Stefan Elbers

154 Chapter 6 was regarded as the optimal form to test both strategies within existing IMPT programs, given the available budget and development time. The strategies within the workbook were based on experience from practice (e.g., patient interviews, stakeholder discussions, HCP feedback) and general self-regulation principles that relate to maintenance of newly learned behaviors (e.g., habit formation and goal setting) (de Ridder et al., 2008; Elbers et al., 2021; Kwasnicka et al., 2016; Nicholas et al., 2011). The main goal of the workbook was to support and facilitate the transfer of individually meaningful insights and learned skills to the personal context of each patient. Treatment teams provided feedback on the workbook design to ensure that the form and content would fit existing treatment principles (Wood & Rünger, 2016). To determine if these strategies are eligible for further development and efficacy testing, it is important to investigate their potential in a real-world setting. According to Bowen and colleagues (Elbers et al., 2021), feasibility studies are important to select promising interventions for further development and obtain specific feedback regarding factors such as usability and implementation. To provide insight into patient and HCP evaluations regarding the relapse prevention strategies, our primary study objective was to examine the level of acceptability to stakeholders of the current workbook prototype within the context of IMPT programs. To explore how well the workbook fits within the existing treatment program, we additionally investigated the degree of applicability. METHODS Study Design To investigate the feasibility of the strategies, we conducted a qualitative study to assess patient and HCP evaluations related to acceptability and applicability of the prototype intervention within the existing treatment program. Ethical approval was granted by the local ethics committee (Medical Research Ethics Committee Zuyderland 16-N-46). Participants The study was performed in two locations of the Adelante Rehabilitation Centre: Hoensbroek and Maastricht. Patients with chronic musculoskeletal pain were referred to the program by general practitioners or specialists who determined that primary care treatment was insufficient to address all existing biopsychosocial factors. Patients were eligible for treatment when their pain and pain-related disability interfered with daily life functioning to a moderate or severe extent. Patients could not participate in the