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Table 1 Thematic content analysis based on the Theoretical Domains Framework (TDF)

From: Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework

TDF domainsa Number of questions Utterances Reduceb(%) Increasec(%) No influence (%) Specific beliefs Themes
Nature of the behaviors 2 88 45 (51.1) 35 (39.8) 8 (9.1) 7 Lumbar x-ray utilization
Skills 3 1 0 (0) 0 (0) 1 (100) 1 None identified
Beliefs about capabilities 3 106 70 (66) 31 (29.2) 5 (4.7) 5 Capabilities; ease of ordering test
Motivation & goals 5 50 28 (56) 17 (34) 5 (10) 4 Intrinsic motivations
Beliefs about consequences 4 334 93 (27.8) 211 (63.2) 30 (18.9) 15 Consequence of ordering lumbar x-rays; attitudes
Environmental context and resources 2 41 16 (39) 25 (61) 0 3 Environmental resource; Signs within the clinic
Social influences 2 128 37 (29) 62 (48) 19 (13.3) 6 Influence of others’ opinions (colleagues, patients); influence of organization and new literature
Emotion 2 4 1 (25) 1 (25) 2 (50) 2 Own emotions
Knowledge 7 86 39 (45.3) 33 (38.4) 14 (16.3) 6 Awareness of the guidelines; knowledge of evidence
Memory, attention, and decision process 4 77 67 (87) 10 (13) 0 (0) 8 Factors that influence decision; ease of decision
Social/professional role &identity 4 133 39 (29) 67 (50.4) 27 (20.3) 12 Professional role; professional norms; professional agreement
Behavioral regulation 5 91 91 (100) 0 (0) 0 (0) 12 Ways to reduce testing; barriers; organizational changes; post intentional behavior
Total 43 1,139 526 (46.2) 492 (43.2) 109 (9.6) 88 23
  1. aTDF domains are presented in the order in which questions were asked in the focus groups. bUtterances perceived to reduce x-ray utilization (facilitators). cUtterances perceived to increase x-ray utilization (barriers).