Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention.
Identifieur interne : 000465 ( Main/Exploration ); précédent : 000464; suivant : 000466Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention.
Auteurs : Owis Eilayyan [Canada] ; Aliki Thomas [Canada] ; Marie-Christine Hallé [Canada] ; Sara Ahmed [Canada] ; Anthony C. Tibbles ; Craig Jacobs ; Silvano Mior ; Connie Davis [Canada] ; Roni Evans [États-Unis] ; Michael J. Schneider [États-Unis] ; Heather Owens [Canada] ; Fadi Al Zoubi [Canada] ; Jan Barnsley [Canada] ; Cynthia R. Long [États-Unis] ; Andre Bussières [Canada]Source :
- Chiropractic & manual therapies [ 2045-709X ] ; 2019.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Autosoins (psychologie), Bases de connaissances (MeSH), Chiropraxie (MeSH), Dorsalgie (psychologie), Dorsalgie (thérapie), Enquêtes et questionnaires (MeSH), Femelle (MeSH), Gestion de soi (psychologie), Humains (MeSH), Jeune adulte (MeSH), Mâle (MeSH), Ontario (MeSH), Patients (psychologie), Personnel de santé (psychologie), Recherche médicale translationnelle (MeSH), Sujet âgé (MeSH).
- MESH :
- psychologie : Autosoins, Dorsalgie, Gestion de soi, Patients, Personnel de santé.
- thérapie : Dorsalgie.
- Adolescent, Adulte, Adulte d'âge moyen, Bases de connaissances, Chiropraxie, Enquêtes et questionnaires, Femelle, Humains, Jeune adulte, Mâle, Ontario, Recherche médicale translationnelle, Sujet âgé.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Back Pain (psychology), Back Pain (therapy), Chiropractic (MeSH), Female (MeSH), Health Personnel (psychology), Humans (MeSH), Knowledge Bases (MeSH), Male (MeSH), Middle Aged (MeSH), Ontario (MeSH), Patients (psychology), Self Care (psychology), Self-Management (psychology), Surveys and Questionnaires (MeSH), Translational Medical Research (MeSH), Young Adult (MeSH).
- MESH :
- geographic : Ontario.
- psychology : Back Pain, Health Personnel, Patients, Self Care, Self-Management.
- therapy : Back Pain.
- Adolescent, Adult, Aged, Chiropractic, Female, Humans, Knowledge Bases, Male, Middle Aged, Surveys and Questionnaires, Translational Medical Research, Young Adult.
Abstract
Background
The literature supports the effectiveness of self-management support (SMS) to improve health outcomes of patients with chronic spine pain. However, patient engagement in SMS programs is suboptimal. The objectives of this study were to: 1) assess participation in self-care (i.e. activation) among patients with spine pain, 2) identify patients' barriers and enablers to using SMS, and 3) map behaviour change techniques (BCTs) to key barriers to inform the design of a knowledge translation (KT) intervention aimed to increase the use of SMS.
Methods
In summer 2016, we invited 250 patients with spine pain seeking care at the Canadian Memorial Chiropractic College in Ontario, Canada to complete the Patient Activation Measure (PAM) survey to assess the level of participation in self-care. We subsequently conducted individual interviews, in summer 2017, based on the Theoretical Domains Framework (TDF) in a subset of patients to identify potential challenges to using SMS. The interview guide included 20 open-ended questions and accompanying probes. Findings were deductively analysed guided by the TDF. A panel of 7 experts mapped key barriers to BCTs, designed a KT intervention, and selected the modes of delivery.
Results
Two hundred and twenty-three patients completed the PAM. Approximately 24% of respondents were not actively involved in their care. Interview findings from 13 spine pain patients suggested that the potential barriers to using SMS corresponded to four TDF domains:
Conclusions
Almost one quarter of study participants were not actively engaged in their spine care. Key barriers likely to influence uptake of SMS among patients were identified and used to inform the design of a theory-based KT intervention to increase their participation level. The proposed multi-component KT intervention may be an effective strategy to optimize the quality of spine pain care and improve patients' health-outcomes
DOI: 10.1186/s12998-019-0267-6
PubMed: 31636895
PubMed Central: PMC6794734
Affiliations:
- Canada, États-Unis
- Colombie-Britannique , Iowa, Minnesota, Ontario, Pennsylvanie, Québec
- Montréal, Pittsburgh, Toronto, Vancouver
- Université McGill, Université de Pittsburgh, Université de Toronto, Université de la Colombie-Britannique
Links toward previous steps (curation, corpus...)
