Physiotherapists’ perceptions of implementing STarT Back in New Zealand: A thematic analysis of focus group data

Authors

  • Cathy M. Chapple Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  • Claudia McKenna Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  • Julia Hill Active Living and Rehabilitation: Aotearoa, Health and Rehabilitation Research Institute; Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
  • Richard Ellis Active Living and Rehabilitation: Aotearoa, Health and Rehabilitation Research Institute; Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
  • Duncan Reid Active Living and Rehabilitation: Aotearoa, Health and Rehabilitation Research Institute; Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
  • Ramakrishnan Mani Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  • Steve Tumilty Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  • G. David Baxter Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand

DOI:

https://doi.org/10.15619/NZJP/50.3.02

Keywords:

Implementation, Low Back Pain, Psychosocial Factors, Stratified Care, STarT Back

Abstract

STarT Back is a stratified care approach to identify and manage psycho-social factors for persisting low back pain and associated disability. A STarT Back course was held at the School of Physiotherapy, University of Otago, in June 2019, introducing a small cohort of physiotherapists (n = 20) to the approach, including psychologically informed interventions. The study aim was to gain insight into these physiotherapists’ perceptions of the feasibility of implementing STarT Back in their own practice and more widely in New Zealand. Semi-structured focus group interviews were conducted with 14 physiotherapists who attended the training course and had subsequently used STarT Back to different extents in their own practice. Data were analysed using reflexive thematic analysis. Six themes were identified: confidence in current practice; STarT Back as a useful framework; concerns over the low-risk group; difficulties in translation; education is essential; and behaviour change. The need for behaviour change was a unifying theme with interpretation aided by the Capability, Opportunity, and Motivation Behaviour (COM-B) model. Practical suggestions to enhance implementation were made, with participants identifying strategies that promoted use of STarT Back in their practice. Issues identified included concerns about care for low-risk patients, health system structure and funding, and resistance to changing usual practice. Participants were cautious about the feasibility of wider implementation of STarT Back in New Zealand.

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Published

10-05-2023

How to Cite

Chapple, C. M., McKenna, C., Hill, J., Ellis, R., Reid, D., Mani, R., Tumilty, S., & Baxter, G. D. (2023). Physiotherapists’ perceptions of implementing STarT Back in New Zealand: A thematic analysis of focus group data. New Zealand Journal of Physiotherapy, 50(3), 106–116. https://doi.org/10.15619/NZJP/50.3.02