Promoting Physical Activity for Low Back Pain: Evidence-Based Strategies for Healthcare Delivery and Policy Implementation

Abstract

Low back pain (LBP) is the leading cause of disability worldwide and a major contributor to disability-adjusted life years (DALYs). Although physical activity is strongly recommended as a first-line management strategy, its implementation in routine practice remains limited. This thesis explored the evidence, developed and evaluated strategies to strengthen the promotion, delivery, and uptake of physical activity for individuals with LBP, with a focus on digital health, health communication, and system-level integration. A mixed-methods program of research was conducted, including systematic reviews, synthesis of guideline evidence, development and evaluation of educational interventions, and qualitative studies within community settings. Innovative tools such as a storytelling-based video and a mobile application (app) were piloted to support patient education, encourage physical activity, and test the role of social media in disseminating health information. Feasibility and acceptability were assessed with particular attention to user experience, health literacy, and content quality. Findings demonstrated that while digital strategies can broaden access and enhance self-management, barriers remain, including fragmented systems, limited digital literacy, and partial engagement with online materials. Social media engagement metrics and qualitative insights highlighted the importance of culturally relevant, credible, and user-friendly resources. This thesis contributes to implementation research by offering practical frameworks and tools for translating evidence into action.