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Table 1 Description of the process used to develop the KEDS intervention

From: A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: face validity and feasibility of implementation

The barriers and enablers identified from the focus groups The TDF domains linked to the barriers and enablers identified from the focus groups Intervention components (BCTs, mode & content) selected to overcome the modifiable barriers and enhance the enablers
Physiotherapists lack awareness of certain communication strategies Knowledge BCT: Information regarding the behaviour
Mode: Continuing education meeting
Content: Information was presented about the specific communication strategies. For example, physiotherapists watched a video where the use of these communication strategies with a typical chronic low back patient was demonstrated
Physiotherapists are unsure of how and when to use certain communication strategies with patients Skill BCT: Goal-setting and problem-solving
Mode: 1. Continuing education meeting; and
2. Individual coaching session
Content: 1. At the end of the education meeting, physiotherapists were encouraged to set a goal and develop an action plan to practice one/ two communication strategies. Physiotherapists provided with a goal and action sheet to facilitate this. 2. Physiotherapists in collaboration with the coach set goals related to implementing the communication strategies in practice and problem-solved any likely barriers to implementation.
BCT: Self-monitoring
Mode: Individual coaching session
Content: After each audio recorded patient consultation, physiotherapists recorded and reflected on their use of the communication strategies during the consultation
Physiotherapists lack self-confidence in their ability to successfully implement certain strategies Beliefs about capabilities BCT: Goal-setting and problem-solving Mode & content as described for the Skill domain
BCT: Self-monitoring Mode & content as described for the Skill domain
BCT: Feedback
Mode: Individual coaching session
Content: Verbal and written feedback provided to each physiotherapist during the coaching session regarding their use of the communication strategies based on audio recorded patient consultations
Physiotherapists are working in isolation. There are limited social networks to encourage or support the use of new strategies Social influences BCT: Social processes of encouragement and support
Mode: Continuing education meeting
Content: Group based discussion within the meeting where physiotherapists shared the positive experiences they had using these communication strategies with patients and discussed ways by which they could support and encourage their colleagues in using these strategies in their clinical practice
Physiotherapists’ beliefs regarding communication being a core part of their professional role is a motivating factor to implement these strategies effectively Professional role and identity (physiotherapist perspective) BCT: Persuasive communication
Mode: Continuing education meeting
Content: Respected physiotherapist who is part of the research team discussed the evidence and benefits of using these communication strategies with patients to promote active management of their LBP. Group based discussion to allow opportunity to discuss importance of communication among colleagues at the meeting
Physiotherapists do make conscious and practical adjustments (e.g., reminding themselves of these strategies prior to a consultation) to their practice in order to improve their implementation of these communication strategies. Behavioural regulation BCT: Prompts, triggers, cues
Mode: 1. Continuing education meeting; and 2. Individual coaching session
Content: 1. Physiotherapists provided with a communication strategy reminder sheet at the end of the continued education meeting which could be placed in patients’ files to remind the physiotherapist to use these strategies in their practice. 2. Physiotherapists emailed a copy of the agreed updated goal and action sheet within 24 h of the coaching session.
Barriers identified from the focus groups which were deemed beyond the scope of the study
Patients can present with a specific expectation regarding treatment and a preconceived perception of the role of a physiotherapist in the management of their condition (i.e. expectation of hands on treatment, passive role in their own treatment) Professional role and identity (patient perspective)  
Clinics have long waiting lists, less staff, and fewer resources. These communication strategies become secondary in a time pressured environment Environmental context and resources  
  1. Note: Details of focus group participants: Mean age = 37.4 years (SD = 6.4); Average years total physiotherapy experience = 12.6 years (SD = 5.5); Average years’ experience in primary care clinical practice = 10.2 years (SD = 5.6)