CoChat
Sign Up
Cited by 257Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care.

Von Korff, Michael, Moore, James E., Lorig, Kate, Cherkin, Daniel C., Saunders, Kathleen, González, Virginia M., Laurent, Diana, Rutter, Carolyn +1 more·1998·Spine
DOI 10.1097/00007632-199812010-00016
Open this paper in CoChat — free account

Abstract

STUDY DESIGN: Randomized, controlled trial. OBJECTIVE: To evaluate a four-session self-management group intervention for patients with pain in primary care, led by trained lay persons with back pain. The intervention was designed to reduce patient worries, encourage self-care, and reduce activity limitations. BACKGROUND DATA: Randomized trials of educational interventions suggest that activating interventions may improve back pain outcomes. Expert opinion increasingly regards effective self-management of back pain as important in achieving good outcomes. In this study, an educational intervention designed to activate patients and support effective self-management was evaluated. METHODS: Six to 8 weeks after a primary care visit for back pain, patients were invited to participate in an educational program to improve back pain self-management. Those showing interest by returning a brief questionnaire became eligible for the study. Participants (n = 255) randomly were assigned to either a self-management group intervention or to a usual care control group. The effect of the intervention, relative to usual care, was assessed 3, 6, and 12 months after randomization, controlling for baseline values. The intervention consisted of a four-session group applying problem-solving techniques to back pain self-management, supplemented by educational materials (book and videos) supporting active management of back pain. The groups were led by lay persons trained to implement a fully structured group protocol. The control group received usual care, supplemented by a book on back pain care. RESULTS: Participants randomly assigned to the self-management groups reported significantly less worry about back pain and expressed more confidence in self-care. Roland Disability Questionnaire Scores were significantly lower among participants in the self-management groups relative to the usual care controls at 6 months (P = 0.007), and this difference was sustained at 12 months at borderline significance levels (P = 0.09). Among self-management group participants, 48% showed a 50% or greater reduction in Roland Disability Questionnaire Score at 6 months, compared with 33% among the usual care controls. CONCLUSIONS: Self-management groups led by trained lay persons following a structured protocol were more effective than usual care in reducing worries, producing positive attitudes toward self-care, and reducing activity limitations among patients with back pain in primary care.

Integrity signals

Registry

Crossref · 10.1097/00007632-199812010-00016

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Von Korff, M., Moore, J. E., Lorig, K., Cherkin, D. C., Saunders, K., González, V. M., Laurent, D., Rutter, C., & Comite, F.
Affiliations
  • Virginia Mason Medical Center (US)
  • Stanford University (US)
  • Group Health Cooperative (US)
  • Yale University (US)
Corresponding author
  • Cherkin, Daniel C.
  • Saunders, Kathleen
  • Rutter, Carolyn
ORCID
Venue
Spine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-12
Volume
23
Issue
23
Pages
2608-2615
ISSN
0362-2436 (ISSN-L)
DOI
10.1097/00007632-199812010-00016
OpenAlex
W2046947448
Cited by
257
References
22
Citations by year
2026: 3 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 9 · 2015: 13 · 2014: 3 · 2013: 15 · 2012: 11
FWCI
4.38
Type
journal article
Language
en
Open access
closed
Locations
  • Spine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Dental and Craniofacial Research (P01DE008773)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords
back pain, self-management, group intervention, primary care, patient education, problem-solving strategies, disability, activity limitation, worry, self-care confidence, teaching materials
MeSH terms
Activities of Daily Living, Adult, Aged, Back Pain, Behavioral Symptoms, Disability Evaluation, Female, Health Maintenance Organizations, Humans, Male, Middle Aged, Pain Measurement, Patient Education as Topic, Primary Health Care, Surveys and Questionnaires, Self Care, Self-Help Groups, Washington, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review