App-delivered self-management intervention trial selfBACK for people with low back pain: protocol for implementation and process evaluation

Rasmussen, C. D. N., Svendsen, M. J., Wood, K., Nicholl, B. I. , Mair, F. S. , Sandal, L. F., Mork, P. J., Søgaard, K., Bach, K. and Stochkendahl, M. J. (2020) App-delivered self-management intervention trial selfBACK for people with low back pain: protocol for implementation and process evaluation. JMIR Research Protocols, 9(10), e20308. (doi: 10.2196/20308) (PMID:33118959) (PMCID:PMC7661240)

Abstract

Background: Implementation and process evaluation is vital for understanding how interventions function in different settings, including if and why interventions have different effects or do not work at all. Objective: This paper presents the protocol for an implementation and process evaluation embedded in a multicenter randomized controlled trial conducted in Denmark and Norway (the selfBACK project). selfBACK is a data-driven decision support system that provides participants with weekly self-management plans for low back pain. These plans are delivered through a smartphone app and tailored to individual participants by using case-based reasoning methodology. In the trial, we compare selfBACK in addition to usual care with usual care alone. Methods: The aim of this study is to conduct a convergent mixed-methods implementation and process evaluation of the selfBACK app by following the reach, effectiveness, adoption, implementation, and maintenance framework. We will evaluate the process of implementing selfBACK and investigate how participants use the intervention in daily life. The evaluation will also cover the reach of the intervention, health care provider willingness to adopt it, and participant satisfaction with the intervention. We will gather quantitative measures by questionnaires and measures of data analytics on app use and perform a qualitative exploration of the implementation using semistructured interviews theoretically informed by normalization process theory. Data collection will be conducted between March 2019 and October 2020. Results: The trial opened for recruitment in February 2019. This mixed-methods implementation and evaluation study is embedded in the randomized controlled trial and will be collecting data from March 2019 to October 2020; dissemination of trial results is planned thereafter. The results from the process evaluation are expected 2021-2022. Conclusions: This study will provide a detailed understanding of how self-management of low back pain can be improved and how a digital health intervention can be used as an add-on to usual care to support patients to self-manage their low back pain. We will provide knowledge that can be used to explore the possibilities of extending the generic components of the selfBACK system and key drivers that could be of use in other conditions and diseases where self-management is an essential prevention or treatment strategy. Trial Registration: ClinicalTrials.gov NCT03798288; https://www.clinicaltrials.gov/ct2/show/NCT03798288 International Registered Report Identifier (IRRID): DERR1-10.2196/20308.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nicholl, Dr Barbara and Mair, Professor Frances and Wood, Miss Karen
• Authors: Rasmussen, C. D. N., Svendsen, M. J., Wood, K., Nicholl, B. I., Mair, F. S., Sandal, L. F., Mork, P. J., Søgaard, K., Bach, K., and Stochkendahl, M. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: JMIR Research Protocols
• Publisher: JMIR Publications
• ISSN: 1929-0748
• ISSN (Online): 1929-0748
• Published Online: 29 October 2020
• Copyright Holders: Copyright © 2020 Charlotte Diana Nørregaard Rasmussen, Malene Jagd Svendsen, Karen Wood, Barbara I Nicholl, Frances S Mair, Louise Fleng Sandal, Paul Jarle Mork, Karen Søgaard, Kerstin Bach, Mette Jensen Stochkendahl
• First Published: First published in JMIR Research Protocols 9(10): e20308
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
172430		SELFBACK	Barbara Nicholl	European Commission (EC)	689043	HW - General Practice and Primary Care