Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

Archives of Public Health

Geert M Rutten⁶  Janneke Harting⁸  Leona K Bartholomew⁵  Jozé C Braspenning³  Rob van Dolder¹  Marcel FGJ Heijmans⁴  Erik JM Hendriks²  Stef PJ Kremers⁶  Roland PS van Peppen¹  Steven TJ Rutten⁷  Angelique Schlief³  Nanne K de Vries⁶  Rob AB Oostendorp³ 

[1] Department of Physiotherapy and Research Centre for Innovation in Health Care, Institute for Human Movement Studies, University of Applied Sciences, PO Box 85182, 3508 AD, Utrecht, The Netherlands

[2] Department of Epidemiology, Maastricht University; Faculty of Health, Medicine and Life Sciences, PO Box 616, Maastricht 6200, MD, The Netherlands

[3] Radboud University Nijmegen Medical Centre, Scientific Institute for Quality in Healthcare (IQ healthcare), Nijmegen 6500, HB, The Netherlands

[4] Fysiomaatwerk Heeswijk Dinther, Physical Therapy and Manipulative Physical Therapy, Heilarensestraat 64a, Heeswijk Dinther 5473, RB, The Netherlands

[5] Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler Blvd., Houston 77030, TX, USA

[6] NUTRIM, Department of Health Promotion, Maastricht University; Faculty of Health, Medicine and Life Sciences, P.O. Box 616, Maastricht 6200, MD, The Netherlands

[7] FH Aachen University of Applied Sciences, Heinrich-Mußmann-Str. 1, Jülich 52428, Germany

[8] Department of Public Health, Academic Medical Centre University of Amsterdam, PO BOX 22660, Amsterdam 1100, DD, The Netherlands

关键词: Physical therapy;    Practice management;    Individual professional;    Multilevel program;    Quality improvement;    Low back pain;    Guideline implementation;   

Others  :  790652
DOI  :  10.1186/2049-3258-72-1

 received in 2013-08-16, accepted in 2013-12-16,  发布年份 2014

【 摘 要 】

Background

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists.

Methods

We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed.

Results

Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation.

