Table 2 Barriers to key guidelines-related behaviours and applied intervention functions to address the barriers
Barriers to key behaviours, identified by implementers, during the initiation of the guideline implementation intervention | COM-B component | Intervention functions applied to address the identified barriers | Identified as a barrier by some target physicians in 2020 |
|---|---|---|---|
Lack of knowledge and understanding of: • pain and treatment of pain, especially chronic pain • how to assess work disability and need for sick leave • consequences of (prolonging) sick leaves for employees and employers | Psychological Capability | Education | Yes Yes |
Forgetting to take into account all relevant factors, when making decisions about pain treatment, work disability, need for sick leave, and alternatives for full-time sick leave | Psychological Capability | Enablement | |
Routinized practice, based on outdated knowledge learned long ago; without an awareness of the need for change | Psychological Capability | Enablement | |
Lack of time to engage in recommended behaviours, experienced especially by OHS general practitioners. | Opportunity: Physical environment | Environmental restructuring | Yes |
Scarcity of admission hours to occupational physicians | Opportunity: Physical environment | None | Yes |
Scarcity of non-pharmacological pain treatment tools in the OHS | Opportunity: Physical environment | Environmental restructuring | Yes |
Doubts about personal capability to handle difficult situations with patients | Reflective Motivation | Education | |
Perception of guidelines as restricting professional autonomy | Reflective Motivation | Persuasion | |
Anticipation of negative consequences to oneself for applying the guidelines as recommended | Reflective Motivation | Persuasion | Yes |
Intention not to learn new guidelines-related behaviours if learning seems burdensome | Reflective Motivation | Persuasion |