Abstract
Background
Medical Research Council (MRC) guidelines recommend applying theory within interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. This literature review aimed to determine the use of behaviour change theory and techniques within group-based self-management randomised controlled trials for chronic musculoskeletal pain, including CLBP and OA.
Methods
A two phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded independently for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93 item taxonomy, Taxonomy (v1).
Results
25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 29 BCTs were coded across all articles with the most commonly identified techniques being ‘instruction on how to perform the behaviour’, ‘demonstration of the behaviour’, ‘behavioural practice’, ‘credible source’, ‘graded tasks’ and ‘body changes’.
Conclusion
The findings demonstrate that theoretically driven research within self- management for chronic musculoskeletal pain is lacking, or is poorly reported and may partly explain the weak evidence surrounding its effectiveness, Future research that follows MRC and CONSORT guidelines regarding the use of theory and the importance of its reporting is warranted. Programmes should be theoretically based, and focus on comprehensive reporting of all trial aspects, including the basis of technique and theory selection.
Conflicts of interest: No conflicts of interest
Sources of funding: This review was conducted as part of Health Research Award HRA_HSR/2012/24 from the Health Research Board of Ireland.
