title: The influence of a biopsychosocial educational internet-based intervention on pain, dysfunction, quality of life, and pain cognition in chronic low back pain patients in primary care: a mixed methods approach.
abstract: BACKGROUND
  Low back pain is the highest reported musculoskeletal problem worldwide. Up to 90 % of patients with low back pain have no clear explanation for the source and origin of their pain. These individuals commonly receive a diagnosis of non-specific low back pain. Patient education is a way to provide information and advice aimed at changing patients' cognition and knowledge about their chronic state through the reduction of fear of anticipatory outcomes and the resumption of normal activities. Information technology and the expedited communication processes associated with this technology can be used to deliver health care information to patients. Hence, this technology and its ability to deliver life-changing information has grown as a powerful and alternative health promotion tool. Several studies have demonstrated that websites can change and improve chronic patients' knowledge and have a positive impact on patients' attitudes and behaviors. The aim of this project is to identify chronic low back pain patients' beliefs about the origin and meaning of pain to develop a web-based educational tool using different educational formats and gamification techniques.
  
  
  METHODS
  This study has a mixed-method sequential exploratory design. The participants are chronic low back pain patients between 18-65 years of age who are attending a primary care setting. For the qualitative phase, subjects will be contacted by their family physician and invited to participate in a personal semi-structured interview. The quantitative phase will be a randomized controlled trial. Subjects will be randomly allocated using a simple random sample technique. The intervention group will be provided access to the web site where they will find information related to their chronic low back pain. This information will be provided in different formats. All of this material will be based on the information obtained in the qualitative phase. The control group will follow conventional treatment provided by their family physician.
  
  
  CONCLUSIONS
  The main outcome of this project is to identify chronic low back pain patients' beliefs about the origin and meaning of pain to develop a web-based educational tool using different educational formats and gamification techniques.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02369120 Date: 02/20/2015.
authors.affiliation: Universidad de Lleida, Facultad de Enfermería y Fisioterapia, Montserrat Roig 2, Lleida, 25198, Spain. fvp1969@infermeria.udl.cat.|Grupo de Estudios Sociedad, Salud, Educación y Cultura, Universidad de Lleida, Pl. de Víctor Siurana 1, Lleida, 25003, Spain. fvp1969@infermeria.udl.cat.|Grup de Recerca de Cures de Salut, Institut de Recerca Biomèdica, Avda Alcalde Rovira Roure 80, Lleida, 25198, Spain. fvp1969@infermeria.udl.cat.
authors.forename: Fran
authors.initials: F
authors.lastname: Valenzuela-Pascual
authors.affiliation: Grupo de Estudios Sociedad, Salud, Educación y Cultura, Universidad de Lleida, Pl. de Víctor Siurana 1, Lleida, 25003, Spain.|Universidad de Lleida, Facultad de Educación, Psicología y Trabajo Social, Av. Estudi General 4, Lleida, 25001, Spain.
authors.forename: Fidel
authors.initials: F
authors.lastname: Molina
authors.affiliation: Universidad de Lleida, Institut Nacional d'Educació Física de Catalunya, Centro de Lleida, Partida Caparrella s/n, Lleida, 25192, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Corbi
authors.affiliation: Universidad de Lleida, Facultad de Enfermería y Fisioterapia, Montserrat Roig 2, Lleida, 25198, Spain.|Grupo de Estudios Sociedad, Salud, Educación y Cultura, Universidad de Lleida, Pl. de Víctor Siurana 1, Lleida, 25003, Spain.|Grup de Recerca de Cures de Salut, Institut de Recerca Biomèdica, Avda Alcalde Rovira Roure 80, Lleida, 25198, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Blanco-Blanco
authors.affiliation: Departamento de Informática e Ingeniería Industrial, Universidad de Lleida, Jaume II 69, Lleida, 25001, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Gil
authors.affiliation: Grupo de Estudios Sociedad, Salud, Educación y Cultura, Universidad de Lleida, Pl. de Víctor Siurana 1, Lleida, 25003, Spain.|Universidad de Lleida, Facultad de Medicina, Montserrat Roig 2, Lleida, 25198, Spain.|Institut Català de la Salut, Rambla de Ferran 44, Lleida, 25007, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Soler-Gonzalez
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D017116:Low Back Pain / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D058748:Pain Perception; D010353:Patient Education as Topic / Q000379:methods*; D011320:Primary Health Care; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult