Validation and evaluation of a work-based individualised digital health intervention (BACK-On-LINETM) to support self-management of low back pain

Chen, Minghao 2024. Validation and evaluation of a work-based individualised digital health intervention (BACK-On-LINETM) to support self-management of low back pain. PhD Thesis, Cardiff University. Item availability restricted.

Preview	PDF - Accepted Post-Print Version Download (9MB) | Preview
	PDF (Cardiff University Electronic Publication Form) - Supplemental Material Restricted to Repository staff only Download (2MB)

Abstract

Background: Low back pain (LBP) imposes physical, psychological and financial burdens on individuals, especially the working-age population. Self-management offering education, encouraging exercise and staying in work is recommended, but existing support is mainly provided within primary care settings. Digital health interventions developed for health self-management (DHSMIs) provides an opportunity for early intervention of LBP in the workplace. However, existing DHSMIs tend to be unidimensional focused on physical behaviours in work, providing generic LBP advice with minimal individualisation as recommended within clinical guidelines. BACK-on-LINE™ (BOL) has been designed as an individualised DHSMI accessible to people with LBP in the workplace. It incorporates the previously developed BOL selfassessment to classify LBP into nociceptive and nociplastic pain subgroups by pain mechanisms and provides an individualised work-based intervention for LBP management. Therefore, this PhD project aimed to first synthesise and appraise existing evidence on DHSMIs, focused on individualised LBP self-management in the workplace. The technological feasibility, acceptability and potential benefits of using BOL for LBP across three different work settings was determined and, baseline data from this evaluation determined reliability and validity of the BOL self-assessment. Methods: Based on the UK National Institute For Health And Care Research and Medical Research Council’s complex intervention assessment framework, a threephase mixed-methods research design was conducted. The systematic review (Phase 1) reviewed current DHSMI research on LBP self-management in the workplace, particularly individualised DHSMIs. Phase 2 established the cut-off points and assessed the reliability and validity of the BOL self-assessment in discriminating LBP subgroups among the working population. In Phase 3, technological feasibility, acceptability and potential benefits of applying BOL to assist LBP self-management in the workplace were evaluated through a comprehensive interpretation of the mixed data. Results: The systematic review revealed a scarcity of DHSMIs for LBP selfmanagement in the workplace, and self-management of LBP was predominantly unidimensional, with only one study attempting individualisation. Phase 2 established the cut-off point (36 points) of BOL self-assessment for discriminating LBP subgroups in the working population. The BOL self-assessment demonstrated good test-retest reliability, internal consistency, construct and criterion validity. In Phase 3, BOL was found to be technologically feasible and acceptable in aspects such as usage (10.25 visits per participant), self-assessment and offering individualised feedback. There was a significant loss in follow-up, which may be attributed to the industrial shutdown and the shifted work focus of the involved NHS occupational health departments due to COVID-19. Conclusion: There is a lack of high-quality research on the DHSMI for LBP in the workplace, with further scarcity of individualised DHSMIs. Classifying LBP based on pain mechanisms is deemed useful and welcomed by BOL users. It is technologically feasible and acceptable to use BOL to support LBP self-management in the healthcare, education and transport industries. Enhancing adaptability and functionality were suggested areas by BOL participants for improving individualisation.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Healthcare Sciences
Date of First Compliant Deposit:	17 March 2025
Last Modified:	17 Mar 2025 12:10
URI:	https://orca.cardiff.ac.uk/id/eprint/176903

Actions (repository staff only)

Edit Item