JMIR Publications

ABSTRACT

Background:

Self-management is the key recommendation for managing non-specific low back pain (LBP). However, there are well-documented barriers to self-management, therefore methods of facilitating adherence are required. Smartphone apps are increasingly being used to provide feedback and reinforcement to support self-management of long-term conditions such as LBP.

Objective:

The aim of this study was to assess the usability and acceptability of the selfBACK smartphone app, designed to support and facilitate self-management of non-specific LBP. The app provides weekly self-management plans, comprising physical activity, strength/flexibility exercises, and patient education. The plans are tailored to the patient’s characteristics and symptom progress by using case-based reasoning methodology.

Methods:

The study was carried out in two stages, using a mixed-methods approach. All participants undertook surveys, and semi-structured telephone interviews were conducted with a subgroup of participants. Stage 1 assessed an app version with only the physical activity component and a web-questionnaire that collects information necessary for tailoring the self-management plans. The physical activity component included monitoring of steps recorded by a wristband, goal-setting, and a scheme for sending personalised, timely, and motivational notifications to the user’s smartphone. Findings from stage 1 were used to refine the app and inform further development. Stage 2 investigated an app version that incorporated three self-management components (physical activity, exercises, and education). A total of 16 participants (age range 23-71 years) with ongoing or chronic non-specific LBP were included in stage 1, and 11 participants (age range 32-56) were included in stage 2.

Results:

In stage 1, 94% of participants reported that the baseline questionnaire was easy to answer and 84% found completion time to be acceptable. Overall, participants were positive about the usability of the physical activity component but only 31% found the app functions to be well integrated. Ninety percent of the participants were satisfied with the notifications and they were perceived as being personalised (80%). In stage 2, all participants reported that the web-questionnaire was easy to answer and the completion time acceptable. The physical activity and exercise components were rated useful by 80% while 60% rated the educational component useful. Overall, participants were satisfied with the usability of the app; however, only 50% found the functions to be well integrated and 20% found them to be inconsistent. Overall, 80% of participants reported it to be useful for self-management. The interviews largely reinforced the survey findings in both stages.

Conclusions:

This study has demonstrated that participants considered the selfBACK app to be acceptable and usable and that they thought it would be useful for supporting self-management of LBP. However, we identified some limitations and suggestions useful to guide further development of the selfBACK app, and other mHealth interventions. Clinical Trial: N/A