Changing physiotherapy behaviour to optimise outcome: feasibility of a knowledge translation intervention

Abstract

Background: Adherence is associated with outcome following musculoskeletal physiotherapy, but rates of non-adherence are as high as 70%. Research indicates adherence may be improved through a person-centred approach combined with targeted behaviour change techniques. However, integration into routine physiotherapy practice has proven complex. We aimed to test the feasibility of an active, multi-component knowledge translation intervention to support adoption of these techniques into practice. Methods: A mixed methods feasibility trial involving n=14 physiotherapists. N=9 attended a one-day workshop, followed by a three-month knowledge broker period and access to an online discussion forum. The remainder attended the workshop but received no additional support. Semi-structured interviews were used to explore perspectives regarding what helped or hindered uptake. Data were analysed using conventional content analysis. Findings: The workshop provided important foundational knowledge, but alone was not sufficient to change practice. Knowledge brokers played a critical role in supporting knowledge translation, particularly when they adopted a structured approach, created a safe space for reflection, and were perceived as having ‘expert’ knowledge. Techniques were more easily integrated into practice when perceived as simple and as having an intuitive fit with existing practice. Ongoing use was contingent upon seeing results. Discussion: Knowledge brokers may be effective at supporting integration of new techniques into physiotherapy practice so long as certain other conditions are met. These findings provide an in-depth view of the implementation process as perceived by clinicians. Health psychologists could play a leading role in implementation activities given it is inherently a behaviour change process.