Accepted for/Published in: JMIR Human Factors
Date Submitted: Jul 26, 2023
Date Accepted: Mar 20, 2024
Feasibility and preliminary effects of a web-based self-management program for chronic non-cancer pain: A mixed-method study
ABSTRACT
Background:
In Canada, adults with chronic non-cancer pain face a persistent insufficiency of publicly funded resources, with the gold-standard multidisciplinary pain treatment facilities unable to meet the high clinical demand. Web-based self-management programs cost-effectively increase access to pain management and can improve several aspects of physical and emotional functioning. Aiming to meet the demand for accessible, fully automated resources for individuals with chronic non-cancer pain, we developed a French web- and evidence-based self-management program, Agir pour moi (APM). This program includes pain education, and strategies to reduce stress, practice mindfulness, apply pacing, engage in physical activity, identify and manage thinking traps, sleep better, adapt diet, and sustain behavior change.
Objective:
This study assessed the APM self-management program's feasibility, acceptability, and preliminary effects in adults awaiting specialized services from a Center of Expertise in Chronic Pain management.
Methods:
We conducted a mixed-method study with an explanatory sequential design, including a web-based one-arm trial and qualitative semi-structured interviews. We integrated the results from both phases through joint displays.
Results:
Response rates were 68.3% at post-intervention and 55.6% at 3-month follow-up among the 63 consenting participants who provided self-assessed information at baseline. Twenty-nine participants completed the program. Fifteen interviewees expressed their appreciation for a globally acceptable program, easy to use and engaging. They highlighted the features that impacted their self-efficacy and the adoption of self-management strategies. We observed indications of improvement in self-efficacy, pain intensity, pain interference, depression, and catastrophizing. Interviewees described these and various other effects as potentially influenced by macrolevel engagement through behavioral change.
Conclusions:
These findings provide preliminary evidence that the APM self-management program and research methods are feasible, although some participants would require at least phone reminders and minimal support to engage. Recruitment strategies of a future randomized controlled trial should focus on attracting a broader representation of individuals with chronic pain in terms of gender and ethnicity. Clinical Trial: Trial registration: Clinicaltrial.gov NCT05319652
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