Acute low back pain self-management intervention for urban primary care patients: Rationale, design, and predictors of participation

Objectives. To describe the rationale and design of a self-management program for low-income, urban, primary care patients with acute low back pain. Issues related to recruitment and protocol delivery, and attendance patterns and predictors of program attendance are described. Methods. Two hundred eleven adult patients (73% female; 60% African American) were recruited from primary care neighborhood health centers. Focus groups were conducted for program development, and participants then completed a baseline interview and were randomized into groups receiving either usual care or a self-management intervention. Results. Twenty-nine percent of the intervention group attended the self-management class. Significant predictors of attendance included being older, reporting less income, and not working for pay. Attendees did not differ from nonattendees on back pain severity, symptoms, health-related quality of life, self-management processes, or satisfaction with care. Conclusion. Effective minimal-contact behavioral interventions are needed to reach larger portions of the patient population.