Table 1.

An overview of identified change objectives from the literature and group discussions for people with back pain, including potential interventions and the relevant components

Who	What: Change objects	How: Interventions	Intervention components
People with back pain	Quality of life	Education, exercises and activity engagement	Sum of all components
	Self-efficacy, and sense of control	Education and exercise	Information about back pain (triggers, prognosis, treatment guidelines, imaging, structures of the back) Promotion of cognitive and behavioural strategies (balancing resources and demands, understanding pain mechanisms, exploring movements, self-management) Reassurance that pain does not mean harm Decreasing fear of movement through increased confidence in physical/back capacity
	Self-management Disability	Education and exercise	Encouragement to stay physically active and continue with normal/everyday activities Encouragement to explore different ways of moving during exercise Increasing functional activity level via progressive exercises
	Pain experience and control over pain	Education and exercise	Understanding and accepting pain Use of exercise for pain relief Identifying worsening and easing componentsPromotion of pain coping skills (e.g. goal-setting, action planning, pacing, problem solving, relaxation, distraction, graded exposure)
	Negative thoughts and beliefs	Education and exercise	Education about changing thought patterns to avoid catastrophising and negative thoughts Experiences of increased physical capacity via progressive exercisesPromotion of a positive and ‘in control’ attitude
	Structural beliefs	Education and exercise	Encouragement to stay physically active and continue with normal/everyday activities Reassurance about the favourable prognosisReassurance that pain does not mean harm
	Expectations about exact diagnosis and imaging	Education	Describing back pain as a recurrent condition Explaining that imaging is not generally recommended because findings are unspecific and do not inform care
	Better interaction with health professionals	Education	Recognition that back pain interacts with many aspects of life
	Free and natural movements	Education and exercise	Individually adapted level of exercises including strength and flexibility An approach to exercise that does not dictate one correct way Encouragement to explore variation in movement during exercise
	Fear of movement	Education and exercise
	Muscle strength	Exercise
	Physical fitness	Education, exercise and physical activity	Explanations of beneficial effects of physical activity and exercise