Web-Based Consumer Health Education About Back Pain: Findings of Potential Tensions From a Photo-Elicitation and Observational Study

Abstract

Background Low back pain (LBP) is a leading cause of disability worldwide, with huge social and economic impact. There is extensive extant literature investigating the efficacy of various management approaches ranging from surgery to psychological interventions to exercise. However, this work has focused almost entirely on efficacy in terms of pain reduction, functional improvement, and psychological changes. This focus has meant that unanticipated social or socio-cultural effects of back pain health care have received little attention. Objective This study aimed to scrutinize some of the conceptual tensions inherent in contemporary LBP health care approaches and to highlight their material effects. Methods We used a qualitative research design adapted from discourse analysis, which was able to consider key discursive tensions underpinning a LBP website. Data collection involved observing the interaction between adult participants with LBP and the website in the following two ways: (1) observational interview, where participants were observed interacting with the website for the first time and asked to discuss their responses to it as they moved through the website and (2) photo-elicitation, where for a month after their first use of the website, people took photographs of what was happening in their lives when they thought of the website and discussed them in a follow-up interview. We used a postcritical discourse analysis approach to examine data produced from these methods. Results Our postcritical discourse analysis identified key discursive tensions, including between living with and reducing LBP, keeping active and resting, and patient choice and giving guidance. Conclusions Our analysis suggests ways for considering less dominant perspectives without having to discard the benefits of dominant ones. Although the focus of LBP discourses has changed (less biomedical and less about cure), they still hold on to some of the problematic dominant paradigmatic concepts such as biomedicine and individualism. The tensions we highlight are likely to be highly useful for teaching and implementing LBP care across multiple health care settings.

Effect of a Consumer-Focused Website for Low Back Pain on Health Literacy, Treatment Choices, and Clinical Outcomes: Randomized Controlled Trial

“…However, our sample had low quality of life utility scores compared with Australian norms (our data: mean 0.55, SD 0.22, vs mean 0.799, 95% CI 0.792-0.806 [ 31 ]). Despite the co-design of MyBackPain in individuals with LBP, the presentation of information might not be optimal for those with low quality of life [ 32 ].…”

“…It is recommended that information resources be tested for the credibility and accuracy of content [ 39 ]. According to these criteria, the MyBackPain website has a strong foundation supported by research with consumers [ 32 ] and expert consultation for content accuracy [ 21 , 40 ]. Multimedia Appendix 6 [ 10 , 21 , 25 , 32 , 41 - 43 ] considers MyBackPain against evidence standards for digital health technologies [ 41 ].…”

Staying moving, staying strong: Protocol for developing culturally appropriate information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout

“…Data will be collected and analysed in parallel so that emerging interpretations can be tested and challenged in subsequent interviews. Data will be analysed using a critical approach [ 43 ] and the outcome will be categorised into themes describing the participants’ experiences of engaging with the culturally adapted arthritis resources.…”