{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T14:51:59Z","timestamp":1761576719889,"version":"build-2065373602"},"reference-count":74,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fonds pour la recherche Clinique et le maintien des comp\u00e9tences","award":["#00391001","#00391001","#00391001","#00391001","#00391001","#00391001"],"award-info":[{"award-number":["#00391001","#00391001","#00391001","#00391001","#00391001","#00391001"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chiropr Man Therap"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical guidelines for managing non-specific spine pain recommend providing patient education and self-management support strategies (SMSS) as first-line treatment. However, SMSS implementation in daily chiropractic care remains challenging. This study aimed to assess the level of patient activation in their care, explore chiropractic senior interns and clinician supervisors\u2019 beliefs about evidence-based practice (EBP) and self-management support, and identify theoretical barriers and facilitators to implementing SMSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a three-phase mixed-methods convergent design. In phase 1, during the spring and summer of 2022, 250 consecutive adults with spine pain at the outpatient chiropractic clinic at the Universit\u00e9 du Qu\u00e9bec \u00e0 Trois-Rivi\u00e8res, Quebec, Canada, were invited to complete the patients\u2019 activation measure (PAM). In phase 2, all senior interns (n\u2009=\u200939) and clinician supervisors (n\u2009=\u200929) were invited to complete three self-administered online questionnaires: 1) EBP Beliefs and Implementation Scales, 2) Pain Attitudes and Beliefs Scale (PABS), and 3) the Practice Style questionnaire. In phase 3, patients, interns and clinicians having completed the questionnaires were convened to semi-structured individual interviews based on the Theoretical Domains Framework (TDF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In phase 1, three quarters of patients (76.3%) reported a moderate-to-high level of activation. In phase 2, interns and clinician supervisors had similar EBP Beliefs mean scores (62.8% and 62.5%, respectively) and EBP Implementation scores (28.6% and 38.2%, respectively). For the PABS, no predominant biomedical or behavioural treatment orientations were observed among interns (mean (SD)\u2009=\u200934.8 (6.3) \/60 vs 36.7 (3.5) \/48) or clinicians (34.7 (9.1) \/60 vs 34.6 (4.9) \/48). Interns primarily had a pragmatic practice style, whereas clinicians were equally pragmatic and receptive. In phase 3, four key TDF domains emerged for patients (Social influences, Behavioural regulation, Emotions, and Goals); five for interns (Knowledge, Environmental Context and Resources, Skills, Memory, Attention and Decision Process, and Goals), and four for clinicians (Knowledge, Environmental Context and Resources, Social Influences and Beliefs on Consequences).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although patients demonstrated moderate-to-high activation, EBP and SMSS implementation among interns and supervisor was limited. Treatment orientation, practice style, and contextual factors highlight the need for targeted educational and organizational strategies to bridge the knowledge-practice gap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12998-025-00611-1","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T13:18:56Z","timestamp":1761571136000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceptions and use of self-management support strategies to improve the management of spine pain patients in a French-Canadian chiropractic teaching program: a mixed method study"],"prefix":"10.1186","volume":"33","author":[{"given":"Philippe","family":"Rousseau","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danikel","family":"Giroux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chlo\u00e9","family":"Branconnier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emile","family":"Marineau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn J.","family":"Lemire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Bussi\u00e8res","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"issue":"1","key":"611_CR1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s12916-018-1151-2","volume":"16","author":"A Williams","year":"2018","unstructured":"Williams A, et al. 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