Skip to main content

Table 1 Multifaceted implementation activities to facilitate the implementation of the SAMBA model for integrated OA care

From: Implementing international osteoarthritis treatment guidelines in primary health care: study protocol for the SAMBA stepped wedge cluster randomized controlled trial

Target group Barrier Activity Description
Patients Awareness, knowledge, preference Education material All patients receive an OA booklet from the PT with information about OA, treatment, and self-management.
  Awareness, knowledge, compliance Reminder material, exercise diary Together with the electronic questionnaire at 3 months, a check-list of recommended OA care will be provided. The patients are asked to keep an exercise diary to register each session.
  Accessibility, availability Direct access to FLS and PT in private practice, geographically spread PT locations The PTs working at FLS or in private practice will be asked to prioritize the SAMBA patients by ensuring a quick initial assessment and enrolment in the OA programme. Availability will be ensured by recruiting PTs working at different geographical locations.
General practitioners Awareness, knowledge, attitude, motivation to change, and behavioural routines Workshop (provision of information) The GPs will receive oral and written information on recommended OA care, the PT treatment programme, imaging modalities in OA, and information about the appropriate time to refer to an orthopaedic surgeon. The workshop will be embedded in existing GP meetings, be interactive, and allow time for discussions. SAMBA will be presented as a useful ‘tool’. The PTs will be invited to the GP workshop and vice versa in order to know more about each others’ role in OA care.
  Awareness, knowledge Education material The GPs will receive a summary of international guidelines for OA care.
  Awareness, knowledge, attitude, motivation to change, and behavioural routines Education outreach visits All general practice clinics will be visited twice during the intervention period. Each clinic will receive a reminder call quarterly by the project coordinator.
  Awareness Reminder material Posters, pens, post-it note pads, and mouse mats will be distributed during the workshop.
  Motivation to change Opinion leaders/endorsement Local opinion leaders will be identified and asked to promote the intervention among their colleagues. The GPs’ association will be asked to endorse the SAMBA model.
  Awareness, motivation to change Feedback, audit Study newsletters will be distributed 3 times a year. Feedback on recruitment rate will be included.
  Accessibility, attitude, behavioural change Direct access to FLS and PT in private practice The PT working at FLS or in private practice will be asked to prioritize the SAMBA patients by ensuring a quick initial assessment and enrolment in the OA programme.
Physiotherapists at FLS and in private practice Awareness, knowledge, attitude, motivation to change and behavioural routines Workshop (provision of information) The PTs will be educated in delivering OA care in accordance with clinical guidelines with a standardized patient education material and exercise programme recommendations for patients with OA symptoms primarily from the hip or knee + how to adapt the standard modes of delivery to the needs of the individual OA patient. The PTs will be invited to the GP workshop and vice versa in order to know more about each others’ role in OA care.
  Awareness, knowledge Education material The PTs will receive a summary of international guidelines for non-pharmacological OA care.
  Awareness, knowledge, attitude, motivation to change, and behavioural routines Education outreach visits All FLSs and private PT practices will be visited twice during the intervention period. Each clinic will receive a follow-up call quarterly by the project coordinator.
  Awareness Reminder material Posters, pens, and post-it note pads will be distributed during the workshop.
  Motivation to change Feedback, audit Study newsletters will be distributed 3 times a year.
  Awareness, motivation to change Endorsement, continuing educational points The Norwegian Physiotherapist Association will be asked to endorse the ActiveA programme and to provide accreditation of the workshop for continuing educational points.
  1. *Dark cells represent intervention periods, and blank cells represent control periods. The inclusion of patients will start on January 15th 2015 and end on June 15th 2016. The last six month follow-up will be in December 2016 and the last 12-month follow-up will be in June 2017
  2. # The 6 municipalities will switch from control phase to intervention phase in a randomized order