TEXT4myBACK’ text message intervention to improve function in people with low back pain

INTERVENTION: Participants randomised to the intervention will receive semi‐personalised text messages providing advice, motivation and information to improve diet, physical activity, sleep, mood, use or care and medication. 'Semi‐personalised' relates to the use of the participants chosen contact name for the welcome to the study message, end of study thank you message and some of the advise, motivation and information messages were the character count allows for the addition of their name. This has been previously shown to increase the participants engagement with the messages received. Participants will receive 4 text messages every week for 12 weeks. The messages will be sent on random days of the week, including weekends but excluding public holidays. The time of day the messages will be randomly selected from 4 slots: 9am, 12.30pm, 4 pm and 6 pm. Participants will be eligible to receive all messages regardless of content as they will be evidence based and generic in nature. The content of the message will be selected using an algorithm derived from key domains of the study (physical activity, education, sleep, mood, use or care and medication). The text message delivery will be managed by the ‘TEXT me’ software program through the University of Sydney and is designed to be delivered one‐way (to the participant only). Participants will not be monitored for adherence to reading or opening the text messages, however, they will have the ability to reply to the messages with "STOP" if they wish to discontinue receiving the messages. The system is designed be one‐way (to the participant only), however all return messages will be monitored for any return messages alluding to the participants health and safety. Change in participant behaviour as a result of the messages will be based on the changes in the health outcome measures used (pain levels, patient specific function, physical and sedentary activity levels, quality of life and use of care). CONDITION: acute low back pain ; This is a validated measure that has not been specifically designed for the study. ; SECONDARY OUTCOME: Health care utilisation (via MBS/PBS and diary) Health‐related quality of life will be measured with the AQoL‐4D questionnaire. Participant’s global impression of change (Global Change). Patient reported pain‐related disability (Pain Disability Index). Physical activity engagement (Active Australia Questionnaire). Sedentary Behaviour (Sedentary Behaviour Questionnaire). INCLUSION CRITERIA: • Aged 18 years or older. • Present to a participating pharmacists with an acute episode of low back pain (less than 6 weeks duration) • Have pain classed as ‘moderate’ in the pain scale of the SF‐12 • Familiarity with the use and access to, a phone that can receive text messages PRIMARY OUTCOME: Average pain intensity during past week. This will be a self‐reported measure using a single question to rate the participant’s average pain of the preceding 7 days. It uses an 11 point numerical rating scale 0‐10 (0 meaning no pain and 10 meaning worst pain possible) and relies on the patient’s memory of the actual pain severity experienced. It is considered to be responsive to change, easy to understand and complete and will take less than a minute to complete. Patient‐specific functional scale. This is a condition‐specific measure used to quantify activity limitation and function in patients with musculoskeletal pain. The participant will be asked to identify three important activities that they are unable to do or are having difficulty with as a result of their LBP. They will rate each activity using a numerical rating scale of 0‐10 (0 meaning unable to perform activity and 10 meaning able to perform activity to the same level as before the injury or/problem). This will take approximately 2 minutes to complete.