{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:38:00Z","timestamp":1792841880280,"version":"4.5.0"},"reference-count":64,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Decisions about low back pain (LBP) care are shaped by beliefs, perceived benefits, and healthcare access. Most studies originate from high-income settings, and few link belief profiles to both current care-seeking behaviour and future preferences within the same dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined how LBP-related beliefs and psychosocial factors relate to treatment behaviours and preferences among adults of Pakistani origin living in Pakistan or Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey of adults with non-specific LBP captured measures of back beliefs, fear-avoidance, catastrophising, pain resilience, imaging beliefs, and pain intensity. Outcomes included treatments used for the most recent episode, preferred treatments for a future episode, and preferred healthcare professional. Associations were analysed using logistic regression models adjusted for demographic covariates, based on complete-case data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 461 participants, psychosocial and demographic factors were not independently associated with exercise use, within the adjusted models. Higher pain intensity was associated with medication use (OR\u2009=\u20091.13, 95% CI 1.02, 1.26). Compared to Australia, participants in Pakistan reported lower odds of rest (OR\u2009=\u20090.64, 95% CI 0.42, 0.97) and lower preference for massage (OR\u2009=\u20090.36, 95% CI 0.22, 0.57). Female gender predicted preference for medication (OR\u2009=\u20091.83, 95% CI 1.16, 2.87). In provider preferences, higher fear-avoidance was associated with preferring a medical specialist, catastrophising was associated with preference for alternative practitioners (e.g., herbal, homeopathic, or Unani), and lower education predicted self-management\/ no care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Beliefs were not significantly associated with exercise use, but specific constructs were associated with provider preferences away from physiotherapy\/ exercise based care. Pain intensity was associated with medication use rather than beliefs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538127261454796","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T18:21:12Z","timestamp":1779646872000},"page":"1907-1922","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beliefs, treatment use, preferences, and provider choice for low back pain among adults of Pakistani origin: A cross-sectional study"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9128-6942","authenticated-orcid":false,"given":"Muhammad Naseeb Ullah","family":"Khan","sequence":"first","affiliation":[{"name":"School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2509-1239","authenticated-orcid":false,"given":"Aastha","family":"Malhotra","sequence":"additional","affiliation":[{"name":"School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5788-8790","authenticated-orcid":false,"given":"Melainie","family":"Cameron","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia"},{"name":"Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia"},{"name":"Physical Activity, Sport, and Recreation (PhASRec) research niche, North-West University, Potchefstroom, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002775"},{"key":"e_1_3_3_3_2","article-title":"Identifying patients\u2019 beliefs about treatments for chronic low back pain in primary care: a focus group study","volume":"63","author":"Dima A","unstructured":"Dima A, Lewith GT, Little P, et al. Identifying patients\u2019 beliefs about treatments for chronic low back pain in primary care: a focus group study. British Journal of General Practice 2013 Jun 28; 63: e490\u2013e498.","journal-title":"British Journal of General Practice"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13685"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1892"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2020.09.011"},{"key":"e_1_3_3_7_2","article-title":"Individual preferences for physical exercise as secondary prevention for non-specific low back pain: a discrete choice experiment","volume":"12","author":"Aboagye E","unstructured":"Aboagye E, Hagberg J, Ax\u00e9n I, et al. Individual preferences for physical exercise as secondary prevention for non-specific low back pain: a discrete choice experiment. PLoS ONE 2017 Dec 15; 12: e0187709. https:\/\/doi.org\/10.1371\/journal.pone.0187709","journal-title":"PLoS ONE"},{"key":"e_1_3_3_8_2","first-page":"28","article-title":"Preference of musculoskeletal pain treatment in middle-aged and elderly Chinese people: a machine learning analysis of the China health and retirement longitudinal study","volume":"24","author":"Mei F","unstructured":"Mei F, Dong S, Li J, et al. Preference of musculoskeletal pain treatment in middle-aged and elderly Chinese