A remote first nation community-informed virtual care approach to chronic back pain management: a mixed methods study

Chronic back pain (CBP) is a widespread public health issue. There is a lack of community-based care options for Indigenous Peoples with CBP. A virtual care clinic co-designed with community was implemented in the Cree Community of Pelican Narrows using remote presence (RPR) technology. Methods We used a community-based participatory action framework and pre-post design to evaluate this intervention. Pain, quality of life and experience outcomes were measured. An assessment was provided by a local nurse practitioner and a physical therapist joining over RPR. The physical therapist provided jp to four follow-up treatments per participant using RPR. Results Thirty-eight participants were assessed, and 78 follow-up treatments delivered. No significant differences between pre- and post- pain or quality of life were found. Thirteen patient participants and five health providers completed interviews. Patient themes included: (1) community and healthcare context, (2) community preferences for back pain care, and (3) experience with virtual back pain clinic. Health care provider themes included: (1) getting people to clinic, (2) experience with virtual back pain clinic, and (3) ways to enhance care. Conclusion Virtual CBP clinic enhanced access to therapy and was experienced positively. Participants suggested ways to address challenges, including a hybrid model of care.