Table 5.

Selection of the intervention functions and rationale based on the APEASE criteria.

Intervention functions	Definition	Does the intervention function meet the APEASE criteria?
Education	Increasing knowledge or understanding.	Yes. Education is an essential tool that can be used to create the awareness, change knowledge, attitudes and beliefs of healthcare professionals. It is suggested the design of a pain curriculum be considered in the context of affordability, length of time it takes to upskill healthcare professionals and the cost-effectiveness of the program.
Persuasion	Using communication to induce positive or negative feelings or stimulate action.	As a standalone intervention, may be ineffective or minimally effective as there is evidence from our previous study (15) that healthcare professionals are aware of the biopsychosocial approach to musculoskeletal pain care, yet they lack the confidence and capability to apply it in clinical practice.
Incentivisation	Creating an expectation of reward.	Challenges acceptability, as adoption of a biopsychosocial approach to pain care is a best practice standard. Using social rewards or professional accolades to recognize individuals or clinics or organisations for implementing biopsychosocial pain care may be an appropriate incentive (versus monetary gains).
Coercion	Creating an expectation of punishment or cost.	Unacceptable and unethical to healthcare professionals.
Training	Imparting skills.	Yes, ongoing training can be embedded within the continuing professional development requirement to maintain recency of practice and reflect alignment with evidence and best practice standards.
Restriction	Using rules to reduce the opportunity to engage in the target behaviour (or to increase the target behaviour by reducing the opportunity to engage in competing behaviours).	Impractical, as there are no options to restrict in this context.
Environmental restructuring	Changing the physical or social context.	Yes. Use of virtual “community of practice” can mitigate against geographical barriers to help foster shared learning and useful discussion among healthcare professionals to support the adoption of biopsychosocial musculoskeletal pain care. Project ECHO (44) is an example of a collaborative model/virtual community that provides access to knowledge, mentorship and ongoing support for healthcare professionals.
Modelling	Providing an example for people to aspire to or imitate.	Yes. Support and leadership from opinion leaders, clinical champions, and patient advocates with lived experience, in the field of musculoskeletal pain, are helpful.
Enablement	Increasing means/reducing barriers to increase capability (beyond education and training) or opportunity (beyond environmental restructuring).	Yes. Data registries, such as the electronic Persistent Pain Outcomes Collaboration (ePPOC), facilitate the collection of data from pain management services. This helps to analyse healthcare utilization and outcomes and these data can be used for benchmarking practice and to promote research into important areas of pain management (45). Websites such as the Cochrane musculoskeletal group (46) and the International Association of the Study of Pain (IASP) (47) are helpful online platforms that collate the latest scientific evidence and enable sharing of these trustworthy information to healthcare professionals and patients to inform clinical decision making.
Suggested intervention functions	Education Training Environmental restructuring Modelling Enablement

APEASE, affordability, practicability, effectiveness/cost-effectiveness, acceptability, side-effects/safety, and equity.