For a study, researchers sought to assess the facilitators and barriers to reducing needless imaging for NSLBP among family doctors in Newfoundland and Labrador (NL) to guide a more extensive study to develop and evaluate a theory-based intervention to reduce improper imaging. This exploratory, qualitative study used the Theoretical Domains Framework (TDF) to describe family practitioners’ practices and experiences with diagnostic imaging for non-specific LBP in Newfoundland. In-depth, semi-structured interviews were used to gather the data. Transcripts were processed deductively (assigning text to one or more domains) and inductively (creating themes at each domain) before the results were assessed to determine which domains should be targeted to reduce imaging. About 9 family doctors (4 males; 5 females) working in community (n=4) and academic (n=5) clinics in both rural (n=6) and urban (n=3) settings participated in this study. For patients with NSLBP, investigators identified 5 obstacles to decreasing imaging: unfavorable effects, patient demand for health system organization, time, and access to resources. The following domains were connected to these: Beliefs about outcomes, Beliefs about aptitudes, Emotion, Reinforcement, Resources, and the environment, Social effects, and Behavior management. Family doctors feared that if they did not imagine, they might miss something serious, face significant patient demands for imaging, work in a system that encouraged unnecessary imaging, and lack time to counsel patients about why they didn’t need imaging and did not have access to the exemplary practitioners, community programs, and treatment modalities to recommend to their patients. About 7 TDF domains were connected to these obstacles. A specific intervention that tackles these obstacles using the tried-and-true behavior change method was necessary to reduce inappropriate imaging successfully. These methods ought to be directly matched to pertinent TDF domains. Finding the contextual barriers and the domains to which they were associated was an essential initial step in this process, represented by their study’s findings.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01751-6
