JMIR Publications

ABSTRACT

Background:

The Internet is used for information related to health conditions, including low back pain, but most low back pain websites provide inaccurate information. Few studies have investigated the effectiveness of Internet resources to change health literacy or treatment choices.

Objective:

To evaluate the effectiveness of MyBackPain website compared to unguided internet use, on health literacy, choice of treatments and clinical outcomes in people with low back pain.

Methods:

This was a pragmatic, online, participant- and assessor-blinded randomized trial of individuals with low back pain stratified by duration. Participants were randomly allocated to have access to the evidence-based MyBackPain website which was designed with input from consumers and expert consensus, or inguided internet use. Co-primary outcomes were two dimensions of the Health Literacy Questionnaire (Dimension 2: ‘having sufficient information to manage my health’; Dimension 3: ‘actively managing my health’, converted to scores 1-100) at three months. Secondary outcomes included additional Health Literacy Questionnaire dimensions, quality of treatment choices, and clinical outcomes.

Results:

453 participants were recruited and 321 (71%) completed primary outcomes. Access to MyBackPain was not superior to unguided internet use on primary outcomes (Dimension 2: mean difference = -0.87 units, 95%CI -3.56 to 1.82; Dimension 3: mean difference = -0.41 units, 95%CI -2.78 to 1.96). Quality of stated treatment choices was improved at 1 month (mean difference = 0.93 units, 95%CI 0.03 to 1.84). Between-group differences in other secondary outcomes had inconsistent direction and unlikely to be clinically important.

Conclusions:

MyBackPain was not superior to unguided internet use for health literacy but may empower users to make better treatment choices in the short-term. Clinical Trial: ACTRN12617001292369 (registered on 7th September 2017).