Table 2 Synthesis of PTs’ barriers identified from the focus groups

Psychological Capability

Knowledge

Lack of knowledge on the risk factors for and management of recurrences of LBP, and BCTs

PT5; PT6; PT7

“From my experience, I think one of the most common risk factors is the family socioeconomic status (…) Now, recommendations for the prevention of new episodes, I find it more difficult to… I think I would need to think a little bit more about that” (PT6, FG1)

Skills

Lack of skills for the implementation of the intervention

PT2; PT4; PT10; PT11; PT13

“The tailored exercise prescription, I don’t feel comfortable (…) Exercise prescription, I honestly think I still don’t have tools strong enough to be able to… to be able to apply it.” (PT4, FG1)

Social Opportunity

Social influences

Lack of peer interaction and discussions

PT10

“(…) we work a lot alone. We end up not being able to share in loco with anyone, nor to clear a doubt that arises at that moment, the best strategy (…)” (PT10, FG2)

Physical Opportunity

Environmental context and resources

Lack of time to implement and schedule incompatibilities between patients’ and primary healthcare’s schedules

PT2; PT4; PT9; PT13

“We only work 7 hours, right? (…) it will be my pleasure to participate, but I’m just thinking about the daily time that we have, we don’t stop, right?” (PT4, FG1)

Existence of other priorities from their contexts (COVID-19 pandemic and vaccination)

PT3; PT13

“(…) for two years we have been trying to get the ACES to carry out the implementation of other interventions and it still hasn’t been implemented. (…) things haven’t been easy and now with the vaccination problem, first it was the pandemic, now it’s the vaccination.” (PT3, FG1)

Lack of organisational support, that does not consider the intervention a priority

PT3; PT7

“In our case, it has to do with the organisation of the ACES, right? That doesn’t even allow us to implemente it (…)” (PT7, FG1)

Lack of human and material resources

PT6; PT7; PT8

“(…) I understand what all the colleagues have been saying, because we really are very few physiotherapists in the health centers.” (PT6, FG1)

Current focus on treatment rather than prevention

PT9

“To my workplace, the priority is maybe very low (…) what I mean is interventions focused on prevention are not a priority (…) the priority is to solve the problem of that person who is sick and needs a physiotherapy intervention at that moment.” (PT9, FG2)

Low number/lack of patient referrals

PT5; PT8; PT9; PT12

“So, in my case, I work in a health center a little bit more… geographically a little further away from the center and in my case, I almost have no referrals (…) It’s one of my handicaps.” (PT5, FG1)

Unable to implement other interventions

PT1; PT3; PT7; PT13

“Then, about my workplace, you must have already noticed, right? If I’m not even able to implement other interventions…” (PT13, FG2)

Reflective Motivation

Social/professional role and identity

Practice according to a paternalistic model of care that does not promote patient autonomy

PT13

“(…) but in general, we still have a lot of control over the patients (…) We often say to them, or we tell each other, that they don’t do anything for themselves, but maybe many of us don’t do anything so that the patients understand this.” (PT13, FG2)

Beliefs about capabilities

Lack of confidence for the implementation of the intervention

PT1; PT2; PT4; PT5; PT7; PT8; PT11

“Then there’s also another issue that worries me, which is the difficulty in changing behaviors (…) and I've been having that difficulty (…) " (PT8, FG2)

Optimism

Pessimism about the implementation of the intervention

PT7

“(…) so, I really want to implement. My wish is to implement, without a doubt, but since other interventions still haven’t been implemented… I’m not very, I don’t have a lot of expectations (…)” (PT7, FG1)