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Cooper K1, Sani S2, Massie S2, Wiratunga N2
1Robert Gordon University, School of Health Sciences, Aberdeen, United Kingdom, 2Robert Gordon University, School of Computing Science & Digital Media, Aberdeen, United Kingdom
Background: The SELFBACK study consortium are developing a smart decision support system (smartphone app) to facilitate, improve and reinforce self-management of non-specific low back pain (LBP). SELFBACK is underpinned by behaviour change and normalisation process theories and will incorporate evidence-based education, specific exercises, and will encourage users to be physically active. In keeping with iterative design processes and guidelines for the development of complex interventions, we conducted a study of a preliminary version of SELFBACK to explore feasibility and acceptability of the physical activity component of the app and study processes in order to inform further development and testing of the app.
Purpose: The feasibility objectives were: (i) to measure completion rates for proposed outcome measures; (ii) to explore user interaction with the SELFBACK app; (iii) to explore user-identified difficulties in engaging with the SELFBACK app. The acceptability measures were: to explore the opinions of people with LBP on: (i) the content, mode of delivery, usefulness and effectiveness of the SELFBACK physical activity component; and (ii) to explore barriers and facilitators to using the SELFBACK physical activity component.
Methods: This was a sequential, explanatory mixed methods study. Sixteen adults (aged 18+) with self-reported LBP were recruited from the University physiotherapy clinic and from the wider University population. Following screening for suitability, participants were issued with a wrist-worn Mi-Band (Xiaomi, Beijing) activity tracker and link to download the SELFBACK app to their smartphone. The app consisted of physical activity goal-setting, monitoring, and theory-based notifications. Participants completed online baseline measures, used the app for a one-month period, then completed an electronic survey (SurveyMonkeyTM) on usability and acceptability. Ten participants agreed to take part in telephone interviews to further explore their perceptions of the app.
Results: Participants were aged 23-71 (mean 52) and 63% were male. Completion rates for the outcome measures were 10-38 minutes (mean 18). Most participants wore the Mi-Band continuously and opened the app on average 6.2 times per day and received 1.8 messages per day. Some participants experienced difficulties downloading the app and/or synchronising the Mi-Band with their smartphone. The electronic survey and interviews resulted in a range of opinions on various aspects of the app. Participants were overall positive; 69% would download the app and use it long-term, but limitations and barriers were identified and are being used in the further development of SELFBACK. Participants liked: personalisation of physical activity notifications; step-counting; goal-setting; in-app feedback. Potential barriers to using SELFBACK were: older age, older smartphones, irregular access to smartphone. Facilitators were: personalised notifications, daily feedback, and GP recommendation.
Conclusion(s): The SELFBACK physical activity component is feasible and acceptable to people with LBP. Study processes are likewise feasible and acceptable. A number of recommendations can be incorporated in the iterative design process of the SELFBACK Smart Digital Intervention for LBP Self-management.
Implications: This feasibility study generated important knowledge for the further development and testing of the full SELFBACK digital intervention, which will be the subject of a randomised controlled trial beginning in 2019.
Keywords: Low Back Pain, Digital Health, Self-management
Funding acknowledgements: This project received funding from the European Union Horizon 2020 research and innovation program under grant agreement No 689043
Purpose: The feasibility objectives were: (i) to measure completion rates for proposed outcome measures; (ii) to explore user interaction with the SELFBACK app; (iii) to explore user-identified difficulties in engaging with the SELFBACK app. The acceptability measures were: to explore the opinions of people with LBP on: (i) the content, mode of delivery, usefulness and effectiveness of the SELFBACK physical activity component; and (ii) to explore barriers and facilitators to using the SELFBACK physical activity component.
Methods: This was a sequential, explanatory mixed methods study. Sixteen adults (aged 18+) with self-reported LBP were recruited from the University physiotherapy clinic and from the wider University population. Following screening for suitability, participants were issued with a wrist-worn Mi-Band (Xiaomi, Beijing) activity tracker and link to download the SELFBACK app to their smartphone. The app consisted of physical activity goal-setting, monitoring, and theory-based notifications. Participants completed online baseline measures, used the app for a one-month period, then completed an electronic survey (SurveyMonkeyTM) on usability and acceptability. Ten participants agreed to take part in telephone interviews to further explore their perceptions of the app.
Results: Participants were aged 23-71 (mean 52) and 63% were male. Completion rates for the outcome measures were 10-38 minutes (mean 18). Most participants wore the Mi-Band continuously and opened the app on average 6.2 times per day and received 1.8 messages per day. Some participants experienced difficulties downloading the app and/or synchronising the Mi-Band with their smartphone. The electronic survey and interviews resulted in a range of opinions on various aspects of the app. Participants were overall positive; 69% would download the app and use it long-term, but limitations and barriers were identified and are being used in the further development of SELFBACK. Participants liked: personalisation of physical activity notifications; step-counting; goal-setting; in-app feedback. Potential barriers to using SELFBACK were: older age, older smartphones, irregular access to smartphone. Facilitators were: personalised notifications, daily feedback, and GP recommendation.
Conclusion(s): The SELFBACK physical activity component is feasible and acceptable to people with LBP. Study processes are likewise feasible and acceptable. A number of recommendations can be incorporated in the iterative design process of the SELFBACK Smart Digital Intervention for LBP Self-management.
Implications: This feasibility study generated important knowledge for the further development and testing of the full SELFBACK digital intervention, which will be the subject of a randomised controlled trial beginning in 2019.
Keywords: Low Back Pain, Digital Health, Self-management
Funding acknowledgements: This project received funding from the European Union Horizon 2020 research and innovation program under grant agreement No 689043
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: Robert Gordon University
Ethics committee: School of Health Sciences School Research Ethics Panel
Ethics number: SHS17_14
All authors, affiliations and abstracts have been published as submitted.
