Performance objectives Performance objectives are listed in Table 1. Examples of performance objectives for clinical reasoning were choosing the correct patient profile, administering questionnaires, and adopting a hands-off approach in the case of acute low back pain with a favourable natural course. In relation to self-regulation, find more information the physical therapists were to regularly reflect on the content of their work, judge their actual performance and react on the basis of that assessment. For quality managers, performance objectives included initiating a quality improvement project in their practice. Planning, preparing and managing the quality improvement project should include establishing a practice structure and a practice culture that facilitate guideline adherence.

Table 1 Performance objectives for physical therapist and practice quality managers Creating change objectives We combined performance objectives with determinants to create matrices of change objectives, the specific targets for the intervention. Excerpts of the matrices are included in Table 2, and examples of change objectives are included in this section. For physical therapists to decide to improve adherence, social norms and self-efficacy were important determinants. The intervention, therefore, would have to help therapists ��Recognize that patients are not extremely negative about the hands off policy or the activating approach�� and ��Express confidence in applying guideline adherent care even when the patient prefers non-adherent care��.

At the practice management level, change objectives were related to knowledge, self-efficacy and skills for general management, monitoring, motivation and advocacy. The quality manager intervention would therefore have to bring managers to ��Name and explain the steps of a quality improvement plan��, ��Express confidence in developing and preparing for a quality improvement project�� and ��Demonstrate skills in the ability to involve colleagues in the setting of attainable goals��. Table 2 Change objectives for the individual physical therapist (PT) and practice quality manager (PQM; selection) Theory-informed behavior change methods and practical applications Based on the change objectives, we used the next 3�C4 months to match theory-informed intervention methods to the change objectives for therapists and managers and to formulate practical applications.

An intervention method (also referred to as behavior change technique [21]) is a theoretically and empirically supported process for effecting behavior change in individuals, groups, or social structures. A practical application is the way a method is GSK-3 delivered to match the context of the priority population. An overview of methods and applications with reference to the theories from which they are derived is presented in Table 3.