- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06153199
Self-management of Low Back Pain in Horticulture Workers
February 21, 2024 updated by: University of Florida
Effectiveness and Implementation of Self-management Strategies for Low Back Pain Among Horticulture Workers
The primary purpose of this hybrid comparative effectiveness and implementation study is to compare two self-management strategies to manage pain, and adjust work-related ergonomic risk in nursery and landscape workers.
This cluster randomized pragmatic study will compare interventions with different degrees of support and Specific aim 1 is to determine if self-management plus individualized guided participatory ergonomic choices (SM+PE) is more effective than self-management (SM) alone for improving LBP among horticulture workers.
Both groups will review short self-management video modules to introduce general pain concepts and the importance of managing pain without medication, risks of opioid use, self-management of pain, and simple ergonomic strategies for both groups.
Both groups will choose 1 self-management strategy to manage pain at home and 1 ergonomic workplace strategy to limit pain.
The SM+PE participant's choices will be guided using branching logic questions matched to their self-identified most difficult work activities due to pain.
guide choices matched to participant's most difficult work activities.
This group will also: 1) review videos of their work tasks, 2) receive text reminders to support implementation, and 3) supervisors will participate in additional discussions of processes and support of workers.
Surveys will include instruments reflecting low back pain disability, pain, work ability, and affective or cognitive characteristics (self-efficacy, pain anxiety, depression, coping), collected at baseline, pre- and post-intervention, with follow-ups at 3- and 6-months.
Workers will be videoed pre- and post-intervention to inform simulated work analysis for calculation of work risk and to compare any changes for the most difficult tasks.
Specific aim 2 will identify contextual factors impacting engagement, adoption, effectiveness, and implementation.
Interviews, focus groups, and field notes will be used to explain results and establish patterns to inform future translation.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
Primary dependent variables will be collected at all measurement points: pain severity, interference, and persistence, pain with specific work tasks, disability, work ability, and pain medication use.71-74
Affective or cognitive characteristics potentially impacting adoption and effectiveness (secondary dependent variables or confounders) such as coping, fear, anxiety, depression, will also be collected.75-78
The post- and follow-up survey questions will also reflect adoption, opinions of interventions, effectiveness, facilitators, and barriers.
Study Type
Interventional
Enrollment (Estimated)
170
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Kim Dunleavy, PT, PhD
- Phone Number: 13522736114
- Email: kdunleavy@phhp.ufl.edu
Study Contact Backup
- Name: Janeen Blythe, PT, DPT, ATC
- Phone Number: 15613191035
- Email: janeenmccormick@ufl.edu
Study Locations
-
-
Florida
-
Gainesville, Florida, United States, 32608
- University of Florida
-
Contact:
- Kim Dunleavy
- Phone Number: 734-717-1848
- Email: kdunleavy@phhp.ufl.edu
-
Sub-Investigator:
- Heidi Radunovich, PhD
-
Sub-Investigator:
- Kelly Gurka, PhD
-
Sub-Investigator:
- Jason Beneciuk, PT, PhD
-
Sub-Investigator:
- Boyi Hu, PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
Workers
- working full time (30 hours or more per week) in physically demanding nursery or landscape work
- currently employed or self-employed in small (<20) or medium (21-40) size businesses
- 18 years of age or older
- English or Spanish speaking
- experiencing continuous or intermittent LBP over the past 3 months
- willing to be videotaped during work activities for movement analysis
Owners, managers, supervisors
- Owners, managers, or supervisors who meet the same inclusion criteria as workers will be eligible to participate in the training interventions as well as the supervisory roles.
- All owners, managers, and supervisors who are willing to participate will be enrolled.
Exclusion Criteria:
Workers
- history of major trauma, surgery, or spinal nerve blocks in the past year
- seeking disability or workman's compensation
- self-disclosed pregnancy
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Self-management
Participants will review short video modules on pain self-management without medication and ergonomic work adjustment Participants will be asked to select 1 self-management option and 1 ergonomic option to use for 10 weeks
|
Short video modules on self-management of back pain without medication
Other Names:
Short video module on ergonomic adjustment for limiting back pain in nursery and landscape work
|
Experimental: Self-management and Guided Participatory Ergonomics
Participants will review short video modules on pain self-management without medication and ergonomic work adjustment Supervisors in these work settings will also discuss options to adjust work processes and ways to support workers implement ergonomic strategies Participants will be asked to select 1 self-management option and 1 ergonomic option to use for 10 weeks.
