{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T09:14:17Z","timestamp":1775294057489,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1172928"],"award-info":[{"award-number":["1172928"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1079102"],"award-info":[{"award-number":["GNT1079102"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1086738"],"award-info":[{"award-number":["GNT1086738"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the relationship between a previously purpose\u2010developed lifestyle behavior scale and health care cost savings related to low back pain (LBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal study used data from the Australian Twin Back (AUTBACK) study. LBP and lifestyle behavior measures were collected at baseline. Physical activity (PA) was objectively quantified via an accelerometer. A lifestyle behavior scale was created using variables of body mass index, PA, smoking status, and sleep quality. Weekly health care use for LBP was collected over one year. Health care costs were calculated by aggregating expenses for health care visits and medications, encompassing personal and Australia Medicare costs, and analyzed by two\u2010part models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Individuals with lower lifestyle behavior scores, women, and those with a baseline episode of LBP were more likely to incur health care use costs (n = 307). A total of 2.6% of participants accounted for over 56% of the total expenditures. A one\u2010point improvement in the lifestyle behavior scale was significantly associated with 23% decrease in overall health care costs for LBP (95% confidence interval [CI] 7%\u221236%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.006), 25% decrease in medication costs for LBP (95% CI 13%\u221235%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and 27% decrease in health care visit costs for LBP (95% CI 14%\u221239%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). The predicted difference in yearly health care use costs between individuals with the lowest and highest lifestyle scores was AU$873.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated the association between greater adherence to positive lifestyle behaviors and reduced health care costs related to LBP. Interventions aimed at improving lifestyle behaviors could yield substantial cost savings for individuals and the health care system, mitigating the burden of LBP.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr25653-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25653","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T08:28:04Z","timestamp":1758184084000},"page":"537-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Positive Lifestyle Behaviors on Direct Health Care Cost Savings for Low Back Pain"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4958-5609","authenticated-orcid":false,"given":"Ye","family":"Tian","sequence":"first","affiliation":[{"name":"School of Health Science, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0017-0803","authenticated-orcid":false,"given":"Katharine E.","family":"Roberts","sequence":"additional","affiliation":[{"name":"School of Health Science, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Musculoskeletal Health, The Kolling Institute University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2024-4945","authenticated-orcid":false,"given":"Michelle","family":"Hall","sequence":"additional","affiliation":[{"name":"Sydney Musculoskeletal Health, The Kolling Institute University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula R.","family":"Beckenkamp","sequence":"additional","affiliation":[{"name":"School of Health Science, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Sabag","sequence":"additional","affiliation":[{"name":"School of Health Science, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karoline","family":"Moe","sequence":"additional","affiliation":[{"name":"Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Paula","family":"Carvalho\u2010e\u2010Silva","sequence":"additional","affiliation":[{"name":"School of Health Science, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily J.","family":"Callander","sequence":"additional","affiliation":[{"name":"School of Public Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo H.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"School of Health Science, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1098100"},{"key":"e_1_2_7_4_1","unstructured":"Back problems.Australian Institute of Health and Welfare. 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