92 | NEW ZEALAND JOURNAL OF PHYSIOTHERAPY CLINICAL PERSPECTIVE The Bridge Between Theory and Practice for Supporting Patient Self-Management: A Clinical Perspective for Physiotherapists Amanda Wilkinson PhD Research Fellow, Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand Hilda Mulligan PhD Associate Professor, Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand Jessie Snowdon BPhty, PGCertHealSc (Clinical Rehabilitation)  Multiple Sclerosis and Parkinson’s Canterbury Inc., Christchurch, New Zealand Klaus Pfeifer PhD Chair for Exercise and Health, Institute of Sport Science and Sport, Friedrich-Alexander University (FAU), Erlangen-Nürnberg, Germany ABSTRACT Self-management behaviours, if constructively used, can assist people with long-term conditions to manage their health and well- being more effectively. The role of clinicians is to provide support for patient self-management because we know that incorporating constructive behaviours into daily life can be challenging for patients. The aim of this paper is to provide an opportunity for clinicians to understand how the content and delivery of interventions could support patient self-management. In this paper, we therefore highlight a number of theoretical frameworks that may assist clinicians to explicitly identify components of their interactions with patients. As an illustrative example, we use a self-management programme for fatigue, developed with people with multiple sclerosis (MS) in New Zealand. We believe that with a better understanding of behaviour change processes, clinicians have an opportunity to see the full range of behaviour change techniques (BCTs) available to them and how these could be used, to think more carefully about the BCTs they embed in their practice and, therefore, to critically refect on how they could better support patient self- management. Wilkinson, A., Mulligan, H., Snowdon, J., & Pfeifer, K. (2020). Bridging theory and practice for supporting patient self- management. New Zealand Journal of Physiotherapy, 48(2), 92-97. https://doi.org/10.15619/NZJP/48.2.05 Key Words: Behaviour Change, Long-Term Conditions, Self-Management Support INTRODUCTION As clinicians we often notice patterns of behaviours in ourselves that are potentially detrimental to our own health. We also know, however, that self-management behaviours, if constructively used, can assist us to manage our health and well-being effectively. This is also true for people with long- term conditions. Yet we know only too well that incorporating constructive behaviours for self-management into daily life is challenging (Harvey et al., 2015; Jerant et al., 2005; Kralik et al., 2004; Wilkinson et al., 2014). Our role as clinicians is to provide support to patients toward self-management. Thus, an important aim for clinicians is to understand how to best support patients to develop and include self-management behaviours into their daily lives. In a guest editorial of the New Zealand Journal of Physiotherapy, Mulligan (2019) argued that effcacy of physiotherapy interventions could be improved through incorporating patients’ preferences and contexts into physiotherapy interventions. Abraham, Michie and colleagues present a growing body of research about theory, and understanding of behaviour and behaviour change, specifcally as these relate to health interventions. This has included development of the Behaviour Change Wheel, which incorporates the Capability, Opportunity and Motivation for Behaviour (COM-B), a framework for characterising and designing behaviour change interventions (Michie, van Stralen, & West, 2011). The COM-B system proposes that for a person to achieve behaviour change, the individual requires capability for the behaviour, opportunity for the behaviour change, and motivation to change the behaviour in order to achieve success in changing their behaviour (Michie, van Stralen, & West, 2011). Michie and colleagues’ work has also included the Theoretical Domains Framework, an integrative theoretical framework developed for behaviour change research (Cane et al, 2012). Furthermore, they have developed a formal system to characterise components of interventions, and have explained how to link these with the context for delivery of each component within an intervention (Michie et al., 2013; Michie, van Stralen & West, 2011). The intent of this body of work has been to facilitate understanding of the behaviour change processes that underpin effective behavioural interventions. Thus, development of the Behaviour Change Wheel and Theoretical Domains Framework can assist clinicians to explicitly understand the theory/theories underpinning self-management