408fecc26c9ce085762024-04-07T11:20:20ZengBMCImplementation Science Communications2662-22112024-04-015112110.1186/s43058-024-00568-xDeveloping a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design studyMaja Husted Hubeishy0Camilla Blach Rossen1Petra Dannapfel2Kristin Thomas3Tue Secher Jensen4Thomas Maribo5Nanna Rolving6Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Hospital in Central Denmark RegionInterdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Hospital in Central Denmark RegionDepartment of Health, Medicine and Caring Sciences, Linköping UniversityDepartment of Health, Medicine and Caring Sciences, Linköping UniversityDiagnostic Centre – Imaging Section, Silkeborg Regional HospitalDepartment of Public Health, Aarhus UniversityDepartment of Public Health, Aarhus UniversityAbstract Background Low back pain is still the leading cause of disability and societal burden, with 619 million prevalent cases worldwide in 2020. Most countries produce clinical guidelines to support healthcare professionals in evidence-based care regarding low back pain. However, several studies have identified relatively poor uptake of guidelines. Tailored strategies to facilitate the implementation of guidelines have been argued to increase uptake. This study aimed to develop a contextually tailored implementation programme to enhance evidence-based low back pain care among Danish physiotherapists and chiropractors in primary care. Methods A theory-driven implementation programme development study was conducted using the Behaviour Change Wheel, with high healthcare professional involvement. Data collection included four workshops with seven physiotherapists and six chiropractors from primary care clinics. The development process consisted of [1] establishing a theoretical frame, [2] involving participants, [3] understanding the behaviour, [4] designing the implementation programme, and [5] final implementation programme. Results The target behaviours selected (guideline recommendations) for the implementation programme were (i) screening of psychosocial risk factors and (ii) offering patient education. The barriers and facilitators for the selected behaviours were described and linked to intervention functions and behavioural techniques. Finally, the implementation programme comprised five strategies: webinars, e-learning videos, communication exercises, peer learning, and group dialogue meetings. In addition, the programme consisted of implementation support: champions, a physical material folder, a weekly email reminder, a specially designed website and a visit from an implementation consultant. An essential element of the overall programme was that it was designed as a step-by-step implementation process consisting of 16 h of education and training distributed over 16 weeks. Conclusions A programme for implementing low back pain guideline recommendations was developed based on behaviour change theory and four co-design workshops involving healthcare professionals to overcome the contextually identified barriers. A theory-driven approach involving healthcare professionals was useful in identifying relevant target behaviours and tailoring the programme to consider contextual barriers and facilitators for implementation. The effectiveness of the final implementation programme will be evaluated in the project’s next phase. Trial registration Central Denmark Region, Registered November 11, 2021, act no. 1-16-02-93-19.https://doi.org/10.1186/s43058-024-00568-xDevelopmentImplementation programmeInvolvementBehaviour Change WheelCOM-BLow back pain |
| spellingShingle | Maja Husted Hubeishy Camilla Blach Rossen Petra Dannapfel Kristin Thomas Tue Secher Jensen Thomas Maribo Nanna Rolving Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study Implementation Science Communications Development Implementation programme Involvement Behaviour Change Wheel COM-B Low back pain |
| title | Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study |
| title_full | Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study |
| title_fullStr | Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study |
| title_full_unstemmed | Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study |
| title_short | Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study |
| title_sort | developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the behaviour change wheel a theory driven design study |
| topic | Development Implementation programme Involvement Behaviour Change Wheel COM-B Low back pain |
| url | https://doi.org/10.1186/s43058-024-00568-x |
| work_keys_str_mv | AT majahustedhubeishy developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy AT camillablachrossen developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy AT petradannapfel developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy AT kristinthomas developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy AT tuesecherjensen developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy AT thomasmaribo developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy AT nannarolving developingalowbackpainguidelineimplementationprogrammeincollaborationwithphysiotherapistsandchiropractorsusingthebehaviourchangewheelatheorydrivendesignstudy |