people: a machine learning analysis of the China health and retirement longitudinal study. BMC Musculoskelet Disord 2023 Jun 29; 24: 28.","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2077-6"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2024.02.002"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000193"},{"key":"e_1_3_3_12_2","article-title":"Low back pain and sciatica: summary of NICE guidance","volume":"356","author":"Bernstein IA","unstructured":"Bernstein IA, Malik Q, Carville S, et al. Low back pain and sciatica: summary of NICE guidance. Br Med J 2017 Jan 6; 356: i6748.","journal-title":"Br Med J"},{"key":"e_1_3_3_13_2","volume-title":"WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Geneva: NCBI Bookshelf, 2023, https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK599212\/."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2367"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102916"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000044"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/papr.13354"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000142007.38256.7f"},{"key":"e_1_3_3_19_2","first-page":"97","article-title":"Patient perspectives on low back pain treatment in primary care: a qualitative study of hopes, expectations, and experiences","volume":"25","author":"Madsen SD","unstructured":"Madsen SD, Stochkendahl MJ, Mors\u00f8 L, et al. Patient perspectives on low back pain treatment in primary care: a qualitative study of hopes, expectations, and experiences. BMC Musculoskelet Disord 2024 Dec 5; 25: 97.","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00441-5"},{"key":"e_1_3_3_21_2","first-page":"14","article-title":"Exploring the association between adherence to home-based exercise recommendations and recovery of nonspecific low back pain: a prospective cohort study","volume":"25","author":"Arensman RM","unstructured":"Arensman RM, Pisters MF, Kloek CJJ, et al. Exploring the association between adherence to home-based exercise recommendations and recovery of nonspecific low back pain: a prospective cohort study. BMC Musculoskelet Disord 2024 Aug 1; 25: 14.","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_3_3_22_2","article-title":"Insights into the provision of physical therapy services at public sector hospitals in Pakistan: an exploratory qualitative study","volume":"15","author":"Hanif QAM","unstructured":"Hanif QAM, Pradhan NA, Hameed W, et al. Insights into the provision of physical therapy services at public sector hospitals in Pakistan: an exploratory qualitative study. BMJ Open 2025 Apr 1; 15: e084854.","journal-title":"BMJ Open"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/24740527.2020.1732808"},{"key":"e_1_3_3_24_2","article-title":"Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis","volume":"376","author":"Ho EKY","unstructured":"Ho EKY, Chen L, Simic M, et al. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. Br Med J 2022 Mar 30; 376: e067718.","journal-title":"Br Med J"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.3138\/ptc.2012-56BC"},{"key":"e_1_3_3_26_2","first-page":"34","article-title":"Using behaviour change theory and preliminary testing to develop an implementation intervention to reduce imaging for low back pain","volume":"18","author":"Jenkins HJ","unstructured":"Jenkins HJ, Moloney NA, French SD, et al. Using behaviour change theory and preliminary testing to develop an implementation intervention to reduce imaging for low back pain. BMC Health Serv Res 2018 Sep 24; 18: 34.","journal-title":"BMC Health Serv Res"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2023.11622"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20120060"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.07.009"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1861484"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S258314"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.010"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2021.102460"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_3_3_35_2","volume-title":"Sampling techniques","author":"Cochran WG","year":"1977","unstructured":"Cochran WG. Sampling techniques. 3rd ed. New Delhi: Wiley, 1977.","edition":"3"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk052"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-1742-3"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2024.2317422"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-01896-5"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-02878-0"},{"key":"e_1_3_3_41_2","first-page":"694","article-title":"What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments","volume":"161","author":"Kamper SJ, Logan G, Copsey B, Thompson J, Machado GC, Abdel-Shaheed C, et al","unstructured":"Kamper SJ, Logan G, Copsey B, Thompson J, Machado GC, Abdel-Shaheed C, et al. What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments. Pain 2019 Nov 14; 161: 