Funding for this research was provided by:
Etelä-Savon Rahasto (3.4.2018)
Suomen Kulttuurirahasto (28.1.2019)
State research funding (4.2017)
Received: 3 February 2020
Accepted: 29 March 2020
First Online: 6 April 2020
Ethics approval and consent to participate
: The study is approved by the Ethics Committee of the University Hospital of Oulu, Finland (109/2016), and will be performed in accordance with the Declaration of Helsinki. The final approval date was 23rd January, 2017 and all the participants will provide informed written consent. All the participating health care regions have approved the study. Main topics of the study include: 1) avoidance of inappropriate imaging; 2) systematic identification of psychosocial risk factors and individual risk-based treatment plans; 3) avoidance of nocebo messages; 4) improvement in the delivery to patients of evidence-based, correct information; 5) enhancement of therapeutic alliance and support of self-efficacy; and 6) emphasis on physiotherapists’ role in rehabilitation. The aim is to implement the research results into everyday practice, which will require great effort. As it would be ethically wrong to disallow normal improvement strategies within organizations during the study, we will use the Benchmarking Controlled Trial (BMCT) as our design, which allows each area to act as its own control before and after implementation. This will enable evaluation of the differences between the areas and development of the care strategies during the process. The participants will be informed of the aim of the study, the eligibility criteria, the progress of the study, and the risks and benefits. They will be informed that participation in the study is voluntary and will not influence their treatment decisions in the health care region. Personal information will be kept in secured facilities and replaced with ID codes for analyses.
: Not applicable.
: A-SS, AM and JK: Payments for talks or clinical workshops related to a biopsychosocial approach for LBP care from organizations or clinics outside of the current study. NB has no competing interests.