The Development and Testing of a Checklist to Study Behaviour Change Techniques used in a Treatment Programme for Canadian Armed Forces Members with Chronic Non-specific Low Back Pain

Abstract

Purpose: There are reports of increased use of a variety of behaviour change techniques (BCT) by physiotherapists and findings of beneficial effects of use. However, there is a lack of physiotherapy-specific definitions of these techniques, as well as a sense of how physiotherapists use them in practice. Through this study, the authors created and field tested a preliminary nomenclature and description for BCT in patients with chronic non-specific low back pain (CNSLBP). Methods: Items for the Physiotherapy Behaviour Change Technique (PT-BCT) checklist were derived from a nomenclature created for use in psychology and also from publications of studies using cognitive behaviour therapy-based approaches in physiotherapy. Content validity was tested via survey of clinical and research experts. Videotapes of a 6-week patient self-management rehabilitation programme were used for training, reliability testing, and field testing of the PT-BCT checklist. Results: Checklist items were endorsed by the majority of experts surveyed; intra-and interrater reliability were moderate to high. In the field study, a broad range of BCT types (behavioural, cognitive, and motivational) were observed in both classroom and gym settings. Conclusions: The BCT nomenclature arising from this study and the PT-BCT checklist will be useful to further explore behaviour change in physiotherapy practice. The observation in this study that BCT were integrated into physiotherapists' practice illustrates how physiotherapists can play a role in changing behaviour, specifically in the presence of CNSLBP.Key Words: health behavior; low back pain; psychological techniques; rehabilitation. RÉ SUMÉObjectif : On signale une utilisation accrue, par les physiothé rapeutes, de tout un é ventail de techniques de modification du comportement (TMC) et l'on constate des effets bé né fiques. Il manque toutefois des dé finitions de ces techniques qui sont spé cifiques à la physiothé rapie et l'on ne sait pas trop comment nous les avons utilisé es dans la pratique. Cette é tude a cré é une nomenclature et une description pré liminaires de TMC chez les patients souffrant de lombalgie chronique non spé cifique (LCNS) et l'on en a fait l'essai pratique. Mé thodes : Les questions figurant sur la liste de contrô le des techniques de modification des comportements en physiothé rapie (TMC-PT) ont é té tiré es d'une nomenclature cré é e pour la psychologie et aussi d'é tudes publié es au cours desquelles on a utilisé des dé marches basé es sur la thé rapie comportementale cognitive en physiothé rapie. La validité du contenu a é té vé rifié e au moyen de sondages d'experts cliniques et de recherches. On a utilisé des enregistrements vidé o d'un programme de ré adaptation de l'autoprise en charge d'un patient d'une duré e de six semaines pour la formation, l'essai de fiabilité et l'essai pratique de la liste de contrô le TMC-PT. Ré sultats : La majorité des experts sondé s a approuvé les é lé ments de la liste. La fiabilité intra et interé valuateurs a varié de modé...

The GLA:D BACK self‐management adherence and competence checklist (SMAC Checklist)—Development, content validity and feasibility

“…Assessment of clinician's delivery of BCTs has been used widely to investigate fidelity to intervention protocols of self‐management and behaviour change interventions, with considerable similarities regarding the choice of BCTs (Beck et al, 2016; French et al, 2015; Harman et al, 2014; Keogh et al, 2015; Lawford et al, 2019; Mars et al, 2013). Similar to our checklist, others combined the assessment of BCTs with items related to communication style (Keogh, Matthews, & Hurley, 2018; Keogh, Matthews, Segurado, & Hurley, 2018; Lawford et al, 2019).…”

Pain and the field of affordances: an enactive approach to acute and chronic pain

“…Finally, many interventions targeting global processes may shape not only the dimension of mineness but also the closely related dimension of temporal horizon, such as behavior change techniques including goal setting, prompting intention formation, and pacing (see appendix in Harman et al, 2014). In the context of pain management, a common thread across these techniques is the importance of patient-centered pain education and motivational interviewing to help guide patients to recognize possibilities for change and future action that are meaningful to them.…”

Assessing physiotherapists’ communication skills for promoting patient autonomy for self-management: reliability and validity of the communication evaluation in rehabilitation tool

“…[17]. Similarly, there has been research into designing a tool to assess how well physiotherapists use behaviour change techniques to promote patient self-management for those with chronic low back pain [18][19]. However, no measurement tool has been developed to specifically assess health care providers' competency in using needs supportive communication strategies in clinical practice which is also an important component for assessing fidelity of treatment delivery of SDT-based interventions [20].…”