694\u2013702.","journal-title":"Pain"},{"key":"e_1_3_3_42_2","first-page":"205510291989884","article-title":"Are common sense model constructs and self-efficacy simultaneously correlated with self-management behaviors and health outcomes: a systematic review","volume":"7","author":"Breland JY","unstructured":"Breland JY, Wong JJ, McAndrew LM. Are common sense model constructs and self-efficacy simultaneously correlated with self-management behaviors and health outcomes: a systematic review. Health Psychol Open 2020 Jan 1; 7: 2055102919898846.","journal-title":"Health Psychol Open"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2021.102342"},{"key":"e_1_3_3_44_2","first-page":"78","article-title":"Back beliefs in patients with low back pain: a primary care cohort study","volume":"20","author":"Gr\u00f8n S","unstructured":"Gr\u00f8n S, Jensen RK, Jensen TS, et al. Back beliefs in patients with low back pain: a primary care cohort study. BMC Musculoskelet Disord 2019 Dec 1; 20: 78.","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijosm.2016.01.005"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.61919\/fcf64590"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2024.12406"},{"key":"e_1_3_3_48_2","first-page":"514","article-title":"Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review","volume":"60","author":"Htwe O","unstructured":"Htwe O, Yuliawiratman BS, Tannor AY, et al. Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review. Eur J Phys Rehabil Med 2024 Mar 29; 60: 514\u2013522.","journal-title":"Eur J Phys Rehabil Med"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17176428"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2022.100413"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2018.05.006"},{"key":"e_1_3_3_52_2","first-page":"1117","article-title":"Predictors of communication preferences in patients with chronic low back pain","volume":"7","author":"Farin E","unstructured":"Farin E, Schmidt E, Gramm L. Predictors of communication preferences in patients with chronic low back pain. Patient Prefer Adherence 2013 Oct 1; 7: 1117.","journal-title":"Patient Prefer Adherence"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-016-9782-2"},{"key":"e_1_3_3_54_2","article-title":"Pain catastrophizing, kinesiophobia and fear-avoidance in non-specific work-related low-back pain as predictors of sickness absence","volume":"15","author":"Mac\u00edas-Toronjo I","unstructured":"Mac\u00edas-Toronjo I, Rojas-Oca\u00f1a MJ, S\u00e1nchez-Ramos JL, et al. Pain catastrophizing, kinesiophobia and fear-avoidance in non-specific work-related low-back pain as predictors of sickness absence. PLoS ONE 2020 Dec 10; 15: e0242994.","journal-title":"PLoS ONE"},{"key":"e_1_3_3_55_2","first-page":"15","article-title":"Health literacy and health outcomes in patients with low back pain: a scoping review","volume":"21","author":"See YKC","unstructured":"See YKC, Smith HE, Car LT, et al. Health literacy and health outcomes in patients with low back pain: a scoping review. BMC Med Inform Decis Mak 2021 Jul 13; 21: 15.","journal-title":"BMC Med Inform Decis Mak"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.13598"},{"key":"e_1_3_3_57_2","article-title":"Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis","volume":"10","author":"Sharma S","unstructured":"Sharma S, Traeger AC, Reed B, et al. Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis. BMJ Open 2020 Aug 1; 10: e037820.","journal-title":"BMJ Open"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-08118-1"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13144005"},{"key":"e_1_3_3_60_2","first-page":"61","article-title":"Methodology series module 3: cross-sectional studies","volume":"61","author":"Setia M","unstructured":"Setia M. Methodology series module 3: cross-sectional studies. Indian J Dermatol 2016 Jan 1; 61: 61.","journal-title":"Indian J Dermatol"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-022-00287-8"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2026-0001"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20100224"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200826080-00004"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30488-4"}],"container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538127261454796","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10538127261454796","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538127261454796","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:15:48Z","timestamp":1792840548000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10538127261454796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,24]]},"references-count":64,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/10538127261454796"],"URL":"https:\/\/doi.org\/10.1177\/10538127261454796","relation":{},"ISSN":["1053-8127","1878-6324"],"issn-type":[{"value":"1053-8127","type":"print"},{"value":"1878-6324","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,24]]}}}