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Area of Science:

  • Chiropractic care and evidence-based practice.
  • Knowledge translation in healthcare.
  • Behavioral science in clinical practice.

Background:

  • Suboptimal adherence to spinal pain management guidelines and practice variations persist.
  • The Canadian Chiropractic Guideline Initiative aims to improve non-specific neck pain management by chiropractors.
  • A knowledge translation (KT) intervention was developed using the Theoretical Domains Framework (TDF).

Purpose of the Study:

  • To explore factors influencing chiropractors' use of multimodal care for non-specific neck pain.
  • To map behavior change techniques to key theoretical domains.
  • To develop a targeted KT intervention to improve guideline adherence.

Main Methods:

  • Individual telephone interviews with 13 chiropractors based on the TDF.
  • Thematic content analysis of interview transcripts by two independent assessors.
  • Expert panel meetings to design the KT intervention.

Main Results:

  • Nine TDF domains were identified as relevant, including Social Influences, Environmental Context and Resources, and Reinforcement.
  • Facilitating factors included Skills, Behavioural Regulation, Knowledge, and Memory, Attention and Decision Processes.
  • Conflicting beliefs regarding professional autonomy and speed of recovery were noted.

Conclusions:

  • A multifaceted KT educational intervention was developed for chiropractors managing neck pain.
  • The intervention includes an online webinar series, clinical vignettes, and a video.
  • The intervention's effectiveness requires further testing.