title: The long-term effects of a self-management program for inner-city primary care patients with acute low back pain.
abstract: BACKGROUND
  We evaluated the effect of a self-management program for low-income primary care patients with acute low back pain (ALBP) from inner-city neighborhood health centers.
  
  
  METHODS
  We conducted a randomized controlled trial of a self-management program compared with usual care at university-affiliated neighborhood health centers and an emergency department of an inner-city public teaching hospital. We enrolled 211 patients who visited a physician for ALBP (<90 days' duration). The self-management program consisted of 3 group sessions and telephone follow-up that focused on understanding back pain, increasing physical activity, and dealing with fears and frustrations.
  
  
  RESULTS
  At baseline, 4 months, and 12 months, blinded interviewers assessed back pain physical function (Roland Disability Questionnaire), health status (Arthritis Impact Measurement Scales), self-efficacy, and time spent in physical activity. Compared with patients receiving usual care, intervention patients reported significantly better scores on the Roland Disability Questionnaire (P =.009), mental functioning (P =.009), self-efficacy to manage ALBP (P =.03), time spent in physical activity (P =.047), and reduced fears of movement/reinjury (P =.005) after 12 months.
  
  
  CONCLUSIONS
  A self-management program can improve and maintain functional status, mental functioning, and self-efficacy to manage future symptoms for 1 year among primary care patients with ALBP living in the urban, inner city.
authors.affiliation: Indiana University Center for Aging Research, Regenstrief Institute Inc., Indiana University School of Medicine, 1050 Wishard Boulevard, Indianapolis, IN 46202-2872, USA. tdamush@regenstrief.org
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Damush
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perkins
authors.forename: Jaya K
authors.initials: JK
authors.lastname: Rao
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
authors.forename: Rong
authors.initials: R
authors.lastname: Qi
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D006304:Health Status; D006801:Humans; D007196:Indiana; D017116:Low Back Pain / Q000628:therapy*; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014505:Urban Population