Acute low back pain self-management intervention for urban primary care patients: rationale, design, and predictors of participation

Abstract

Objectives: To describe the rationale and design of a self-management program for low-income, urban, primary care patients with acute low back pain. Issues related to recruitment and protocol delivery, and attendance patterns and predictors of program attendance are described.

Methods: Two hundred eleven adult patients (73% female; 60% African American) were recruited from primary care neighborhood health centers. Focus groups were conducted for program development, and participants then completed a baseline interview and were randomized into groups receiving either usual care or a self-management intervention.

Results: Twenty-nine percent of the intervention group attended the self-management class. Significant predictors of attendance included being older, reporting less income, and not working for pay. Attendees did not differ from nonattendees on back pain severity, symptoms, health-related quality of life, self-management processes, or satisfaction with care.

Conclusion: Effective minimal-contact behavioral interventions are needed to reach larger portions of the patient population.