Co-creating a Choosing Wisely leaflet supporting the reduction of imaging usage in low back pain management - A multi-method study.

Patient Educ Couns

Center for General Practice at Aalborg University, Denmark; Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark; Department of Physical Therapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark.

Published: June 2025


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Article Abstract

Objective: The objective was to co-create an information resource in the form of a leaflet, to be distributed in clinical settings, websites or social media targeting people with low back pain.

Methods: This multi-method study was conducted in four stages: literature search, input from practice consultants, program theory development, and think-aloud interviews with people experiencing low back pain. Each stage was followed by a consensus meeting in which the steering group refined the leaflet based on the emerging knowledge.

Results: The literature search highlighted patients' need for easy-to-understand information about their back pain diagnosis, management strategies, social activities, work and solutions for supported self-management strategies. Practice consultants emphasized concise, relatable content. The program theory identified potential mechanisms for content creation, development, and implementation of the leaflet, such as addressing patient concerns, reducing diagnostic uncertainty, insights into management options, and validation. Think-aloud interviews with 18 people living with low back pain informed the iteration of the leaflet, enhancing language clarification and content comprehension.

Conclusions: We co-created a new Choosing Wisely leaflet, created with end-users in mind, specifically focused on reducing unnecessary imaging for low back pain.

Practice Implications: This leaflet may support clinical settings in delivering evidence-based approaches and supporting self-management.

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Source
http://dx.doi.org/10.1016/j.pec.2025.108730DOI Listing

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