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Title: The dissemination and implementation of the Back Skills Training Trial (BeST)
Author: Richmond, Helen Louise
ISNI:       0000 0004 5349 7639
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2014
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Effective management of low back pain (LBP) is a worldwide health concern. The Back Skills Training Trial (BeST) demonstrated the clinical and cost-effectiveness of a cognitive behavioural (CB) approach for non-specific low back pain. Uptake of such evidence into routine clinical practice is problematic. Provision of training presents an early challenge in the implementation process. Online training has the potential to enable greater access at reduced costs. This thesis aimed to establish the potential efficacy and acceptability of an online training implementation strategy for providing physiotherapists with the skills required to implement BeST within the NHS. Following a systematic review investigating the effectiveness of online learning among health professionals, a comprehensive online training programme (i-BeST) was developed to train physiotherapists in BeST. Mixed methodology was used to evaluate i-BeST consisting of an exploratory randomised controlled trial (n=35) comparing i-BeST to face-to-face training, and concurrent semi-structured interviews (n=13) to explore the acceptability of receiving the BeST training online. Quantitative and qualitative data were analysed separately and integrated during the discussion of this thesis. Implementation of the BeST intervention was low (n=12) and did not differ significantly between groups. Online participants were sceptical about the plausibility of learning through online methods. Despite these reservations, all participants reported a positive impact of the training on their clinical practice; however both groups showed anxiety around adopting a CB approach. This thesis identified a number of important barriers to the implementation of BeST ranging from factors associated with the physiotherapists themselves, to the adaptability of the BeST intervention and organisational/cultural factors. Future implementation strategies need to address these barriers and enhance support for physiotherapists adopting a CB approach. This may be challenging in resource constrained services.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC Internal medicine