Table 2 Main behaviour change techniques that are incorporated into the intervention components for both trial arms
Behaviours: | |||
- Undertake strengthening exercise program | |||
- Undertake negotiated physical activity plan | |||
Behaviour change technique | Written information | Physiotherapist discussion | Other |
Consequences of behaviour | |||
Explanation of benefits of exercise & physical activity. | ✓ OA Info booklet | ✓ Consult #1 | |
Explanation that exercise & physical activity will not make joint structural damage worse. | ✓ OA Info booklet | ✓ Consult #1 | |
Goal setting & action planning | |||
Use of a plan stating how often to exercise & which exercises to do (including dosage). | ✓ Knee plan & log book | ✓ Consults #1–5 | |
Development of specific goals related to patient’s knee problems. | ✓ Consult #1 & 5 | ✓ Pre-consultation survey | |
Development of specific physical activity & step goals. | ✓ Knee plan & log book | ✓ Consults #2–5 | |
Barrier identification/planning | |||
Information & discussion about barriers to exercise & physical activity adherence, including problem-solving. | ✓ OA Info booklet | ✓ Consults #1–5 | |
✓ Knee plan & log book | |||
✓ Exercise booklet | |||
Behavioural grading & instruction | |||
Strengthening exercises are graded in number, intensity and/or difficulty to get progressively harder over time. | ✓ Knee plan & log book | ✓ Consults #1–5 | ✓ Four graded resistance bands |
✓ Exercise booklet | |||
Physical activity is graded in duration, intensity and/or frequency to get progressively harder over time. | ✓ OA Info booklet | ✓ Consults #1–5 | |
✓ Knee plan & log book | |||
Instruction in where, when and how to perform physical activity | ✓ Knee plan & log book | ✓ Consults #2–5 | |
Instruction in where, when and how to perform strengthening exercises | ✓ Knee plan & log book | ✓ Consults #1–5 | ✓ Four graded resistance bands |
✓ Exercise booklet | |||
Demonstration of how to perform strengthening exercises | ✓ Consults #1–5 | ✓ Online video library | |
Encouragement to join group exercise classes. | ✓ OA Info booklet | ✓ Consults #2–5 | |
Encouraged to involve partner or family to join in with exercising & physical activity. | ✓ OA Info booklet | ✓ Consults #2–5 | |
Self-monitoring & feedback | |||
Encouraged to self-monitor exercise & physical activity | ✓ Knee plan & log book | ✓ Consults #1–5 | ✓ Activity monitor |
Physiotherapist review of & and feedback on exercise & physical activity recorded | ✓ Knee plan & log book | ✓ Consults #2–5 | ✓ Activity monitor |
Relapse prevention | |||
Instruction on how to modify exercise & physical activity during flare-ups | ✓ Exercise booklet | ✓ Consults #1–5 | |
Planning for set-backs in physical activity & how to overcome them | ✓ Consult #2 | ||
Dealing with lapses & set-backs with exercise & physical activity; use of constructive self-talk | ✓ Exercise booklet | ✓ Consult #5 | |
Pain & emotional control | |||
Encouragement to use activity pacing & pain coping activities (eg relaxation, pleasant imagery, mindfulness) | ✓ OA Info booklet | ✓ Consults #2 & 3 | |
Tips for healthy sleep | ✓ OA Info booklet | ✓ Consult #3 | |
Prompts | |||
Encouraged to use reminders to exercise. | ✓ OA Info booklet | ||
Rewards | |||
Patient encouraged to use self-rewards for achieving exercise & physical activity goals | ✓ OA Info booklet | ✓ Consults #2–5 | |
Physiotherapist congratulates adherence to exercise & physical activity | ✓ Consults #2–5 | ||
Social comparison | |||
Encourage reading of patient success stories | ✓ OA Info booklet | ✓ Consult #5 | |
Review | |||
Review of behavioural goals (exercise & physical activity) at follow-up. | ✓ Consults #2–5 | ||
Review of outcomes (pain and function) at follow-up. | ✓ Consults #2–5 | ||
Review, supervision and correction of strengthening exercise technique. | ✓ Consults #1–5 | ||