• Jaynie Bjornaraa, Anne Bowers, David Mino, Denee Choice, Douglas Metz, and Kimberly Wagner.
• American Specialty Health, Carmel, IN; Doctor of Physical Therapy Program, St. Catherine University, St. Paul, MN. Electronic address: jaynieb@ashn.com.
• Pain Manag Nurs. 2022 Aug 1; 23 (4): 397-410.

PurposeA remotely delivered cognitive behavioral coaching (CBC) program was offered as a service benefit for commercial health plan members with low back pain (LBP). This study describes changes in self-rated functional disability in a sample of plan members participating in the program (N=423).MethodsIndependent measures included demographics, length of program enrollment, total CBC sessions, and baseline self-reported patient activation and presenteeism levels. Participants rated their functional disability level due to LBP using the Oswestry Disability Index (ODI). Dependent outcomes quantified change in participant functional disability rating (final ODI score minus baseline ODI score). Nonparametric tests compare differences between groups and within-group ODI score change. Two generalized linear models test for associations between independent variables and the ODI change score.ResultsA significant difference between baseline and final ODI scores was observed at the overall program level (p<.001) and within all independent variable categories of interest. Over 68% of total participants (n=289) reported improved functional ability from baseline to final (decrease in ODI score). Participants who completed more CBC sessions demonstrated significantly greater improvement in functional ability (p=.038) compared to those who completed fewer sessions. Participants aged 55 and older were significantly more likely to show deterioration in functional ability from baseline to final (p=.021).ConclusionOutcomes suggest that program participation can influence self-rated functional disability in the management of LBP.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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