Interactive Program to Manage and Prevent Back Pain

描述（由申请人提供）：在美国，背痛是导致工作致残的主要原因。它为所有美国人带来了过高的医疗、保险和法律费用，并导致员工生产力损失数十亿美元。在人生的某个阶段，80%的劳动力都会遭受某种形式的背痛。虽然美国疼痛协会建议采用多学科方法来管理疼痛，包括认知、身体和教育干预，但工人们很少有机会获得这些治疗。总之，由于大多数患有背痛的成年人从未接受过治疗，因此迫切需要制定易于实施和广泛传播的多学科疼痛管理和预防计划。该项目将开发和测试一种交互式多媒体程序，用于在工作场所没有接受医疗护理的背痛患者。网络/光盘培训计划将包括背痛评估工具、反馈和建议，以及帮助制定目标和制定疼痛管理行动计划。这将是一次重复访问，多学科干预，包括认知行为技术（例如，放松练习，解决问题，减少恐惧等），物理技术（例如，拉伸，对齐，加强等）和教育（例如，关于多学科方法，人体工程学，生活方式问题）。该计划将包括视频和动画教程，激励同伴的证词，行为建模的小插曲，和信息文章。第一阶段的概念验证将包括(a)背痛评估工具，该工具将提供阶段性的反馈和建议，(b)目标设定，以及(c)行动计划模块。将使用主题内设计评估在互联网上的可行性。此外，由国家疼痛管理专家组成的独立小组将进行系统审查。I期临床试验的预期结果将证明疼痛管理意图、态度和自我效能方面的效用、可行性和前后变化。在第二阶段，完整的计划将在互联网上的一个更大的随机试验中开发和评估。第二阶段产品的潜在市场是员工援助公司、行为健康组织、健康保险公司和疼痛管理诊所。每五个成年人中就有四个在人生的某个阶段遭受背痛的折磨，治疗背痛的最佳方法是结合心理、生理和教育策略的多学科方法。不幸的是，医生缺乏时间和培训来采用这些方法，保险公司不包括这些方法，提供这些方法的诊所也不容易找到。建议的互联网计划提供了广泛的6周多学科的背部疼痛干预。

DESCRIPTION (provided by applicant): Back pain is the leading cause of work-related disability in America. It contributes to excessive medical, insurance, and legal costs for all Americans and results in billions of dollars in lost productivity for employees. At some point in their lives, 80% of the work force will suffer some form of back pain. While the American Pain Society recommends a multidisciplinary approach to pain management that integrates cognitive, physical, and educational interventions, workers have little access to these treatments. In sum, because most adults who suffer from back pain never receive treatment, there is a critical need to develop multidisciplinary pain management and prevention programs that can be easily implemented and widely disseminated. This project will develop and test an interactive multimedia program for back pain sufferers in the workplace who are not receiving medical care. The Internet/CD-Rom training program will include a Back Pain Assessment Tool, feedback and recommendations, and assistance with setting goals and developing a pain management action plan. It will be a repeat visit, multidisciplinary intervention incorporating cognitive- behavioral techniques (e.g., relaxation exercises, problem-solving, fear-reduction, etc.), physical techniques (e.g., stretching, alignment, strengthening, etc.) and education (e.g., about multidisciplinary approaches, ergonomics, life style issues). The program will incorporate video and animated tutorials, motivational peer testimonials, behavior modeling vignettes, and informational articles. The Phase I proof of concept will include (a) the Back Pain Assessment Tool, which will provide stage- tailored feedback with recommendations, (b) goal setting, and (c) action plan modules. It will be evaluated for feasibility on the Internet using a within-subject design. In addition, an independent panel of national experts in pain management will conduct a systematic review. The anticipated results from the Phase I trial will demonstrate utility, feasibility, and pre-post change with respect to pain management intentions, attitudes, and self-efficacy. In Phase II, the complete program will be developed and evaluated in a larger randomized trial on the Internet. The potential markets for the Phase II product are employee assistance firms, behavioral health organizations, health insurance companies, and pain management clinics. Back pain, which afflicts four out of five adults at some point in their lives, is best treated with a multidisciplinary approach combining psychological, physical, and educational strategies. Unfortunately, doctors lack time and training to incorporate such approaches, insurance companies don't cover them, and clinics offering them aren't readily available. The proposed Internet program provides broad access to a 6- week multidisciplinary back pain intervention.