This group will receive options guided by their self-identified most difficult work activities due to pain and options that they are not using regularly.
|
Short video modules on self-management of back pain without medication
Other Names:
Short video module on ergonomic adjustment for limiting back pain in nursery and landscape work
In person discussion of work processes and support for workers to implement self-management and ergonomic modifications
Survey based guidance on ergonomic choices appropriate for work tasks that are the most difficult due to back pain
Survey based guidance for prioritized choices of self-management
Reminders to implement choices
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Roland Morris Disability Index
Time Frame: 1 year
|
Disability Index for functional difficulties related to low back pain scored from 0-24 with low scores indicating lower disability
|
1 year
|
Numeric Pain Rating Severity
Time Frame: 1 year
|
Severity of pain reported for the past week and for the 3 most difficult work activities 0=no pain, 100=worst imaginable pain, lower scores reflect lower pain
|
1 year
|
Pain Interference
Time Frame: 1 year
|
Extent of pain interference with work activities in the past week, 0=not at all, 100=prevented working at normal level, lower scores reflect less interference
|
1 year
|
Pain persistence
Time Frame: 1 year
|
Pain in the past 3 months reported on a 5 item scale ranging from not at all to pain every day without a break.
|
1 year
|
Pain impact
Time Frame: 1 year
|
2 items with 5 point scale recording impact on work activities and social activities ranging from never to always, with lower scores reflecting less impact
|
1 year
|
Pain frequency
Time Frame: 1 year
|
Number of days in the past week pain is experienced ranging from 0-7
|
1 year
|
Adoption
Time Frame: 1 year
|
Use of the interventions reported for each work or self-management strategy selected (number of days used in the past week, how often used (never, occassionally, consistently) Higher scores and consistently are optimal
|
1 year
|
Difficulty with work tasks
Time Frame: 1 year
|
Patient Specific Functional Scale reported for 3 most difficult work activities with subscales reported on a scale of 0= no difficulty, 100=unable to perform with the average of the 3 items used for analysis.
|
1 year
|
Work ability
Time Frame: 1 year
|
Work Ability short form is reported on numeric rating scale from 0 (completely unable to work) to 10 able to work at your best
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Use of medication and substances
Time Frame: 1 year
|
Frequency of pain medication and substances for pain in past 3 months reported on a 4 item scale (never, 1-2 days, 3-4 days, 5-7 days) never is optimal.
Items for alcohol, cannabis, tobacco, herbal products, acetaminophen, anti-inflammatories, muscle relaxants, opioids).
Frequency of use per day on average also reported for a total estimate.
|
1 year
|
Depression scale
Time Frame: 1 year
|
Center for Epidemiology Depression Scale -Revised consists of 20 items reflecting frequency of depressive symptoms from rarely to most of the time with the total reported out of 60 with lower values as optimal
|
1 year
|
Pain anxiety Symptom Scale
Time Frame: 1 year
|
20 item instrument with the total of items reported from never to always reported out of 50.
Lower values are optimal.
|
1 year
|
Self-efficacy
Time Frame: 1 year
|
PROMIS short form 8a Self-efficacy chronic disease management
|
1 year
|
Self-efficacy and coping - confidence and control over pain
Time Frame: 1 year
|
Coping Skills Questionnaire reporting confidence to be able to work and live a normal lifestyle rated on a 6 point scale from 0=not at all confident to 5=completely confident (total reported out of 10, and 7 point scale for control over pain 0=no control, 6=completely in control.
The total is reported out of 12 with higher values as optimal
|
1 year
|
Ergonomic risk
Time Frame: 6 months
|
Rapid Ergonomic Behavioral Assessment rubric for video analysis with specific criteria rated out of a total of 15 indicating risk levels ranging from 1 negligible to very high
|
6 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Kim Dunleavy, PT, PhD, University of Florida
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
March 15, 2024
Primary Completion (Estimated)
December 15, 2028
Study Completion (Estimated)
March 15, 2029
Study Registration Dates
First Submitted
November 15, 2023
First Submitted That Met QC Criteria
November 29, 2023
First Posted (Actual)
December 1, 2023
Study Record Updates
Last Update Posted (Actual)
February 22, 2024
Last Update Submitted That Met QC Criteria
February 21, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB202300756
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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