The present study seeks to repeat the previously described positive clinical impact of SNPE
in a new population, examine rates of adherence, and compare the effects of face-to-face
versus online courses.
Specific Aims:
Aim 1: Investigate the adherence to an SNPE program in American adults to explore the
generalizability of existing Korean data.
Aim 2: Assess the effects of a 12-week face-to-face vs online SNPE program on back pain.
We hypothesize that the face-to-face group will show greater pain reduction and
improvements in body posture and quality of life compared to the control group after
phase 1.
Aim 3: Compare adherence to and effects of face-to-face vs online 12-week SNPE programs.
Aim 4: Investigate the adherence to and effects of face-to-face vs online 12-week SNPE
programs at a follow-up of 12 weeks.
A single-blind randomized controlled trial (RCT) design with a wait-list control group will
be used to evaluate the effect of SNPE for back pain reduction. The control group will
receive online SNPE intervention after serving as an untreated comparison group. The
wait-list control group serves two purposes. First, it provides an untreated comparison for
the face-to-face group to determine if the intervention had an effect. By serving as a
comparison group, researchers are able to isolate the independent variable and look at the
impact it had. Second, it allows the wait-listed participants an opportunity to obtain the
intervention at a later date.
Recruitment:
Flyers, Billings Clinic employee emails, and social media will be used to recruit
participants. Recruitment messages will include relevant information about the study,
benefits, and inclusion criteria as well as a link to a study-specific website recapitulating
this information (https://xppizim.wixsite.com/snpestudy). When patients contact the
investigators, any questions will be answered. If the patient chooses to go forward, the ODI
Questionnaire and Self-reported Data Form will be collected online (www.surveymonkey.com).
Data will be reviewed for eligibility, and if appropriate, participant will be sent the
information contained on the consent form to review; the actual signed form will be collected
at time of their 1st assessment prior to the collection of data.
After being assessed by a physiatrist, eligible participants will be invited to participate
in the study. All participants will have an equal chance of being randomly assigned (using a
random number table from Microsoft Excel to produce random numbers).
Analyses:
All data will be exported from www.surveymonkey.com and analyzed using the Statistical
Package for Social Sciences (SPSS) application. Descriptive statistics will be used to
summarize demographic variables. To investigate adherence mentioned in Aim 1 and 4,
frequencies and percentages will be analyzed for categorical variables and mean, standard
deviation, quartiles, and ranges for continuous variables. For Aim 2 and 3, all outcome
measures will be compared between groups (Assessment 1 will be considered the baseline for
face-to-face (FTF) and Assessment 2 will be the baseline for online (ONL)), will be analyzed
using an analysis of covariance (ANCOVA) via the General Linear Model (GLM). Age and gender
will be controlled as covariates. If there is a significant difference using ANCOVA, we will
follow up with post hoc testing.