Can the Enhanced Transtheoretical Model Intervention (ETMI) be Implemented in a Public Health Organization

ETMI consists of a physical and functional examination, a discussion about the role of physical activity matched to the patient stage of change, and guided through motivational interviewing techniques, exposure to fast walking, and goal setting. The patient receives a postcard outlining the main messages about physical activity and four simple stretches. The ETMI method consists of four parts: 1. Creating a therapeutic alliance (communication skills and reassurance) 2. Clear messages to the patient: Mandatory 3 sentences: (1." physical activity is the only thing that will help your back pain over time." 2. "It's easy to reduce your pain now - but the important thing is to prevent the next episode"," 3. "Your body must be strong and flexible.") 3. Exposure to brisk walking (brisk walking in the corridor, hand by hand with the therapist) and graded activity. 4. Postcard with reminder messages on how to self manage the back.