Mette Holz Meinhardt Gregersen

Objectives. We aimed to develop a booklet for people with low back pain (LBP) and their healthcare professionals (HCPs), which provides coherent, evidence-based patient education to support helpful pain-related behaviours tailored to individual needs.Methods. People with LBP, HCPs, educators, researchers, and a visual artist were included in a co-design process. Booklet content was developed in an iterative approach comprising three surveys and three in-person workshops. First, HCPs contributed suggestions for educational content in a survey. These were then organised into themes, drafted as text paragraphs and metaphors, and refined through three workshops and two subsequent survey rounds involving all stakeholder groups. Illustrations were sketched during workshops and discussed in surveys.Results. Three overarching themes were agreed on: (1) creating an alliance (HCPs and people with LBP working collaboratively), (2) explaining LBP, and (3) managing LBP. The booklet included these themes by combining suggestions for factual explanations, metaphors, and practical strategies for facilitating a collaborative approach to patient education. In the final survey, the texts for all of 17 outlined messages were endorsed by more than 90% (n = 27) respondents. Of 11 proposed metaphors for explaining LBP, one was excluded due to lack of consensus.Conclusions. We developed a booklet for people with LBP and for HCPs in a co-design process. The content covers topics previously identified as important for LBP education, while the booklet emphasises individualised education delivered through interaction and dialogue rather than generic information transfer. Future research should explore the booklet’s usefulness for supporting people with LBP in managing their condition, and a tailored implementation plan should be developed.Practice implications. The booklet “When Your Back Hurts – A Guide to Back Pain” is available as a source of current information about LBP meant to support an individualised clinical dialogue.

Objectives: Implementing motivational self-management support in low back pain care remains challenging due to barriers including health care providers’ limited confidence in addressing behavioral aspects of pain, people with low back pain’s expectations, and time constraints. To promote person-centered low back pain care, this project engaged people with low back pain, health care providers, and researchers in a co-design process to develop a dialogue tool aimed at supporting motivational conversations and facilitating self-management.Methods: Guided by Design Thinking principles, we conducted a co-design process informed by self-determination theory and structured around the 5A’s model for behavior change (Assess, Advise, Agree, Assist, Arrange). The process included fieldwork, workshops, prototype development, and iterative refinements. To inform refinements, acceptability, appropriateness, and feasibility of the dialogue tool were evaluated through surveys (n = 9 health care providers) and in semi-structured interviews with health care providers (n = 6) and people with low back pain (n = 4).Results: The final product was an analog tool comprising 7 dialogue sheets and 5 information postcards aligned with the 5A’s components. Both health care providers and people with low back pain found the prototype tool acceptable and feasible for structuring person-centered conversations about pain and self-management. The most frequently used elements were those to support a person-centered assessment of pain complexity (Assess) and to provide options for managing pain (Assist). Barriers included lack of experience and need of supplementary training in use of the dialogue tool.Conclusions: Using a co-design process, we developed an analog dialogue tool to facilitate a person-centered approach to support self-management of low back pain. Effects of the tool and strategies for implementation are still to be tested.Practice implications: The dialogue tool may support structured, person-centered conversations about pain beliefs, factors affecting pain, and self-management strategies linked to meaningful goals and activities.