Explaining unsuccessful physical activity promotion in low back pain patients: A secondary analysis on the usage and acceptance of health coaching

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Abstract
Background: Multicomponent interventions combined with health coaching are widely recommended to improve a healthy lifestyle. The present study analysed the usage and acceptance of approaches of a multicomponent intervention (telephone, web and face-to-face coaching) for low back pain patients, with the purpose of understanding why the intervention was not as effective as expected. Methods: A secondary analysis of a randomised controlled trial, aimed at promoting physical activity, was conducted. It was a cross-sectional study based on data of a multicomponent intervention group (baseline=201 participants). For evaluating the usage and acceptance, descriptive statistics were applied. Results: Over half (n=118) of the patients participated at least once in the telephone coaching. Approximately half of the participants (44 of 90) rated the telephone coaching as "good". 34 of 92 (37%) participants reported of visiting the web-platform. The web-platform was comprehensible for nearly one-quarter (n=8 of 33) and very useful for one participant. The face-to-face-contact was rated highly (range: 79.4-88.2 out of 100). Conclusion: Usage of the telephone coaching approach was moderate with even fewer participants visiting the web-platform. In addition, these approaches were not rated as very useful. The acceptance of the face-to-face contact was high. Since the usage and acceptance could influence the effectiveness, utilisation and acceptance studies might help to explain the reason for non-effective lifestyle interventions. Therefore, more studies analysing the usage and acceptance are needed. To improve the usage and acceptance, a stronger participatory orientation in the design of interventions and the integration of face-to-face contact could be helpful. Trial registration: German Clinical Trials Register (DRKS)-ID: DRKS00004878 Keywords: Usage; acceptance; promoting physical activity; health coach; face-to-face contact; telephone coaching; web based coaching
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