Designing a digital support intervention for the self-management of low back pain (SELFBACK) – an intervention mapping approach

Konferenceabstrakt til konference - 2019

Resume

Introduction
Self-management, including patient education, monitoring of symptoms, and physical activity and exercises, are consistently recommended in clinical guidelines as core components for low back pain (LBP) management. However, the adherence to a self-management program is challenging for most patients, especially without feedback and reinforcement. Therefore, digital health solutions have gained increasing interest as potential vehicles for promotion and support.
Methods
We partnered with five medical research teams and four technical partners, and used qualitative synthesis based on an intervention mapping approach (IM). IM aims to facilitate participation and consultation of stakeholders, and provides a structure for the integration of theory, empirical findings, and information collected from a target population. Evidence from systematic reviews and key papers on LBP was combined with theoretical models for changing behavior and stakeholder experience. This was then systematically operationalized and used to guide the development of the content of a digital intervention delivered through a mobile phone application (SelfBACK).
Results
The evidence base for interactive digital interventions to support SM of LBP remains weak, and barriers for their use needs to be addressed. Identification of core outcome domains in relation to pain-related disability and behaviour led to the formulation of specific performance objectives. A three-pronged program with detailed action steps was developed and adapted to delivery in an application format. The three components are; physical exercises of progressing difficulty levels, educational components in the form of advice and quizzes, and monitoring and feed- back of step counts. The design of the app and the delivery of the content was executed by the technical partners after extensive user tests. Adaptation, implementation and evaluation will be conducted in an RCT planned for 2019.
Discussion
In general, intervention mapping was a useful method to develop a digital intervention aimed at reducing pain-related disability in LBP patients. The methodology provided a structured, step-by-step process to unravel a complex problem, and to design an evidence- based intervention embedded in well-established theory of behavior change. The SelfBACK project will provide learning regarding the implementation and effectiveness of an app-based SM intervention for patients with LBP.

Reference

Designing a digital support intervention for the self-management of low back pain (SELFBACK) – an intervention mapping approach. 2019.