Table 1

Detailed planned content for session I of the IMPLEMENT intervention

Session I: Confidence in diagnosis
SectionSection titleContentPlanned behaviour change techniques
I-1Welcome and IntroductionsGroup introductions; Set boundaries; Agenda and content for sessionNone
Viewing of Victorian WorkCover Authority (VWA) videos*Information provision
I-2Small group work No.1: Discussion of pre-session activity about X-rayDiscussion in small groups (3–4) of pre-session activity▸ Barrier identification
▸ Provide opportunities for social comparison
Feedback small group discussion to larger group. Facilitator to note-take barriers and enablers on whiteboard and revisit throughout session▸ Barrier identification
▸ Provide information on consequences
▸ Persuasive communication
▸ Provide opportunities for social comparison
I-3Guideline recommendationsDidactic presentation (facilitator led with group discussion): introduction to acute non-specific low back pain; guideline development and stakeholders; guideline key messages and evidence underpinning them▸ Information provision
▸ Persuasive communication
I-4Small group No.2: Making recommendations specificIn small groups re-write original guideline key messages: by who, applying to who, what, where, whenBarrier identification
I-5Revisit small group discussions No.1 and No.2Group discussion: challenge negative beliefs using persuasive communication and reinforce relevance of key message to GPs’ rolePersuasive communication
I-6Plain film X-ray for acute low back painDidactic presentation from radiologistInformation provision
Outlining harms and utility of X-ray▸ Provide information on consequences
▸ Persuasive communication
I-7Red flag screeningPeer expert: presentation and demonstration (with simulated patient) of identifying red flagsModel/demonstrate the behaviour
I-8Small group No.3: Red flag screening practicalGPs take history of trained simulated patients who are demanding an X-ray▸ Prompt practice (rehearsal)
▸ Role play
Group discussion including feedback from simulated patients to the GPs about their consultationsProvide information on consequences
I-9SummaryGroup discussion: reflect on barriers and enablers on whiteboard; questions; outstanding issues▸ Barrier identification
▸ Persuasive communication
▸ Provide opportunities for social comparison
  • *VWA videos were produced as part of a public health media campaign in the late 1990's. Details of the campaign are provided in Buchbinder et al.29

  • GP, general practitioner.