{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:26:49Z","timestamp":1778110009188,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To prevent low back pain (LBP) from developing into a prolonged disabling condition, clinical guidelines advocate early stage assessment, risk\u2010screening, and tailored interventions. Occupational health services recommend guideline\u2010oriented biopsychosocial screening and individualized assessment and management. However, it is not known whether training a limited number of health care professionals improves the management process. The primary objective of this study is to investigate whether training in the biopsychosocial practice model is effective in reducing disability. Furthermore, we aim to evaluate health\u2010economic impacts of the training intervention in comparison to usual medical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The occupational health service units will be allocated into a training or control arm in a two\u2010arm cluster randomized controlled design. The training of occupational physiotherapists and physicians will include the assessment of pain\u2010related psychosocial factors using the STarT Back Tool and the short version of the \u00d6rebro Musculoskeletal Pain Screening Questionnaire, the use of an evidence\u2010based patient education booklet as part of the management of LBP, and tailored individualized management of LBP according to risk stratification. The control units will receive no training. The study population will include patients aged 18\u201365 with nonspecific LBP. The primary outcome is a patient\u2010reported Oswestry Disability Index from baseline to 12\u2009months. By estimating group differences over time, we aim to evaluate the effectiveness of the training intervention in comparison to usual medical care, and to undertake an economic evaluation using individual patients' health care records (participant\u2010level data) and the participating units' registries (cluster\u2010level data). In addition, through interviews and questionnaires, we will explore the health care professionals' conceptions of the adoption of, the barriers to, and the facilitators of the implementation of the practice model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The evaluation of training in the guideline\u2010oriented biopsychosocial management of LBP in occupational health services is justified because LBP represents an enormous burden in terms of work disability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.251","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T06:01:43Z","timestamp":1614924103000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of training in guideline\u2010oriented biopsychosocial management of low back pain in occupational health services: Protocol of a cluster randomized trial"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2158-6042","authenticated-orcid":false,"given":"Jaro","family":"Karppinen","sequence":"first","affiliation":[{"name":"Medical Research Center Oulu Oulu University Hospital and University of Oulu  Oulu Finland"},{"name":"Finnish Institute of Occupational Health  Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Sofia","family":"Simula","sequence":"additional","affiliation":[{"name":"Medical Research Center Oulu Oulu University Hospital and University of Oulu  Oulu Finland"},{"name":"Department of General Medicine The South Savo Social and Health Care Authority  Mikkeli Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riikka","family":"Holopainen","sequence":"additional","affiliation":[{"name":"Faculty of Sport and Health Sciences University of Jyv\u00e4skyl\u00e4  Jyv\u00e4skyl\u00e4 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