Feasibility Study to Increase use of non-Pharmacological Therapies for Chronic Low Back Pain - PROJECT SUMMARY/ABSTRACT Summary/Abstract: Chronic low back pain (CLBP) is the most prevalent pain condition, affecting nearly 28 percent of Americans, with approximately 80 percent of the population expected to experience low back pain in their lifetime. CLBP disrupts physical abilities, emotional well-being, and quality of life while contributing to $134 billion in annual healthcare costs and even more in lost productivity. Despite the existence of effective and cost-efficient evidence-based non-pharmacological therapies (NPTs) for CLBP, their adoption remains limited due to barriers such as insufficient awareness, access challenges, and insurance coverage. This proposal responds to PAR-25-274, Feasibility Clinical Trials of Mind and Body Interventions for NCCIH High Priority Research Topics by adapting a successful social networking intervention – Game Changers – to empower individuals who have effectively managed their CLBP with NPTs (indexes) to advocate within their social networks (alters), fostering peer support and to drive broader adoption of NPTs. This feasibility study will establish a scientific advisory board and a community advisory board to ensure the intervention is scientifically rigorous, scalable, and sustainable while being contextually appropriate, and informed by the lived experiences of individuals with CLBP and NPT providers. These advisory boards will also help us with our further aims which are to: 1) Develop a comprehensive repository of virtual resources, 2) adapt the original Game Changers materials to focus on CLBP and NPTs, 3) develop and test the feasibility of protocols to recruit, randomize, and retain individuals, and 4) develop, refine, and test a virtual data collection strategy to support the future clinical trial. We will conduct a small randomized controlled feasibility trial with 60 index participants, half randomized to the Game Changers intervention (receiving tailored content on advocacy, motivational interviewing, CLBP, NPTs, and social networks) and the other half assigned to a naturalistic control group to test the feasibility of adapted and developed protocols to run a future clinical trial. Each index will be asked to recruit up to 4 alters, targeting a total of 150 participants (approximately 75 per arm, assuming an average recruitment of 2.5 alters per index). If this feasibility study is successful, we will apply for an R01 grant to support a larger pragmatic implementation trial to rigorously evaluate the intervention's effectiveness, scalability, and impact in real- world settings, advancing the uptake of evidence-based NPTs for CLBP.
