Larsson Caroline, Marley Joanne, Piccinini Flavia, Howes Sarah, Casoni Elisa, Aschettino Vincenzo, Vaz de Carvalho Carlos, McDonough Suzanne
Department of Health Sciences, Lund University, Sölvegatan 19, Lund, 223 62, Sweden, 46 736673026.
School of Health Sciences, Ulster University, Belfast, United Kingdom.
JMIR Form Res. 2025 Aug 27;9:e74948. doi: 10.2196/74948.
Low back pain (LBP) is a leading cause of work absence globally. Digital interventions have the potential to increase access to self-management support for individuals with persistent LBP.
This study aims to evaluate the feasibility, usability, and acceptability of a digital educational program (MyRelief) designed to support self-management strategies for people with persistent LBP.
A prospective uncontrolled feasibility study was conducted across 4 countries (Italy, Portugal, Sweden, and the United Kingdom) between 2020 and 2021. Adults in employment with nonspecific persistent LBP (>3 mo) with access to the internet were eligible to participate. Participants were given access to MyRelief, an 8-unit evidence-based educational self-management program. The feasibility of the MyRelief program was assessed using recruitment rates, an a priori success threshold of >70% of the target sample (50 participants), and a retention <35% dropout rate. Pre- and postintervention measures of functional disability were assessed using the Oswestry Disability Index (ODI), and health-related quality of life using the 5-level EuroQol questionnaire. Additional postintervention measures included the Patient Enablement Instrument and the System Usability Scale. Quantitative data were analyzed descriptively, and qualitative feedback was analyzed using a reflexive analytical approach.
The recruitment feasibility threshold was met, and 40/50 (80%) participants (19 male and 21 female; mean age 57 years) were enrolled in the study. A total of 17 participants (11 male and 6 female) completed both the baseline and 12-week follow-up questionnaires. This represented a retention rate of 42.5% (17/40) and a dropout rate of 57.5%, which did not meet the a priori criteria of <35% dropouts. Approximately half of the participants presented with low baseline disability scores (mean ODI 24.0; 95% CI 18-31) with no significant change at follow-up (mean ODI 23.9; 95% CI 16-31). The 5-level EuroQol questionnaire scores improved from 0.68 (95% CI 0.608-0.76) to 0.72 (95% CI 0.66-0.79), indicating a clinically significant change. Patient Enablement Instrument scores postintervention were high (mean 5.31), indicating good perceived enablement. The mean System Usability Scale score was 72.4 (95% CI 67.5-73.3), indicating a good level of perceived ease-of-use. Overall, the quality of outcome measure completion was high (100%). Qualitative feedback indicated areas for improvement relating to challenges around access and navigation within the website.
The MyRelief study demonstrated feasibility in terms of recruitment but not retention. However, low baseline disability levels are not representative of the wider persistent LBP population. Future studies should broaden recruitment strategies, in particular, by recruiting from health care settings to improve representativeness. Although usability met industry standards, qualitative feedback suggests that navigation and accessibility require further optimization to better align with end user preferences for digital health interventions.
腰痛是全球范围内导致工作缺勤的主要原因。数字干预措施有可能为持续性腰痛患者增加获得自我管理支持的机会。
本研究旨在评估一项旨在支持持续性腰痛患者自我管理策略的数字教育项目（MyRelief）的可行性、易用性和可接受性。
2020年至2021年期间在4个国家（意大利、葡萄牙、瑞典和英国）进行了一项前瞻性非对照可行性研究。有互联网接入且患有非特异性持续性腰痛（>3个月）的在职成年人有资格参与。参与者可以使用MyRelief，这是一个由8个单元组成的基于证据的教育自我管理项目。使用招募率评估MyRelief项目的可行性，先验成功阈值为目标样本（50名参与者）的>70%，保留率<35%的辍学率。使用Oswestry功能障碍指数（ODI）评估干预前后的功能障碍，使用5级欧洲生活质量调查问卷评估与健康相关的生活质量。干预后的其他测量指标包括患者赋能工具和系统可用性量表。对定量数据进行描述性分析，使用反思性分析方法分析定性反馈。
达到了招募可行性阈值，40/50（80%）名参与者（19名男性和21名女性；平均年龄57岁）被纳入研究。共有17名参与者（11名男性和6名女性）完成了基线和12周随访问卷。这代表保留率为42.5%（17/40），辍学率为57.5%，未达到<35%辍学率的先验标准。大约一半的参与者基线残疾评分较低（平均ODI 24.0；95%CI 18 - 31），随访时无显著变化（平均ODI 23.9；95%CI 16 - 31）。5级欧洲生活质量调查问卷得分从0.68（95%CI 0.608 - 0.76）提高到- 0.72（95%CI 0.66 - 0.79），表明有临床显著变化。干预后患者赋能工具得分较高（平均5.31），表明感知赋能良好。系统可用性量表平均得分为72.4（95%CI 67.5 - 73.3），表明感知易用性水平良好。总体而言，结果测量完成质量较高（100%）。定性反馈指出了在网站访问和导航方面存在挑战的需要改进的领域。
MyRelief研究在招募方面证明了可行性，但在保留方面未证明可行性。然而，低基线残疾水平并不代表更广泛的持续性腰痛人群。未来的研究应拓宽招募策略，特别是从医疗保健机构招募以提高代表性。尽管可用性符合行业标准，但定性反馈表明导航和可访问性需要进一步优化，以更好地符合最终用户对数字健康干预的偏好。
