Table 1.

Linkage between learning goals, activities, behaviour change techniques and mechanism of action for Better Back☺ MoC

Target behaviour: Improved HCP confidence and biopsychosocial orientation in treating LBP through adoption of BetterBack☺ MoC
Rational based on modifiable barriers to be addressed: 1. Low confidence in skills/capabilities for improving LBP patient management; 2. Use of a biomedical treatment orientation rather than a biopsychosocial orientation; 3. Low awareness of the model; 4. Beliefs of negative consequences of the model.
Strategy to attain target behaviour: Multifaceted implementation of MoC content to overcome modifiable barriers			Mechanism of action
Learning goals	Learning Activities (Intervention functions)a	Behavioural change techniques used and taxonomy code	TDF domains	COM-B model
1) PTs understand evidence-based guideline recommendations for treatment of LBP. 2) PTs understand the theoretical content and clinical benefits of adopting the BetterBack MoC	• A ‘state-of-the-art’ lecture and web-based resources including an overview of the content of evidence-based guideline recommendations (Ed, P, E)	4.1 Instruction on how to perform the behaviour 6.3 Information about other’s approval 9.1 Credible source 9.2 Pros and cons 9.3 Comparative imagining of future outcomes	Knowledge	CAPABILITY DOMAIN
PTs have the skills to practically use the MoC support tools to: 3) Assist clinical reasoning for matching assessment findings with appropriate diagnosis and stratified treatment 4) Deliver the patient education interventions 5) Deliver exercise interventions	• Demonstration of how to use the MoC support tools (Ed, T, En, M) • Case based practical skills training and role play in small groups using MoC support tools (Ed, T, En) • Peer discussion and reflections upon how they can practically apply the MoC support tools in clinical practice (T, En, M)	1.2 Problem solving 2.2 Feedback on behaviour 3.1 Social support 4.1 Instruction on how to perform the behaviour 6.1 Demonstration of behaviour 6.3 Information about other’s approval 8.1 Behavioural practice/rehearsal 8.7 Graded task 13.2 Framing/re-framing 15.1 Verbal persuasion about capability	Skills
6) PTs have a plan how to start and maintain use of the MoC	• Clinical champion presents an administrative action plan (designed earlier in consensus with clinical colleagues) for the implementation of the MoC at their clinic (Ed, En) • Web-based chat forum for question and feedback (Ed, En)	1.4 Action planning 4.1 Instruction on how to perform the behaviour 12.5 Adding objects to the environment	Behavioural regulation
7) PTs know that their workplace supports delivering the MoC	• Outreached visits before and during the study with managers and clinical champions involved (E, Ed, En)	3.1 Social support 6.3 Information about others’ approval	Organisation	OPPORTUNITY DOMAIN
8) PTs share knowledge and work together and know whom to ask when they experience difficulty in delivering the MoC	• PTs working together with colleagues in small groups addressing the different parts of the MoC with involvement of the clinical champion (T, M, En)	3.1 Social support 13.1 Identification of self as role model 13.2 Framing/reframing	Social Influences
9) PTs believe that the MoC is appropriate for and accepted by the patient	• A ‘state-of-the-art’ lecture and web-based resources including an overview of the content of evidence-based guideline recommendations (Ed, P, E)	9.3 Comparative imagining of future outcomes	Patients
10) PTs experience that they can tailor the MoC to the patient’s need and clinical practice	• Case based practical skills training working with different patient profiles to address use and tailoring of different components of the MoC (Ed, T, En)	12.1. Restructuring the physical environment 12.2. Restructuring the social environment 12.5 Adding objects to the environment	Innovation
11) PTs feel confident that they can deliver the MoC	• A ‘state-of-the-art’ lecture and web-based resources including an overview of the content of evidence-based guideline recommendations (Ed, P, E) • Demonstration of how to use the MoC support tools (Ed, T, En, M) • Case based practical skills training and role play in small groups using MoC support tools (Ed, T, En) • Peer discussion and reflections upon how they can practically apply the MoC support tools in clinical practice (T, En, M)	1.2 Problem solving 2.2 Feedback on behaviour 3.1 Social support 4.1 Instruction on how to perform the behaviour 6.1 Demonstration of behaviour 6.3 Information about other’s approval 8.1 Behavioural practice/rehearsal 8.7 Graded task 9.1 Credible source 9.2 Pros and cons 9.3 Comparative imagining of future outcomes 13.2 Framing/re-framing 15.1 Verbal persuasion about capability	Beliefs about Capabilities	MOTIVATION DOMAIN
12) PTs have positive beliefs about the consequences of adopting the MoC	• Presentation of the benefits of using the MoC support tools for assessment, diagnosis and treatment intervention (Ed, P) • Participants discussed the important future outcomes of the MoC implementation based on: 1. A professional perspective; 2. A patient perspective (M)	4.1 Instruction on how to perform the behaviour 5.3 Information about social and environmental consequences 6.3 Information about other’s approval 9.1 Credible source 9.3 Comparative imagining of future outcomes	Beliefs about consequences
13) PTs intend to use the MoC in their clinics in the future	• Facilitated group discussion about practical organisation of delivery the MoC with examples of solutions with clinical champions involved. (P, En)	3.1 Social support 4.1 Instruction on how to perform the behaviour 9.1 Credible source 9.3 Comparative imagining of future outcomes	Intentions

^aEd Education – Increasing knowledge and understanding, P Persuasion – Inducing feelings to stimulate action, T Training – Imparting skills, En Enablement –Reducing barriers to increase capability,M Modelling – Exemplifying to aspire or imitate, E Environmental restructuring – changing context (physical/social), DIBQ Determinants of Implementation Behaviour Questionnaire, HCP Health Care Practitioner, LBP Low back pain, MoC Model of Care, PT Physiotherapist, COM-B model, “Capability”, “Opportunity”, “Motivation” and “Behavior” Model