Purpose
This study will evaluate the feasibility of distributing the SelfBack app through members
of the Chiropractic Association of Alberta and the feasibility of patients using the app.
Justification
The SelfBack app is a promising decision support system (DSS) App used globally to
support and reinforce desired self-management behaviour for LBP. Selfback's program goal
is to improve the self-management of nonspecific low back pain (LBP) to reduce
pain-related disability. Using applications (apps) has been suggested to be a promising
way to increase the effectiveness of self-management interventions.
Objectives
Our primary objective is to evaluate the feasibility of distributing and using the
SelfBack app. A secondary objective is to assess patient outcomes collected by the
SelfBack app.
Methodology Overview
The Chiropractic Association of Alberta (CAA) will recruit members who are interested in
being enrolled in the study. Those who meet the eligibility criteria and provide consent
will then be trained in the SelfBack app and then respond to a baseline survey to
determine their current attitudes and beliefs regarding using the SelfBack app. Trained
and enrolled chiropractors will then identify chronic LBP patients in their own practice
to receive the SelfBack App. Patients who are eligible and consent to participate will be
provided with the SelfBack App. The SelfBack app then collects patient data and provides
patients with personalized advice regarding education and exercise for chronic LBP.
De-identified group-level Selfback data will then be downloaded by the investigative team
at regular intervals for analysis. Finally, chiropractors will provided with a follow-up
survey to evaluate their attitudes and beliefs following their involvement in the trial.
Overall timeline and setting:
The study will occur between May 2024 and December 2024 (8 months).
Patient Data
Once patients provide consent to the Investigative Team, they will be sent instructions
on how to download and use the SelfBack app. Once installed on the participant's
smartphone, the SelfBack app will ask a series of baseline questions (~ 30 min) to
establish what educational advice and exercises best suit the participant.
The SelfBack app regularly asks questions of the user to determine their ability to
participate in exercise and education and evaluate their progress in the program. The
list of survey questions used by the app was created, approved, and distributed by
Selfback and is attached to this protocol.
The SelfBack will collect two categories of data.
The first category will be related to patient demographics.
The second category is related to patient-related outcome measures, a variety of
established scales, and questionnaires with known psychometric properties. These outcome
measures are used to assess the participant's health status, fitness level, and
psychological health. These specific outcomes are asked at baseline, 3, and 6 months.
Clinician - Patient Interaction
Chiropractors are not excluded from seeing their patients while patients are using the
SelfBack app. Clinical encounters may occur for heart concerns that are unrelated to the
study or require in-person evaluation to determine and evaluate their ability to continue
in the study.
Clinicians are also provided with a real-time dashboard through Selfback where they can
receive information about SelfBack users in real-time. Specifically, the dashboard shows
if triggers have occurred which indicates the patient has entered information into the
app which requires monitoring or follow-up.
Analyses
The general procedure for statistical analysis is as follows:
Descriptive statistics will be generated which will be cross-tabulated with demographic
groups of interest (e.g., gender, age, community size, caregiver status,
self-identification of disability, and ethnic and racial identification).
Feasibility will be judged as successful if 50% of the enrolled participants complete the
education and exercise program recommended by the app.