A REALIST EVALUATION OF A SELF-MANAGEMENT APP TO HELP PEOPLE WITH CHRONIC LOW BACK PAIN

Abstract

BackgroundMobile apps have shown promise in helping people to self-manage conditions like chronic low back pain (CLBP). However, it is unclear who benefits most, why, and under what circumstances. This limits our understanding of how to maximize the potential of mobile app technology.AimThis study aimed to test and refine programme theories about how mobile apps support people to self-manage CLBP in a real-world setting. The theories were based on a previously published realist review.MethodsA realist evaluation was conducted using one-to-one realist interviews by telephone with participants who had used the Curable app to self-manage their CLBP for three months. The interviews were guided by programme theories from the realist review. Analysis of the interviews used abductive and retroductive logic to create chains of inferences, which were then developed into context-mechanism-outcome configurations (CMOCs). These CMOCs offered causal explanations about who might benefit from a mobile app to self-manage CLBP, why and in what circumstances.ResultsTen interviews were conducted (nine with people with CLBP who trialled the app and one with a founding member of Curable LLC). Twenty CMOCs were created that identified key mechanisms such as agency, control and reassurance that interact with contextual factors such as acceptance, internal capacity, and a biopsychosocial approach to pain management. These factors influence whether a person with CLBP will benefit from a mobile app for self-management.ConclusionsTwenty CMOCs were created to support three programme theories centering around concepts of empowerment, burden of care, and timing.Conflicts of interestNoneSources of fundingR Hunter's work was supported by the Inverness and Highland City-Region Deal Studentship Award [2018].Presented at: 13th Congress of the European Pain Federation (EFIC), September 2023, Budapest, Hungary.