Table 1 KT intervention: SIMPLE TIPS tool kit

S – Simplify the regimen

1. Limit exercise prescription to a minimum of 2–5 exercises.

2. Reduce exercises that require special environment and equipment.

3. Match exercises to patient preference, priorities, abilities and prior skills

4. Design programs with as little complexity as possible.

5. Incorporate exercise routine into purposeful dailyactivities.

I – Impart knowledge

1. Talk using nontechnical langauge.

2. Explain the risks and benefits of each treatment option.

3. Create teaching moments using internet information presented by patients.

4. Communicate evidence appropriately to facilitate decision making.

M - Modify psychological response and beliefs

1. Assess and review psychosocial barriers to exercise.

2. Facilitate change behavior by establishing readiness, willingness and confidence for exercise.

3. Include motivational and behavioral adherence enhancement treatment techniques.

4. Avoid talk or action that reinforces pain experience and behavior.

P – Promote therapeutic alliance

1. Create an atmosphere that is both challenging and empowering for patients.

2. Provide constructive feedback about progressor plateau.

3. Seek agreement on treatment goals and tasks.

4. Establish and maintain rapport with patients.

5. Practice patient centred communication.

L - Leave the bias behind

1. Avoid patient stereotypes that connote negative persoanl qualities.

2. Acknowledge and respond to diverse cultural perspectives

3. Make recommendations based on evidence instead of personal beliefs and attitudes.

4. Recognise your own cultural bias and its influence on clinical practice.

E - Evaluate adherence

1. Develop a strategy that patients can use to monitor their own adherence.

2. Review attendance records, exercise skill and overall engagement during clinical encounters.

3. Consider using therapist and patient rated measures to track adherence.

4. Ask simple and direct questions about adherence.

T – Technology can be helpful

1. Use text messaging, mobile phone or email reminders when appropriate.

2. Consider telerehebailitation vis Skype when feasible.

3. Make short exercise videos using patient mobile devices.

4. Include web based treatment tools and outcome measures in the treatment plan.

I – Identify and mitigate barriers

1. Recommend time-efficeint exercises.

2. Provide education on how pain, sleep and energy affects exercise ability.

3. Suggest enjoyable ways to exercise.

4. Plan for transportation and weather challenges.

5. Discuss strategies to help patients remember to exercise.

P – Plan for follow-up

1. Provide booster sessions for long term conditions.

2. Refer patients to community based exercise programs.

3. Maintain updated patient contact information.

4. Dedicate time to reviewing patient progress, pain symptoms and function.

S – Set goals

1. Encourage the setting of SMART goals.

2. Adapt goal setting to the context and the individual.

3. Goal setting should be a collaborative effort that involves other professionals, patients, families and carers.

4. Use patient-specific goal setting measures.