{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:53:04Z","timestamp":1790833984784,"version":"4.1.0"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:00:00Z","timestamp":1695340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["689043"],"award-info":[{"award-number":["689043"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:p><jats:sc>self<\/jats:sc>BACK is an artificial intelligence based self-management app for low back pain (LBP) recently reported to reduce LBP-related disability. The aim of this study was to examine if age, gender, or education modify the effectiveness of the<jats:sc>self<\/jats:sc>BACK intervention using secondary analysis of the<jats:sc>selfBACK<\/jats:sc>randomized controlled trial. Persons seeking care for LBP were recruited from primary care in Denmark and Norway and an outpatient clinic (Denmark). The intervention group (n = 232) received the<jats:sc>selfBACK<\/jats:sc>app adjunct to usual care. The control group (n = 229) received usual care only. Analyses were stratified by age (18\u201334, 35\u201364, \u226565 years), gender (male, female), and education (\u226412, &gt;12 years) to investigate differences in effect at three and nine months follow-up on LBP-related disability (Roland-Morris Disability Questionnaire [RMDQ]), LBP intensity and pain self-efficacy. Overall, there was no effect modification for any of the sociodemographic factors. However, data on LBP-related disability suggest that the effect of the intervention was somewhat more beneficial in older than in younger participants. The difference between the intervention and control group due to interaction was 2.6 (95% CI: 0.4 to 4.9) RMDQ points for those aged \u226565 years as compared to those aged 35\u201364 years. In conclusion, age, gender, or education did not influence the effect of the<jats:sc><jats:bold>selfBACK<\/jats:bold><\/jats:sc>intervention on LBP-related disability. However, older participants may have an additional long-term positive effect compared to younger participants.<\/jats:p><jats:p><jats:bold>Trial registration<\/jats:bold>: ClinicalTrials.gov Identifier:<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03798288\" xlink:type=\"simple\">NCT03798288<\/jats:ext-link>.<\/jats:p>","DOI":"10.1371\/journal.pdig.0000302","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T17:21:30Z","timestamp":1695403290000},"page":"e0000302","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Do age, gender, and education modify the effectiveness of app-delivered and tailored self-management support among adults with low back pain?\u2014Secondary analysis of the selfBACK randomised controlled trial"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4827-453X","authenticated-orcid":true,"given":"Ellen Marie","family":"Bardal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise Fleng","family":"Sandal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom Ivar Lund","family":"Nilsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara I.","family":"Nicholl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Jarle","family":"Mork","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3968-6364","authenticated-orcid":true,"given":"Karen","family":"S\u00f8gaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,9,22]]},"reference":[{"issue":"6","key":"pdig.0000302.ref001","doi-asserted-by":"crossref","first-page":"299","DOI":"10.21037\/atm.2020.02.175","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017.","volume":"8","author":"A Wu","year":"2020","journal-title":"Ann Transl Med."},{"issue":"2","key":"pdig.0000302.ref002","doi-asserted-by":"crossref","first-page":"70","DOI":"10.3109\/02813432.2012.679230","article-title":"Reasons for encounter and disease patterns in Danish primary care: changes over 16 years.","volume":"30","author":"G Moth","year":"2012","journal-title":"Scand J Prim Health Care"},{"issue":"1","key":"pdig.0000302.ref003","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.mayocp.2012.08.020","article-title":"Why patients visit their doctors: assessing the most prevalent conditions in a defined American population","volume":"88","author":"JL St Sauver","year":"2013","journal-title":"Mayo Clin Proc"},{"issue":"2","key":"pdig.0000302.ref004","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1053\/eujp.2001.0311","article-title":"Direct and indirect costs of managing patients with musculoskeletal pain-challenge for health care","volume":"6","author":"PT Mantyselka","year":"2002","journal-title":"Eur J Pain"},{"key":"pdig.0000302.ref005","doi-asserted-by":"crossref","first-page":"i6748","DOI":"10.1136\/bmj.i6748","article-title":"Low back pain and sciatica: summary of NICE guidance","volume":"356","author":"IA Bernstein","year":"2017","journal-title":"BMJ"},{"issue":"7","key":"pdig.0000302.ref006","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians","volume":"166","author":"Clinical Guidelines Committee of the American College of P","year":"2017","journal-title":"Ann Intern Med"},{"issue":"2","key":"pdig.0000302.ref007","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1002\/ejp.1679","article-title":"Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines","volume":"25","author":"N Corp","year":"2021","journal-title":"Eur J Pain"},{"issue":"8","key":"pdig.0000302.ref008","first-page":"405","article-title":"Self-management in adolescents with chronic illness.","volume":"183","author":"SM Sawyer","year":"2005","journal-title":"What does it mean and how can it be achieved? 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