Le document en format XML
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design of a theory-based knowledge translation intervention.</title><author><name sortKey="Eilayyan, Owis" sort="Eilayyan, Owis" uniqKey="Eilayyan O" first="Owis" last="Eilayyan">Owis Eilayyan</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation><nlm:affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</nlm:affiliation><wicri:noCountry code="subField">QC H3S 1M9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Thomas, Aliki" sort="Thomas, Aliki" uniqKey="Thomas A" first="Aliki" last="Thomas">Aliki Thomas</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation><nlm:affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</nlm:affiliation><wicri:noCountry code="subField">QC H3S 1M9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Halle, Marie Christine" sort="Halle, Marie Christine" uniqKey="Halle M" first="Marie-Christine" last="Hallé">Marie-Christine Hallé</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation><nlm:affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</nlm:affiliation><wicri:noCountry code="subField">QC H3S 1M9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Ahmed, Sara" sort="Ahmed, Sara" uniqKey="Ahmed S" first="Sara" last="Ahmed">Sara Ahmed</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation><nlm:affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</nlm:affiliation><wicri:noCountry code="subField">QC H3S 1M9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Tibbles, Anthony C" sort="Tibbles, Anthony C" uniqKey="Tibbles A" first="Anthony C" last="Tibbles">Anthony C. Tibbles</name><affiliation><nlm:affiliation>3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada.</nlm:affiliation><wicri:noCountry code="subField">ON M2H 3J1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Jacobs, Craig" sort="Jacobs, Craig" uniqKey="Jacobs C" first="Craig" last="Jacobs">Craig Jacobs</name><affiliation><nlm:affiliation>3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada.</nlm:affiliation><wicri:noCountry code="subField">ON M2H 3J1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Mior, Silvano" sort="Mior, Silvano" uniqKey="Mior S" first="Silvano" last="Mior">Silvano Mior</name><affiliation><nlm:affiliation>3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada.</nlm:affiliation><wicri:noCountry code="subField">ON M2H 3J1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Davis, Connie" sort="Davis, Connie" uniqKey="Davis C" first="Connie" last="Davis">Connie Davis</name><affiliation wicri:level="4"><nlm:affiliation>4University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4 Canada.</nlm:affiliation><orgName type="university">Université de la Colombie-Britannique</orgName><country>Canada</country><placeName><settlement type="city">Vancouver</settlement><region type="state">Colombie-Britannique </region></placeName></affiliation><affiliation><nlm:affiliation>Centre for Collaboration, Motivation and Innovation, PO Box 1343, Vernon, BC V1T 6N6 Canada.</nlm:affiliation><wicri:noCountry code="subField">BC V1T 6N6 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Evans, Roni" sort="Evans, Roni" uniqKey="Evans R" first="Roni" last="Evans">Roni Evans</name><affiliation wicri:level="2"><nlm:affiliation>6University of Minnesota, Minneapolis, MN 55455 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>6University of Minnesota, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Schneider, Michael J" sort="Schneider, Michael J" uniqKey="Schneider M" first="Michael J" last="Schneider">Michael J. Schneider</name><affiliation wicri:level="4"><nlm:affiliation>7University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><wicri:cityArea>7University of Pittsburgh, 4200 Fifth Ave, Pittsburgh</wicri:cityArea><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Owens, Heather" sort="Owens, Heather" uniqKey="Owens H" first="Heather" last="Owens">Heather Owens</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Zoubi, Fadi Al" sort="Zoubi, Fadi Al" uniqKey="Zoubi F" first="Fadi Al" last="Zoubi">Fadi Al Zoubi</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation><nlm:affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</nlm:affiliation><wicri:noCountry code="subField">QC H3S 1M9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Barnsley, Jan" sort="Barnsley, Jan" uniqKey="Barnsley J" first="Jan" last="Barnsley">Jan Barnsley</name><affiliation wicri:level="4"><nlm:affiliation>8University of Toronto, 27 King's College Cir, Toronto, ON M5S Canada.</nlm:affiliation><orgName type="university">Université de Toronto</orgName><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Long, Cynthia R" sort="Long, Cynthia R" uniqKey="Long C" first="Cynthia R" last="Long">Cynthia R. Long</name><affiliation wicri:level="2"><nlm:affiliation>9Palmer College, Davenport, 1000 Brady St, Davenport, IA 52803 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Iowa</region></placeName><wicri:cityArea>9Palmer College, Davenport, 1000 Brady St, Davenport</wicri:cityArea></affiliation></author><author><name sortKey="Bussieres, Andre" sort="Bussieres, Andre" uniqKey="Bussieres A" first="Andre" last="Bussières">Andre Bussières</name><affiliation wicri:level="4"><nlm:affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</nlm:affiliation><orgName type="university">Université McGill</orgName><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation><nlm:affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</nlm:affiliation><wicri:noCountry code="subField">QC H3S 1M9 Canada</wicri:noCountry></affiliation></author></analytic><series><title