SMART Stepped Care Management for Low Back Pain in the Military Health System

Physical therapy will be delivered using a guideline-concordant approach based off the Department of Defense -Veterans Affairs Low Back Pain Guidelines, focusing on risk-stratified care deliver (using the STarT Back tool as an adjunct).

"Participants will receive education for self-management (video and written materials) to introduce the key domains of holistic health in the Move to Health (M2H) model and their relationship to chronic LBP. Next, the participant will complete a Personal Health Inventory. The Inventory will be reviewed by the health coach and patient in order to identify specific domains for priority based on patient preference:~1. Sleep~2. Physical Activity~3. Nutrition~4. Intrinsic Well-Being (Personal Development, Spiritual Well-Being, Emotional Well-Being)~5. Extrinsic Well-Being (Family/Social Relationships, Surroundings)~Care may range from guided self-management with the researcher to a specialist referral (e.g., sleep specialist, dietician, behavioral health provider, etc.)."

"Throughout the intervention, three core areas are emphasized. Activities include exercises and at-home work for participants to reinforce these core areas.~1. Mindfulness~2. Cognitive reappraisal~3. Savoring of positive experiences"