Limited Health Knowledge as a Reason for Non-Use of Four Common Complementary Health Practices

Burke, Adam; Nahin, Richard L.; Stussman, Barbara J

doi:10.1371/journal.pone.0129336

Cited by 31 publications

(34 citation statements)

References 40 publications

(48 reference statements)

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“…Previous suggestions have also indicated that self-management approaches, particularly those incorporating cognitive behavioral principles, may be more appropriate for higher SES individuals. 9, 10, 17 Consequently, identifying and addressing barriers that low SES patients commonly encounter such as low health knowledge or literacy 6, 13, 70, 72 is appealing as it has potential to enhance LBP treatment outcomes for this often underserved patient population.…”

Section: Discussionmentioning

confidence: 99%

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Beneciuk

Hill

Campbell

et al. 2017

The Journal of Pain

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Identification of patient characteristics influencing treatment outcomes is a top low back pain (LBP) research priority. Results from the STarT Back Trial support the effectiveness of prognostic stratified care for LBP compared to current best care, however patient characteristics associated with treatment response have not yet been explored. The purpose of this secondary analysis was to identify treatment-effect modifiers within the STarT Back Trial at 4 months follow-up (n=688). Treatment response was dichotomized using back-specific physical disability measured by the Roland-Morris Disability Questionnaire (≥7). Candidate modifiers were identified using previous literature and evaluated using logistic regression with statistical interaction terms to provide preliminary evidence of treatment-effect modification. Socioeconomic status (SES) was identified as an effect modifier for disability outcomes (OR = 1.71, P=.028). High SES patients receiving prognostic stratified care were 2.5 times less likely to have a poor outcome compared to low SES patients receiving best current care (OR = 0.40, P=.006). Education level (OR = 1.33, P=.109) and number of pain medications (OR = 0.64, P=.140) met our criteria for effect modification with weaker evidence (0.20>P≥0.05). These findings provide preliminary evidence for SES, education, and number of pain medications as treatment-effect modifiers of prognostic stratified care delivered in the STarT Back Trial. Perspective This analysis provides preliminary exploratory findings about the characteristics of patients who might least likely benefit from targeted treatment using prognostic stratified care for low back pain.

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Section: Discussionmentioning

confidence: 99%

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Beneciuk

Hill

Campbell

et al. 2017

The Journal of Pain

View full text Add to dashboard Cite

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“…Five studies collected data on patient behaviours (15,33,36,39,41), involving ve forms of health outcome measures (Table 4)…”

Section: Behaviourmentioning

confidence: 99%

“…Four studies (Glassman et al, Camerini and Schulz, MacLeod et al, Burke, Nahin and Stussman) involved data on resource utilisation (35,(39)(40)(41). A wide variety of resources were studied, and we broadly grouped these outcomes (Table 4) into utilisation of medications, utilisation of healthcare appointments (e.g.…”

Section: Resource Utilisationmentioning

confidence: 99%

“…The HeLMS provides a more holistic measure of HL, for instance by asking questions on the assessment and usage of health information. HeLMS, and the questionnaires used by Camerini and Schulz (39), MacLeod et al (40) and Burke, Nahin and Stussman (41) have not been used as widely as the S-TOFHLA and NVS, and their content validity in other settings requires con rmation. While a varied questioning style is likely to result in a more complete assessment of HL, measures tended to focus purely on either objective response (e.g.…”

Section: Implications For Future Research and Practicementioning

confidence: 99%

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Health Literacy and Health Outcomes in Patients with Back Pain – A Scoping Review

See

Smith

Car

et al. 2020

Preprint

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BACKGROUND: The World Health Organisation highlights back pain as a leading and growing cause of disability worldwide. In the field of chronic pain, higher health literacy is linked to lower pain intensity and better pain control. However, there remains a paucity of evidence, with a recent systematic review finding only three studies meeting its inclusion criteria. OBJECTIVES: This scoping review had two objectives in exploring research in chronic pain, which were to identify:1) The health literacy measures currently employed. 2) The back-pain health outcomes included in such work and the extent to which these reflect the core outcome set for clinical trials in non-specific low back pain.METHODS: The search broadened the search strategy used in the systematic review. It was conducted using thirteen bibliographic databases, employing medical subject heading (MeSH) terms for back pain and health literacy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A thematic framework approach was used for analysis.RESULTS: The search yielded ten relevant studies for inclusion, amongst which a total of nine health literacy measures and 50 health outcome measures were used. The health outcomes assessed by the included studies could be broadly categorised into: Pain, Disability, Behaviour, Knowledge and Beliefs, and Resource Utilisation. Most outcome measures employed (36 out of 50) were not directly relevant to addressing the core outcome set for clinical trials in non-specific low back pain.CONCLUSIONS: A dearth of studies in this field of research was noted, especially in Asia and low-middle income countries. Methodological limitations were identified, including in study design and outcome measures. To allow for comparison across findings and the development of a rigorous evidence base, future work should include the core outcome set for clinical trials in non-specific low back pain. Furthermore, research thus far has focused on a narrow range of populations and there is an urgent need to broaden the evidence-base to include those with characteristics known to be moderators in health outcomes. Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components.

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“…[23][24][25] For example, approximately 50% of community-dwelling adults with a history of back pain surveyed did not know that acupuncture is not statutorily regulated in the United Kingdom. 23 Lack of knowledge might deter use 26 and is important to address. Therefore, people considering acupuncture might benefit from a reliable online source of accurate, evidence-based information to support their decision-making.…”

Section: Introductionmentioning

confidence: 99%

Supporting informed choice in acupuncture: effects of a new person-, evidence- and theory-based website for patients with back pain

et al. 2019

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Objectives: To test whether a newly developed person-, theory- and evidence-based website about acupuncture helps patients make informed decisions about whether or not to use acupuncture for back pain. Methods: A randomised online study compared a newly developed ‘enhanced website’ to a ‘standard website’. The enhanced website provided evidence-based information in a person-based manner and targeted psychological constructs. The standard website was based on a widely used patient information leaflet. In total, 350 adults with recent self-reported back pain were recruited from general practices in South West England. The two primary outcomes were knowledge change and making an informed choice about using acupuncture. Secondary outcomes were beliefs about and willingness to have acupuncture. Results: Participants who viewed the enhanced acupuncture website had a significantly greater increase in knowledge about acupuncture (M = 1.1, standard deviation (SD) = 1.7) than participants who viewed the standard website (M = 0.2, SD = 1.1; F(1, 315) = 37.93, p < 0.001, η2 = .107). Participants who viewed the enhanced acupuncture website were also 3.3 times more likely to make an informed choice about using acupuncture than those who viewed the standard website (χ2(1) = 23.46, p < 0.001). There were no significant effects on treatment beliefs or willingness to have acupuncture. Conclusion: The enhanced website improved patients’ knowledge and ability to make an informed choice about acupuncture, but did not optimise treatment beliefs or change willingness to have acupuncture. The enhanced website could be used to support informed decision-making among primary care patients and members of the general public considering using acupuncture for back pain.

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Limited Health Knowledge as a Reason for Non-Use of Four Common Complementary Health Practices

Cited by 31 publications

References 40 publications

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Health Literacy and Health Outcomes in Patients with Back Pain – A Scoping Review

Supporting informed choice in acupuncture: effects of a new person-, evidence- and theory-based website for patients with back pain

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