Conclusions

Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

【 授权许可】

   
2014 Rutten et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, et al.: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess 2004, 8(6):1-72.
• [2]Hakkennes S, Dodd K: Guideline implementation in allied health professions: a systematic review of the literature. Qual Saf Health Care 2008, 17(4):296-300.
• [3]Bosch M, van der Weijden T, Wensing M, Grol R: Tailoring quality improvement interventions to identified barriers: a multiple case analysis. J Eval Clin Pract 2007, 13(2):161-168.
• [4]Davies P, Walker AE, Grimshaw JM: A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. Implement Sci 2010, 5:14. BioMed Central Full Text
• [5]Bartholomew LK, Mullen PD: Five roles for using theory and evidence in the design and testing of behavior change interventions. J Public Health Dent 2011, 71(Suppl 1):S20-S33.
• [6]Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A, Group obotPT: Making psychological theory usefull for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005, 14:26-33.
• [7]Dagenais S, Caro J, Haldeman S: A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 2008, 8(1):8-20.
• [8]Bekkering GE, Hendriks HJM, Koes BW, Oostendorp RAB, Ostelo RWJG, Thomassen JMC, van Tulder MW: Dutch physiotherapy guidelines for low back pain. Physiotherapy 2003, 89(2):82-96.
• [9]Heijmans M, Hendriks E, Van der Esch M, Pool-Goudzwaard A, Scholten Peeters G, Van Tulder M, De Wijer A, Oostendorp R: KNGF-richtlijn manuele therapie bij Lage-rugpijn. Ned Tijdschr Fysiother 2003, 113(6):1-40.
• [10]Bekkering GE, van Tulder MW, Hendriks EJ, Koopmanschap MA, Knol DL, Bouter LM, Oostendorp RA: Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy. Phys Ther 2005, 85(6):544-555.
• [11]Fritz JM, Cleland JA, Brennan GP: Does adherence to the guideline recommendation for active treatments improve the quality of care for patients with acute low back pain delivered by physical therapists? Med Care 2007, 45(10):973-980.
• [12]Rutten GM, Degen S, Hendriks EJ, Braspenning JC, Harting J, Oostendorp RA: Adherence to clinical practice guidelines for low back pain in physical therapy: do patients benefit? Phys Ther 2010, 90(8):1111-1122.
• [13]Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Fernández ME: Planning health promotion programs. An intervention mapping approach, third edition edn. San Fransisco: Jossey-Bass; 2011.
• [14]Swinkels I, Van den Ende C, Van den Bosch W, Dekker J, Wimmers R: Physiotherapy management of low back pain: does practice match the Dutch guidelines? Aust J Physiother 2005, 51(2):35-41.
• [15]Rutten G, Kremers S, Rutten S, Harting J: A theory-based cross-sectional survey demonstrated the important role of awareness in guideline implementation. J Clin Epidemiol 2009, 62(2):167-176.
• [16]Rutten GM, Harting J, Bartholomew LK, Schlief A, Oostendorp RA, de Vries NK: Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study. BMC Health Serv Res 2013, 13:194. BioMed Central Full Text
• [17]Schoster B, Altpeter M, Meier A, Callahan LF: Methodological tips for overcoming formative evaluation challenges: the case of the Arthritis Foundation Walk With Ease program. Health Promot Pract 2012, 13(2):198-203.
• [18]Harting J, Rutten GM, Rutten ST, Kremers SP: A qualitative application of the diffusion of innovations theory to examine determinants of guideline adherence among physical therapists. Phys Ther 2009, 89(3):221-232.
• [19]Bandura A: Social cognitive theory of self regulation. Organ Behav Hum Decis Process 1991, 50:248-287.
• [20]Vancouver J: Self-regulation in organizational settings. A tale of two paradigms. In Handbook of Self Regulation. Edited by Boekaerts M, Pintrich P, Zeidner M. San Diego: Elsevier Academic Press; 2005:303-341.
• [21]Michie S, Johnston M, Francis J, Hardeman W, Eccles M: From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol 2008, 57(4):660-680.
• [22]Locke EA, Latham GP: A theory of goal setting and task performance. Englewood Cliffs, NJ: Prentice-Hall; 1990.
• [23]Gollwitzer PM, Brandstatter V: Implementation intentions and effective goal pursuit. J Pers Soc Psychol 1997, 73(1):186-199.
• [24]Bonwell C, Elson J: Active learning: creating excitement in the classroom. In AEHE-ERIC Higher Education Report No1. Washington DC: Jossey-Bass; 1991.
• [25]Chickering AW, Gamson ZF: Development and adaptations of the seven principles for good practice in undergraduate education. New Directions for Teaching and Learning 1999, 80:75-81. San Fransisco: Jossey-Bass Publishers
• [26]Petty R, Cacioppo J: From Communication and persuasion: Central and peripheral routes to attitude change. New York: Springer-Verlag; 1986.
• [27]Prochaska J, DiClemente C, Norcross J: In search of how people change. Applications to addictive behaviors. Am Psychol 1992, 47(9):1102-1114.
• [28]Ajzen I: The theory of planned behavior. Organ Behav Hum Decis Process 1991, 50:179-211.
• [29]Boekaerts M, Pintrich PR, Zeidner M: Handbook of Self Regulation. San Diego: Elsevier Academic Press; 2005.
• [30]Weinstein ND, Sandman PM: A model of the precaution adoption process: evidence from home radon testing. Health Psychol 1992, 11(3):170-180.
• [31]Matsumara L, Slater S, Crosson A: Classroom climate, rigorous instruction and curriculum, and students’ interactions in urban middle schools. The Elementary School Journal 2008, 108(4):294-312.
• [32]Reznitskaya A, Anderson R, Kuo L: Teaching and learning argumentation. The Elementary School Journal 2007, 107(5):449-472.
• [33]Bandura A: Social foundations of thought and action. A social cognitive theory. Englewood cliffs. New Jersey: Prentice Hall; 1986.
• [34]INK Quick scan http://www.ink.nl/nl/p4d9c5f5f1a5fd/ink-quickscan.html webcite
• [35]De Caluwe L, Vermaak H: Leren veranderen. Een handboek voor de veranderkundige. : Alphen a/d Rijn: Kluwer; 2006.
• [36]Vermeylen S: Werken met de SWOT-analyse. Brussel: Politeia; 2005.
• [37]Cohen J: Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
• [38]Rutten GMJ, Harting J, Rutten STJ, Bekkering GE, Kremers SPJ: Measuring physiotherapists’ guideline adherence by means of clinical vignettes: a validation study. J Eval Clin Pract 2006, 12(5):491-500.
• [39]Kwaliteit van meetinstrumenten voor studiehouding en studievaardigheid [Quality of instruments to measure study-attitude and study-skills] http://www.open.ou.nl/lds97/kwaliteit_meetinstrumenten.htm webcite
• [40]Goel V: Anatomy of deductive reasoning. Trends Cogn Sci 2007, 11(10):435-441.
• [41]Alewijnse D, Mesters IE, Metsemakers JF, van den Borne BH: Program development for promoting adherence during and after exercise therapy for urinary incontinence. Patient Educ Couns 2002, 48(2):147-160.
• [42]Koekkoek B, van Meijel B, Schene A, Hutschemaekers G: Development of an intervention program to increase effective behaviours by patients and clinicians in psychiatric services: intervention mapping study. BMC Health Serv Res 2010, 10:293. BioMed Central Full Text
• [43]Verweij LM, Proper KI, Weel AN, Hulshof CT, van Mechelen W: Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees. BMC Public Health 2009, 9:461. BioMed Central Full Text
• [44]Michie S, van Stralen MM, West R: The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011, 6:42. BioMed Central Full Text