Table 1 Screening and enrollment

Initial Screen

N =86 screened

 Excluded, reasons below

40 (47%)

 Patient was not screened at approximately 6 weeks post-fracture

13 (15%)

 Patient has a fragility fracture (a fall from a standing height or less, that results in a fracture)

9 (11%)

 Patient is unwilling to complete the SPOC questionnaire

8 (9%)

 Patient is unwilling to discuss the study

5 (6%)

 Patient does not have the cognitive ability and language skills to participate in CBT interventions

3 (4%)

 Patient is facing current or impending incarceration

1 (1%)

 Patient did not receive internal fixation within 6 weeks of injury

1 (1%)

Secondary Screen

N =46 screened

 Patient does not meet the threshold for unhelpful illness beliefs on the SPOC questionnaire

24 (28%)

Final Screen

N =22 screened

 Excluded, reasons below

19 (22%)

 Patient anticipates problems attending CBT sessions

7 (8%)

 Patient has an active substance use disorder that, in the judgement of the treating surgeon, would interfere in the patient’s ability to partake in the CBT and/or the study

6 (7%)

 Patient is unable to start the CBT at approximately 8 weeks post-fracture

3 (4%)

 Patient is already participating in or planning to start other psychological treatments (including CBT) within the duration of the study (12 months)

3 (4%)

Eligible after Screening

N =3 screened

 Enrolled

3 (4%)