Table 2 Traffic light progression criteria
Green | Amber | Red | Measurement | |
|---|---|---|---|---|
Delivery fidelity — the EPIC-Neck programme being delivered as intended | No areas of concern identified (scores of ≥ 3 for most checklist items) | Minor problems identified (scores between 1.5 & 3 for ≥ 50% of checklist items) | Major problems identified (scores of < 1.5 for most checklist items) | EPIC-Neck appointment audio recordings and observations |
Acceptability — the degree to which people delivering and receiving the EPIC-Neck programme consider it to be appropriate. Measured qualitatively and quantitatively using Sekhon’s acceptability of healthcare intervention domains [41, 42] | Mean acceptability score of ≥ 4 and no areas of concern identified in qualitative interviews | Mean acceptability score 3 and/or minor problems identified in qualitative interviews | Mean acceptability score ≤ 2 and/or major problems identified in qualitative interviews | Acceptability questionnaire at 3 and 6 months [42]. Scores of 4 and above are acceptable, 2 and below are unacceptable, and 3 is neutral EPIC-Neck patient participant interviews at 4 months Interviews with physiotherapists delivering EPIC-Neck programme after the majority of treatment has been completed |
Contamination — the EPIC-Neck programme and usual care exercise are sufficiently different. Measured by the presence of the EPIC-Neck Programme Behavioural Logic Model or Biopsychosocial Exercise Prescription Framework components within usual exercise care | No EPIC-Neck Programme Behavioural Logic Model or Biopsychosocial Exercise Prescription Framework components present within usual exercise care | Minor problems identified | Major problems identified | Usual exercise care appointment audio-recording and observations EPIC-Neck appointment audio-recordings and observations Interviews and questionnaire with physiotherapist delivering usual exercise care after the majority of treatment has been completed |
Mean recruitment rate — the mean rate of recruitment per month. Threshold criteria determined by calculating the time to recruit to an estimated sample size of 248 in a definitive trial using 5 musculoskeletal services [17]. Green would be < 18 months, amber would be 18–30 months, and red would be > 30 months | ≥ 3 per month | 1–2 per month | ≤ 1 per month | Recruitment rates |
Retention rate — the percentage of patient participants completing and returning the Neck Disability Index at 6-month follow-up | ≥ 80% | 70–79% | < 70% | Completed and returned 6-month follow-up questionnaires |