Physiotherapists’ Perceptions of Implementing STarT Back in New Zealand: A Thematic Analysis of Focus Group Data

Date
2022
Authors
Chapple, C
McKenna, C
Hill, J
Ellis, R
Reid, D
Mani, R
Tumilty, S
David, B
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
New Zealand Society of Physiotherapists Inc
Abstract

STarT Back is a stratified care approach to identify and manage psychosocial risk 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.

Description
Keywords
Implementation; Low Back Pain; Psychosocial Factors; Stratified Care, STarT Back
Source
New Zealand Journal of Physiotherapy, 50(3), 106–116. https://doi.org/10.15619/NZJP/50.3.02
Rights statement
New Zealand Journal of Physiotherapy. All rights reserved. Permission is given to copy, store and redistribute the material in this publication for non-commercial purposes, in any medium or format as long as appropriate credit is given to the source of the material. No derivatives from the original articles are permissible.