Dr Jenny Setchell

Funded by:	Arthritis South Australia
Recipient:	Dr Jenny Setchell
Intended Department	School of Health and Rehabilitation Science- The University of Queensland
Project:	Translating low back pain research: identifying potential hidden harms in health messaging

 

The overarching aim of the research was to contribute to improved management of low back pain, the world’s leading cause of disability. People increasingly use the internet to obtain health information. However, most current online information sources do not meet the needs of individuals with back pain, and are often untrustworthy. Accurate and trustworthy education about this condition has the potential to substantially reduce its excessive burden. To address this issue, we had previously developed a (separately funded) online resource. This was done in collaboration with consumer organisation Arthritis Australia; individuals with low back pain; and leading national/international low back pain experts. Our world-first website involved extensive work to identify high quality information and distilled it into an easily understood evidence-based resource in multiple formats (e.g. consumer and clinician videos, information sheets, quiz) and used evidence-based algorithms to create tailored consumer advice. The website’s key messages were:

• enhancing consumer confidence in managing their condition and making evidence based treatment choices;
• de-medicalising back pain and reinforcing that back pain is a natural part of life for many and can often be managed with early return to activity; and
• engaging consumers in behaviours and attitudes to reduce the burden of pain.

The project funded by this grant used techniques from social sciences to evaluate these key messages; examining the principles, understandings and assumptions that these messages take for granted. It considered how these messages (and their underlying assumptions) might be taken up by consumers accessing the website, and considered any potential negative effects on them. The study complemented a separately funded randomised controlled trial of the website.

Project aims were:

1. To investigate the understandings and assumptions that were taken for granted in the key messaging of the website.
2. To determine how key messages (and their underlying assumptions) were taken up by participants and to consider any potential negative effects on participants.
3. To suggest future directions for the website.
4. To contribute to critical broader discussions about the nature of pain and arthritis health messaging.

These aims are highly important for reasons both specific to the website, and more broadly for the management of low back pain.

We used two methodologies to achieve the project aims. We encountered no problems with the implementation of these two study methods and are now considering these two methodologies as separate studies as both produced valuable and different results:

Study 1. an analysis of the key assumptions of the website content (words, images, videos etc) drawing on key social theories. We collaborated with a group of people with different backgrounds to do this: sociology, public health, psychology, occupational therapy, physiotherapy and an ‘expert consumer’ (person with low back pain with social science knowledge)

Study 2. A participatory study where the assumptions were further investigated with individuals with low back pain. This study had two main methods of data collection: 1) we observed and interviewed participants as they first interacted with the website, and then 2) over the next month participants took photographs whenever they thought about the website – these photographs were then shared with the researchers and discussed in a second interview to consider how the website affected participant’s lives.