|Theme||High Implementers||Low Implementers|
|Congruence with clinician role||
▪Risk factors perceived to be relevant to the presenting issues and types of clients seen.|
▪Opportunity to address as part of routine care.
▪Risk factors perceived to be less relevant to the clinicians' role and reason for seeing the client.|
▪Confusion over role boundaries, uncertainty about whether risk factors should be addressed by another health professional.
|Perception of client acceptability||
▪Opportunity to develop rapport with clients.|
▪Linked discussion of risk factors to the presenting issue.
▪Undertook screening for risk factors as part of standard assessment.
▪Flexible approach to intervention.
▪Less able to link discussion of risk factors to presenting issue.|
▪Concerned about being seen as judgemental, receiving a negative reaction from clients and damaging clinician-client relationship.
|Beliefs about capabilities||▪High perceived confidence and comfort in addressing risk factors.||▪Expressed a lack of knowledge, skills or confidence in addressing risk factor issues in an appropriate way.|
|Perceived Effectiveness of risk factor intervention||
▪Low perceived effectiveness but responsibility to provide intervention as part of the role.|
▪Value of intervention recognised but difficulty in assessing and measuring outcomes.
|▪Low perceived effectiveness of risk factor intervention.|
|Clinicians' own lifestyle||▪Own lifestyle habits acted as an enabler for some (eg ex-smoker) or did not influencing risk factor management practices||▪Own lifestyle habits identified as a barrier for some in addressing risk factor issues with clients.|