The role of training preparedness in physical therapists' readiness to deliver psychologically informed care: a cross-sectional survey

Background: Psychologically Informed Physical Therapy (PIPT) is an evidence-based approach for managing musculoskeletal pain, yet its uptake in routine physical therapy practice remains inconsistent. Understanding factors that influence physical therapists’ readiness to implement PIPT may help address the implementation gap. Objective: To examine how perceived adequacy of training relates to physical therapists’ implementation intentions to deliver PIPT, and to identify belief-based mechanisms that may mediate this relationship using a Theory of Planned Behavior-informed framework. Methods: A cross-sectional survey was administered to licensed PTs who were members of the Academy of Orthopedic Physical Therapy. Measures assessed perceived adequacy of training, attitudes towards PIPT, self-efficacy, perceived controllability, and implementation intentions. A path model using structural equation modeling with observed variables was estimated to examine direct and indirect associations, with bootstrapped confidence intervals used to test mediation effects. Results: Data from 260 physical therapists were analyzed. Perceived adequacy of training was positively associated with implementation intentions both directly and indirectly through attitudes and self-efficacy. Self-efficacy demonstrated the strongest association with implementation intentions and accounted for the largest indirect effect. Attitudes also partially mediated the relationship between training adequacy and implementation intentions. Perceived controllability was not independently associated with implementation intentions in the final model. The model explained approximately 48% variance in implementation intentions. Conclusion: Perceived adequacy of training and self-efficacy are key determinants of physical therapists’ readiness to implement psychologically informed care. Educational strategies that enhance clinicians’ confidence and belief-based preparedness may be critical for supporting uptake of PIPT in clinical practice.