A qualitative assessment of a text message intervention for people with low back pain.

BACKGROUND:Text messages represent a simple and scalable strategy to provide self-management to people with low back pain (LBP), yet their usefulness is unknown. OBJECTIVE:To assess the usefulness, delivery format, behaviour-change ability and potential for the TEXT4myBACK intervention to be scaled-up. DESIGN:Qualitative study nested within a randomised controlled trial. METHODS:64 participants of the TEXT4myBACK trial randomised to the intervention arm were invited to participate in online sessions. Participants provided feedback about the text messages received. Online sessions were conducted by two researchers until thematic saturation was achieved. Information was analysed based on framework analysis and thematic data-driven coding. RESULTS:Of the 64 invited, 10 people participated in the sessions and thematic saturation was reached. The following themes were identified: intervention's format, barriers and facilitators for behaviour-change, effectiveness, and implementation into healthcare. The messages were considered useful and their format was well-accepted, whilst some suggested a longer duration. The messages were considered simple to read and understand yet further information about LBP and exercise would be appreciated. Some believed the intervention improved their LBP and others believed its effectiveness would depend on receiver's characteristics. Participants felt the messages helped them to increase physical activity. Provision of information, reminders, and self-awareness were some behaviour-change facilitators. Participants said the intervention could be provided by healthcare professionals either for free or through a small fee. CONCLUSIONS:The TEXT4myBACK intervention was useful and well-accepted. It provided reminders and supported increases in physical activity. Participants provided suggestions for the intervention to be scaled-up.