Barriers and facilitators for the implementation of Tuina (Jingjin) for neck pain in primary care settings in China: a qualitative study protocol.

Neck pain affects millions of people worldwide and is now the fourth leading cause of disability. In China, primary care clinics often rely too heavily on pain medications to treat neck pain, partly because they lack sufficient medical resources and treatment options. Tuina (specifically a technique called Jingjin) is a form of traditional Chinese massage therapy that research shows can effectively treat neck pain without medications. It's considered safe and patients generally accept it well, making it ideal for primary care settings. However, despite these advantages, Tuina Jingjin isn't widely used in Chinese primary care clinics. Researchers are conducting a qualitative study to understand why this treatment isn't being adopted more broadly. They will interview three groups of people: patients with neck pain, traditional Chinese medicine doctors working in primary care, and healthcare administrators who manage these clinics. These interviews will explore what barriers prevent wider use of Tuina Jingjin and what factors could help it become more available. The study will examine multiple levels of influence, including characteristics of the treatment itself, the healthcare environment, individual practitioner factors, and implementation processes. By identifying these obstacles and opportunities, researchers hope to develop strategies that will help primary care clinics offer this evidence-based, non-drug treatment option to more patients suffering from neck pain. If you're interested in Tuina or acupuncture for neck pain, seek a qualified, licensed traditional Chinese medicine practitioner in your area.

This qualitative study protocol aims to identify barriers and facilitators for implementing Tuina (Jingjin) for neck pain management in Chinese primary care settings. Researchers will employ the Consolidated Framework for Implementation Research (CFIR 2.0) to develop semi-structured interview guides examining five core domains: Intervention Characteristics, Outer Setting, Inner Setting, Individual Characteristics, and Process. The study will recruit three stakeholder groups—patients with neck pain, TCM general practitioners, and institutional managers—from geographically diverse primary care institutions across China, with sampling continuing until information saturation is achieved. The rationale stems from current overreliance on pharmacological interventions in resource-limited primary care settings, despite Jingjin Tuina's evidence base, safety profile, and patient acceptance. Clinical takeaway: This implementation science research will inform strategies for integrating evidence-based manual therapies into primary care, addressing the gap between clinical evidence and real-world practice adoption in resource-constrained settings.