Chiropr Man Therap 2025 May 5; 33: 17
Table 5.
Barriers mapped to behavior change techniques
Barrier (n = cases) TDF component Intervention function Behavior change technique Chiropractic treatments won’t help (9)
No change/no goal (6)
Not knowing how to manage condition (3)
Because of type of condition nothing will help the pain (3)
Not having chiropractic care would result in less or no improvement (3)
Choosing other activities over assigned exercises (2)
Not understanding exercises (1)
Not an exerciser (1)
Not capable of exercise (1)
Not capable of being strong (1)
Exercise needs to be difficult to be effective (1)
Focused chiropractic treatment has less benefits (1)
Non-prescribed exercises have the same benefit (1)
Chiropractic treatment increased my pain (1)
Knowledge
Behavioral regulation
Social/professional role and identity
Beliefs about capabilities
Optimism
Goals
Beliefs about consequences
Education Information about health consequences
Feedback on behavior
Feedback on outcome(s) of behavior
Prompts/cues
Self-monitoring of behavior
Verbal persuasion to boost self-efficacy
Chiropractic treatments won’t help (9)
No change/no goal (6)
Because of type of condition nothing will help the pain (3)
Not having chiropractic care would result in less or no improvement (3)
Guilt, shame (2)
Fear (1)
Not an exerciser (1)
Not capable of exercise (1)
Not capable of being strong (1)
Exercise needs to be difficult to be effective (1)
Focused chiropractic treatment has less benefits (1)
Non-prescribed exercises have the same benefit (1)
Chiropractic treatment increased my pain (1)
Emotion
Social/Professional role and identity
Beliefs about capabilities
Optimism
Goals
Beliefs about consequences
Persuasion Information about health consequences
Feedback on behavior
Feedback on outcome(s) of the behavior
Focus on past success
Framing/reframing
Verbal persuasion about capability
No change/no goal (6)
Pain (5)
Psychological impact of capabilities (2)
Guilt, shame (2)
Other medical conditions (1)
Change in environment (1)
Fear (1)
Reinforcement
Emotion
Goals
Incentivization Feedback on behavior
Feedback on outcome(s) of behavior
Self-monitoring of behavior
Discrepancy between current behavior and goal
Remove adverse stimulus
No change/no goal (6)
Pain (5)
Psychological impact of capabilities (2)
Guilt, shame (2)
Other medical conditions (1)
Change in environment (1)
Fear (1)
Reinforcement
Emotion
Goals
Coercion Feedback on behavior
Feedback on outcome(s) of behavior
Self-monitoring of behavior
Discrepancy between current behavior and goal
Incompatible beliefs
Time constraints (12)
Pain (5)
Difficulty performing exercises (4)
Driving distance (3)
Exercise schedule (3)
Difficulty deciding to exercise (2)
Choosing other activities over assigned exercises (2)
Lacking video or in-person demonstration (2)
Space constraints (2)
Psychological impact of capabilities (2)
Not recognizing correct performance of exercises (1)
Difficulty pacing exercises (1)
Working a desk job (1)
Length of treatment visits (1)
Visit frequency (1)
Other medical conditions (1)
Change in environment (1)
Physical skills
Cognitive and interpersonal skills
Memory, attention and decision processes
Behavioral regulation
Environmental context and resources
Reinforcement
Training Demonstration of the behavior
Instruction on how to perform the behavior
Feedback on the behavior
Feedback on outcome(s) of the behavior
Self-monitoring of the behavior
Self-monitoring of outcome(s) of the behavior
Behavior practice/rehearsal
Habit formation
Graded tasks
Time constraints (12)
Driving distance (3)
Exercise schedule (3)
Lacking video or in-person demonstration (2)
Space constraints (2)
Family opinions (1)
Break in therapeutic alliance (1)
Working a desk job (1)
Length of treatment visits (1)
Visit frequency (1)
Social influences
Environmental context and resources
Restriction *No BCTs are linked through restriction Time constraints (12)
Pain (5)
Driving distance (3)
Exercise schedule (3)
Difficulty deciding to exercise (2)
demonstration (2)
Space constraints (2)
Psychological impact of capabilities (2)
Family opinions (1)
Break in therapeutic alliance (1)
Lacking video or in-person
Working a desk job (1)
Length of treatment visits (1)
Visit frequency (1)
Other medical conditions (1)
Change in environment (1)
Memory, attention and decision processes
Social influences
Environmental context and resources
Reinforcement
Environmental restructuring Adding objects to the environment
Prompts/cues
Restructuring the physical environment
Restructuring the social environment
Chiropractic treatments won’t help (9)
No change/no goal (6)
Because of type of condition nothing will help the pain (3)
Not having chiropractic care would result in less or no improvement (3)
Choosing other activities over assigned exercises (2)
Guilt, shame (2)
Family opinions (1)
Break in therapeutic alliance (1)
Fear (1)
Not an exerciser (1)
Not capable of exercise (1)
Not capable of being strong (1)
Exercise needs to be difficult to be effective (1)
Focused chiropractic treatment has less benefits (1)
Non-prescribed exercises have the same benefit (1)
Chiropractic treatment increased my pain (1)
Behavioral regulation
Social influences
Emotion
Social/professional role and identity
Belief about capabilities
Optimism
Goals
Beliefs about consequences
Modeling Demonstration of the behavior Time constraints (12)
No change/no goal (6)
Driving distance (3)
Exercise schedule (3)
Difficulty deciding to exercise (2)
Choosing other activities over assigned exercises (2)
Lacking video or in-person demonstration (2)
Space constraints (2)
Guilt, shame (2)
Family opinions (1)
Break in therapeutic alliance (1)
Working a desk job (1)
Length of treatment visits (1)
Visit frequency (1)
Fear (1)
Memory, attention and decision processes
Behavior regulation
Social influences
Environmental context and resources
Emotion
Goals
Enablement Social support (unspecified)
Social support (practical)
Goal setting (behavior)
Goal setting (outcome)
Adding objects to the environment
Problem solving
Action planning
Self-monitoring of behavior
Restructuring the physical environment
Restructuring the social environment
Review behavior goal(s)
Review outcome goal(s)
Reduce negative emotions
Verbal persuasion about capability