Move to improve - Prescribing physical activity and deprescribing paracetamol for people with low back pain: Findings from a hybrid type III feasibility study.

Objective: To evaluate the feasibility of implementing a culturally adapted multimedia intervention in the waiting room of a public hospital physiotherapy outpatient service to guide the implementation of a large multicentre trial investigating the effects of a multimedia intervention to promote physical activity and reduce paracetamol use in people reporting low back pain (LBP).

Methods: A six-month (March to September 2024) hybrid type III feasibility study was conducted in an outpatient physiotherapy department of a public hospital in Sydney, Australia. The intervention included a brief video and booklet designed to engage patients and encourage informed management of LBP. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the evaluation. The educational materials were available in English, Arabic and Mandarin.

Results: The study revealed limited engagement, with only 11% of 688 potential people exposed to the intervention interacting with it. A total of 66 people completed the surveys (mostly English speakers), and six accepted to participate in a follow-up survey. Despite this low engagement, feedback from those who participated was positive. Satisfaction and usefulness ratings were high, with scores of 7.7-7.9 out of 10 for both video and booklet. Helpfulness was also rated positively, particularly for the video (8.6/10). Barriers to engagement included unfamiliarity with digital formats, video length, and the need for staff assistance in accessing the materials.

Conclusion: The findings suggest that the intervention, as currently designed, is not feasible for effective implementation in its present form. While engagement with the multimedia intervention was limited, findings allowed for a comprehensive understanding of the barriers and contextual factors impacting patient interaction. Notably, the majority of feedback was positive, with high satisfaction and usefulness ratings. The results underscore the need for alternative implementation strategies and further refinement of the approach to improve engagement with culturally diverse populations experiencing LBP and optimise outcomes in future implementations.