level="j">Chiropractic & manual therapies</title><idno type="eISSN">2045-709X</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Back Pain (psychology)</term><term>Back Pain (therapy)</term><term>Chiropractic (MeSH)</term><term>Female (MeSH)</term><term>Health Personnel (psychology)</term><term>Humans (MeSH)</term><term>Knowledge Bases (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Ontario (MeSH)</term><term>Patients (psychology)</term><term>Self Care (psychology)</term><term>Self-Management (psychology)</term><term>Surveys and Questionnaires (MeSH)</term><term>Translational Medical Research (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Autosoins (psychologie)</term><term>Bases de connaissances (MeSH)</term><term>Chiropraxie (MeSH)</term><term>Dorsalgie (psychologie)</term><term>Dorsalgie (thérapie)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Femelle (MeSH)</term><term>Gestion de soi (psychologie)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Mâle (MeSH)</term><term>Ontario (MeSH)</term><term>Patients (psychologie)</term><term>Personnel de santé (psychologie)</term><term>Recherche médicale translationnelle (MeSH)</term><term>Sujet âgé (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Ontario</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Autosoins</term><term>Dorsalgie</term><term>Gestion de soi</term><term>Patients</term><term>Personnel de santé</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Back Pain</term><term>Health Personnel</term><term>Patients</term><term>Self Care</term><term>Self-Management</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Back Pain</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Dorsalgie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Chiropractic</term><term>Female</term><term>Humans</term><term>Knowledge Bases</term><term>Male</term><term>Middle Aged</term><term>Surveys and Questionnaires</term><term>Translational Medical Research</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Bases de connaissances</term><term>Chiropraxie</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Ontario</term><term>Recherche médicale translationnelle</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>The literature supports the effectiveness of self-management support (SMS) to improve health outcomes of patients with chronic spine pain. However, patient engagement in SMS programs is suboptimal. The objectives of this study were to: 1) assess participation in self-care (i.e. activation) among patients with spine pain, 2) identify patients' barriers and enablers to using SMS, and 3) map behaviour change techniques (BCTs) to key barriers to inform the design of a knowledge translation (KT) intervention aimed to increase the use of SMS.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>In summer 2016, we invited 250 patients with spine pain seeking care at the Canadian Memorial Chiropractic College in Ontario, Canada to complete the Patient Activation Measure (PAM) survey to assess the level of participation in self-care. We subsequently conducted individual interviews, in summer 2017, based on the Theoretical Domains Framework (TDF) in a subset of patients to identify potential challenges to using SMS. The interview guide included 20 open-ended questions and accompanying probes. Findings were deductively analysed guided by the TDF. A panel of 7 experts mapped key barriers to BCTs, designed a KT intervention, and selected the modes of delivery.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Two hundred and twenty-three patients completed the PAM. Approximately 24% of respondents were not actively involved in their care. Interview findings from 13 spine pain patients suggested that the potential barriers to using SMS corresponded to four TDF domains: </p></div><div type="abstract" xml:lang="en"><p><b>Conclusions</b></p><p>Almost one quarter of study participants were not actively engaged in their spine care. Key barriers likely to influence uptake of SMS among patients were identified and used to inform the design of a theory-based KT intervention to increase their participation level. The proposed multi-component KT intervention may be an effective strategy to optimize the quality of spine pain care and improve patients' health-outcomes</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31636895</PMID><DateCompleted><Year>2020</Year><Month>02</Month><Day>12</Day></DateCompleted><DateRevised><Year>2020</Year><Month>02</Month><Day>12</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">2045-709X</ISSN><JournalIssue CitedMedium="Internet"><Volume>27</Volume><PubDate><Year>2019</Year></PubDate></JournalIssue><Title>Chiropractic & manual therapies</Title><ISOAbbreviation>Chiropr Man Therap</ISOAbbreviation></Journal><ArticleTitle>Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention.</ArticleTitle><Pagination><MedlinePgn>44</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12998-019-0267-6</ELocationID><Abstract><AbstractText Label="Background">The literature supports the effectiveness of self-management support (SMS) to improve health outcomes of patients with chronic spine pain. However, patient engagement in SMS programs is suboptimal. The objectives of this study were to: 1) assess participation in self-care (i.e. activation) among patients with spine pain, 2) identify patients' barriers and enablers to using SMS, and 3) map behaviour change techniques (BCTs) to key barriers to inform the design of a knowledge translation (KT) intervention aimed to increase the use of SMS.