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

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 adherence to the national CPG for low back pain by Dutch physical METHODS: We systematically developed a program to improve adherence to physical therapy guidelines for low back pain. Based on multi-method research, we formulated program and change objectives. Selected theory- methods of change and practical applications were combined into an program. Implementation and evaluation plans were developed. RESULTS: research revealed influential determinants for physical therapists and quality managers. Self-regulation was appropriate because both the therapists and the practice managers needed to monitor current practice and implement plans for change. The program stimulated interaction practice levels by emphasizing collective goal setting. It combined applications, such as knowledge transfer and discussion-and-feedback, theory-based methods, such as consciousness raising and active learning. implementation plan incorporated the wider environment. The evaluation included an effect and process evaluation. CONCLUSIONS: Intervention useful framework for formative data in program planning in the field of guideline implementation. However, a decision aid to select determinants guideline adherence identified in the formative research to analyse the may increase the efficiency of the application of the Intervention process.