Using intervention mapping to develop a decision support system–based smartphone app (selfBACK) to support self-management of nonspecific low back pain: development and usability study.

Svendsen, Malene Jagd; Sandal, Louise Fleng; Kj�r, Per; Nicholl, Barbara I.; Cooper, Kay; Mair, Frances; Hartvigsen, Jan; Stochkendahl, Mette Jensen; S�gaard, Karen; Mork, Paul Jarle; Rasmussen, Charlotte

Abstract

International guidelines consistently endorse the promotion of self-management for people with low back pain (LBP); however, implementation of these guidelines remains a challenge. Digital health interventions, such as those that can be provided by smartphone apps, have been proposed as a promising mode of supporting self-management in people with chronic conditions, including LBP. However, the evidence base for digital health interventions to support self-management of LBP is weak, and detailed descriptions and documentation of the interventions are lacking. Structured intervention mapping (IM) constitutes a 6-step process that can be used to guide the development of complex interventions. The aim of this paper is to describe the IM process for designing and creating an app-based intervention designed to support self-management of nonspecific LBP to reduce pain-related disability. The first 5 steps of the IM process were systematically applied. The core processes included literature reviews, brainstorming and group discussions, and the inclusion of stakeholders and representatives from the target population. Over a period of >2 years, the intervention content and the technical features of delivery were created, tested, and revised through user tests, feasibility studies, and a pilot study. A behavioral outcome was identified as a proxy for reaching the overall program goal, that is, increased use of evidence-based self-management strategies. Physical exercises, education, and physical activity were the main components of the self-management intervention and were designed and produced to be delivered via a smartphone app. All intervention content was theoretically underpinned by the behavior change theory and the normalization process theory. We describe a detailed example of the application of the IM approach for the development of a theory-driven, complex, and digital intervention designed to support self-management of LBP. This description provides transparency in the developmental process of the intervention and can be a possible blueprint for designing and creating future digital health interventions for self-management.

Citation

SVENDSEN, M.J., SANDAL, L.F., KJÆR, P., NICHOLL, B.I, COOPER, K., MAIR, F., HARTVIGSEN, J., STOCHKENDAHL, M.J., SØGAARD, K., MORK, P.J. and RASMUSSEN, C. 2022. Using intervention mapping to develop a decision support system–based smartphone app (selfBACK) to support self-management of nonspecific low back pain: development and usability study. Journal of medical internet research [online], 24(1), article e26555. Available from: https://doi.org/10.2196/26555

• Journal Article Type: Article
• Acceptance Date: Nov 4, 2021
• Online Publication Date: Dec 16, 2021
• Publication Date: Jan 31, 2022
• Deposit Date: Jan 31, 2022
• Publicly Available Date: Jan 31, 2022
• Journal: Journal of Medical Internet Research
• Print ISSN: 1438-8871
• Electronic ISSN: 1438-8871
• Publisher: JMIR Publications
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 1
• Article Number: e26555
• DOI: https://doi.org/10.2196/26555
• Keywords: Intervention mapping; Behavior change; Low back pain; Self-management; mHealth; App-based intervention; Decision support system; Digital health intervention; Mobile phone
• Public URL: https://rgu-repository.worktribe.com/output/1580586
• Additional Information: The accompanying file contains two supplementary tables, which can be found at the end of the main text (pages 22-47). The preprint for this article was posted on Preprints ( https://doi.org/10.2196/preprints.26555 ) and JMIR Preprints ( https://preprints.jmir.org/preprint/26555 ).