A multimedia campaign to improve back beliefs in patients with non-specific low back pain: a process evaluation

Abstract

BackgroundLow back pain (LBP) is one of the most prevalent and costly disorders worldwide. To reduce its burden in the Netherlands, implementation of a multidisciplinary guideline for LBP was supported by a multifaceted eHealth campaign for patients with LBP. The current study aims 1) to evaluate whether the implementation strategy was performed as planned; 2) to assess the feasibility, barriers and facilitators of the patient based eHealth campaign; 3) to gain insight into the satisfaction and experiences of patients with various ethnic backgrounds with the implementation strategy and to make a comparison between them; and 4) to explore the association between exposure to and satisfaction with the implementation strategy.MethodsThis process evaluation was performed using the Linnan and Steckler framework, and used a mixed methods approach for data collection and analysis. The relationship between satisfaction of patients and exposure to the strategy was statistically examined. Semi-structured interviews were analysed using qualitative data analysis methods.ResultsTwo hundred and fourteen patients participated in the quantitative, and 44 in the qualitative analysis. Most were female and had a high level of education. Many patients did not use the campaign at all or only once, and those that did rated it as reasonable. Patient satisfaction with the campaign increased significantly with an increase in its use. Qualitative analysis showed that four main themes played a role in campaign rating and use: satisfaction with intervention components, perceived benefits of the intervention, usage of the intervention, and satisfaction with the medium used.ConclusionThis process evaluation showed that the eHealth campaign was used only by a small proportion of patients with non-specific LBP. It seemed that the campaign was offered to the patients too late, that the lay-out of the campaign did not meet patient needs, and that healthcare providers rarely discussed the campaign with their patients, while involvement of those providers seemed to improve trustworthiness of the campaign and increase its usage. It is important to invest effort into healthcare providers to motivate patients to use eHealth intervention and to tailor strategies better to the needs of users.Trial registrationNetherlands Trial Register (NTR): NTR4329. Registered December 20th, 2013.

A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders

“…In the previous decades there has been an increase in the number of studies regarding primary prevention of MSD, across a wide range of scientific disciplines, including epidemiology (29), applied physiology (30), biomechanics (31), physical and organizational (macro) ergonomics (25,32), behavioral sciences (33), production engineering (34), organizational management (35), health and business economics (36), and implementation science (37). These disciplines vary largely in their contribution to work-related MSD prevention research, ranging from classic injury surveillance and etiological studies to detailed laboratory studies and animal models exploring injury mechanisms, and studies evaluating interventions and implementation.…”

Effectiveness and cost-utility of a multifaceted eHealth strategy to improve back pain beliefs of patients with non-specific low back pain: a cluster randomised trial

“…It is arguable that the participating patients were in good health states from the start and gaining much improvement on these functional outcomes was not realistic. Process evaluations among participating patients and professionals alongside the present study showed that compliance with the intervention was very low 20 21. Most patients did not comply to the full eHealth intervention: 31% of the participants had not used the campaign materials at all, and 42.9% had only used it once, and professionals almost never discussed the intervention with their patients.…”

“…The literature does not provide explanations for this fact. One explanation could lie, again, in the low compliance rate of patients in this study 20. On the other hand, the use of alternative care could be seen as self-management, because patients decide what they want, when they want it, and how much they are willing to pay for it.…”

“…Most patients did not comply to the full eHealth intervention: 31% of the participants had not used the campaign materials at all, and 42.9% had only used it once, and professionals almost never discussed the intervention with their patients. Probably most participants did not need the intervention to improve their functional ability, but improvement in back pain beliefs could have been possible had the compliance rates in this study been higher 20 21…”

“…The patient intervention was supported by continuing medical education for GPs, PTs and OPs. More detailed descriptions of the patient and professional based interventions are published elsewhere 20 21. Patients in the control group received a digital patient information letter and had no access to the intervention website, materials or social media platforms.…”