J. Marley1, C. Larsson2, F. Piccinini3, S. Howes1, E. Ekvall Hansson2, E. Casoni4, S. McDonough5
1Ulster University, School of Health Science, Londonderry, United Kingdom, 2Lund University, Human Movement: health and rehabilitation, Lund, Sweden, 3INCRA, Centre for Socio-Economic Research on Ageing, Ancona, Italy, 4INCRA, National Institute of Care of the Elderly, Ancona, Italy, 5RCSI, School of Physiotherapy, Dublin, Ireland
Background: Globally, persistent low back pain (LBP) is among the most prevalent, disabling, and expensive conditions to treat.Global prevalence of LBP is increasing, notably, more rapidly within lower- and middle-income countries. Massive Open Online Courses (MOOCs) offer an appealing accessible and scalable platform for delivering educational self-management programmes for individuals with LBP.
Purpose: Four European countries collaborated to develop and test the feasibility of an evidence based, educational self-management intervention for LBP, delivered using the MOOC format. The intervention was available in English, Italian, Portuguese and Swedish.
Methods: Intervention development: A synthesis of international clinical guidelines for LBP, a series of focus groups with individuals with LBP and multidisciplinary transnational meetings led to the development of a multimedia programme consisting of 2 hours of online content, and a downloadable handbook.
Two versions of the intervention were available (1) A free of charge open access MOOC hosted on Udemy (2) A study specific version of the MOOC that was accessed through a study specific link.
Feasibility: study participants were recruited using; social media (Italy, Northern Ireland, Portugal, Sweden), pain clinic (Portugal) and University email distribution lists (Northern Ireland, Sweden). Recruitment, engagement, retention, and completion of outcome measures were used to evaluate the feasibility of the intervention.
Two versions of the intervention were available (1) A free of charge open access MOOC hosted on Udemy (2) A study specific version of the MOOC that was accessed through a study specific link.
Feasibility: study participants were recruited using; social media (Italy, Northern Ireland, Portugal, Sweden), pain clinic (Portugal) and University email distribution lists (Northern Ireland, Sweden). Recruitment, engagement, retention, and completion of outcome measures were used to evaluate the feasibility of the intervention.
Results: Across the four countries, 100 participants registered and consented to take part, 40% completed baseline questionnaires, and 17% completed follow-up questionnaires.
The open access MOOC hosted on Udemy had 1796 enrolments within the study recruitment timeframe, the intervention was accessed in 98 countries, the highest accesses were from Brazil and India (19.4% each). The conversion rates (percentage of individuals that enrolled after visiting the course the course landing page) ranged from 40.35% UK version to 4.94% for the Swedish version.
The open access MOOC hosted on Udemy had 1796 enrolments within the study recruitment timeframe, the intervention was accessed in 98 countries, the highest accesses were from Brazil and India (19.4% each). The conversion rates (percentage of individuals that enrolled after visiting the course the course landing page) ranged from 40.35% UK version to 4.94% for the Swedish version.
Conclusions: While the idea of an open globally accessible, evidence based self-management intervention for LBP is appealing, this multi-country study has highlighted several challenges. An estimated 70% of workload on the study is attributed to developing materials that required multiple translations and heavy editing to ensure the advice and information was appropriate for, and sensitive to, different cultural contexts.
Recruiting participants was difficult, and it is interesting to contrast the small number of participants enrollingin the study, to the large number enrolling via the Udemy MOOC.
However, we know little about the participants accessing the programme via Udemy or their back pain status. MOOC formats offer a very accessible and affordable format for delivery of healthcare interventions, which is important in the context of the increasing prevalence of LBP. To maximise the utility of interventions delivered using a MOOC format, cultural contexts of health need to be considered.Where MOOCs have been developed by reputable institutions, they offer accessible and reliable information that can support self-management and patient enablement.
Recruiting participants was difficult, and it is interesting to contrast the small number of participants enrollingin the study, to the large number enrolling via the Udemy MOOC.
However, we know little about the participants accessing the programme via Udemy or their back pain status. MOOC formats offer a very accessible and affordable format for delivery of healthcare interventions, which is important in the context of the increasing prevalence of LBP. To maximise the utility of interventions delivered using a MOOC format, cultural contexts of health need to be considered.Where MOOCs have been developed by reputable institutions, they offer accessible and reliable information that can support self-management and patient enablement.
Implications: MOOC formats offer an appealing platform for delivery of educational self management interventions for LBP, they have global reach and appear to achieve high enrolments, further analysis of MOOC's to explore retention in different languages, engagement with materials and meaningful outcomes is required.
Funding acknowledgements: Co-funded by the Erasmus programme of the European Union, project-ID:2018-1-DE01-KA204-039144
Keywords:
Low back pain
MOOC
Self management
Low back pain
MOOC
Self management
Topics:
Health promotion & wellbeing/healthy ageing/physical activity
Musculoskeletal: spine
Research methodology, knowledge translation & implementation science
Health promotion & wellbeing/healthy ageing/physical activity
Musculoskeletal: spine
Research methodology, knowledge translation & implementation science
Did this work require ethics approval? Yes
Institution: Ulster University; INCRA; Lund University
Committee: Ulster University Research Ethics Committee (and all participating countries)
Ethics number: REC/20/0045; 72/2021 DGEN; 2020-03536
All authors, affiliations and abstracts have been published as submitted.