</AbstractText><AbstractText Label="Methods">In summer 2016, we invited 250 patients with spine pain seeking care at the Canadian Memorial Chiropractic College in Ontario, Canada to complete the Patient Activation Measure (PAM) survey to assess the level of participation in self-care. We subsequently conducted individual interviews, in summer 2017, based on the Theoretical Domains Framework (TDF) in a subset of patients to identify potential challenges to using SMS. The interview guide included 20 open-ended questions and accompanying probes. Findings were deductively analysed guided by the TDF. A panel of 7 experts mapped key barriers to BCTs, designed a KT intervention, and selected the modes of delivery.</AbstractText><AbstractText Label="Results">Two hundred and twenty-three patients completed the PAM. Approximately 24% of respondents were not actively involved in their care. Interview findings from 13 spine pain patients suggested that the potential barriers to using SMS corresponded to four TDF domains: <i>Environmental Context and Resources; Emotion; Memory, Attention & Decision-Making; and Behavioural Regulation</i>. The proposed theory-based KT intervention includes paper-based educational materials, webinars and videos, summarising and demonstrating the therapeutic recommendations including exercises and other lifestyle changes. In addition, the KT intervention includes Brief Action Planning, a SMS strategy based on motivational interviewing, along with a SMART plan and reminders.</AbstractText><AbstractText Label="Conclusions">Almost one quarter of study participants were not actively engaged in their spine care. Key barriers likely to influence uptake of SMS among patients were identified and used to inform the design of a theory-based KT intervention to increase their participation level. The proposed multi-component KT intervention may be an effective strategy to optimize the quality of spine pain care and improve patients' health-outcomes<i>.</i></AbstractText><CopyrightInformation>© The Author(s). 2019.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Eilayyan</LastName><ForeName>Owis</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomas</LastName><ForeName>Aliki</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hallé</LastName><ForeName>Marie-Christine</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ahmed</LastName><ForeName>Sara</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tibbles</LastName><ForeName>Anthony C</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jacobs</LastName><ForeName>Craig</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mior</LastName><ForeName>Silvano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Davis</LastName><ForeName>Connie</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>4University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Collaboration, Motivation and Innovation, PO Box 1343, Vernon, BC V1T 6N6 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Evans</LastName><ForeName>Roni</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>6University of Minnesota, Minneapolis, MN 55455 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schneider</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>7University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Owens</LastName><ForeName>Heather</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zoubi</LastName><ForeName>Fadi Al</ForeName><Initials>FA</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barnsley</LastName><ForeName>Jan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>8University of Toronto, 27 King's College Cir, Toronto, ON M5S Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Long</LastName><ForeName>Cynthia R</ForeName><Initials>CR</Initials><AffiliationInfo><Affiliation>9Palmer College, Davenport, 1000 Brady St, Davenport, IA 52803 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bussières</LastName><ForeName>Andre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>10</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Chiropr Man Therap</MedlineTA><NlmUniqueID>101551481</NlmUniqueID><ISSNLinking>2045-709X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001416" MajorTopicYN="N">Back Pain</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002684" MajorTopicYN="N">Chiropractic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D051188" MajorTopicYN="N">Knowledge Bases</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009864" MajorTopicYN="N" Type="Geographic">Ontario</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010361" MajorTopicYN="N">Patients</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012648" MajorTopicYN="N">Self Care</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073278" MajorTopicYN="N">Self-Management</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057170" MajorTopicYN="N">Translational Medical Research</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Chiropractic</Keyword><Keyword MajorTopicYN="Y">Knowledge translation</Keyword><Keyword MajorTopicYN="Y">Self-management</Keyword><Keyword MajorTopicYN="Y">Spine pain</Keyword><Keyword MajorTopicYN="Y">Theoretical domains framework</Keyword><Keyword MajorTopicYN="Y">Theory-based intervention</Keyword></KeywordList><CoiStatement>Competing interestsThe authors declare that they have no competing interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>03</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>07</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>10</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>10</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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