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N/A N=144 Health Services Research

Development of STEPPT

Pain · Back Pain · Low Back Pain · Chronic Pain · Neck Pain

Enrolled (actual)
144
Serious AEs
0.0%
Results posted
May 2026
Primary outcome: Primary: Ethnic Disparity in Rate of Physician Referral to Physical Therapy — 13; 30; 13; 22 Participants

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
STEPPT Pilot (Behavioral); Standard Care (Control) (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
San Diego State University
Primary completion
Apr 2025

Outcome Measures

OutcomeResultp-value
PRIMARY
Ethnic Disparity in Rate of Physician Referral to Physical Therapy
13; 30; 13; 22
PRIMARY
Ethnic Disparity in Rate of Patient Adherence to Physical Therapy Referral
5; 16; 7; 10
SECONDARY
Involvement Rating Score
8
SECONDARY
Patient Interviews
6; 11; 5; 5; 5; 3

Summary

This 6-month pilot study aims to assess the feasibility, acceptability, and estimate effect sizes of the pilot STEPPT intervention for addressing ethnic disparities in physical therapy referrals and adherence between Hispanic and Non-Hispanic White patients with spine pain. Feasibility and acceptability will be assessed based on the extent to which the pilot clinic implements all components of the intervention appropriately, feedback from clinic staff during implementation of the intervention, and feedback from patients during post-intervention interviews. The investigators anticipate that the intervention will be both feasible and acceptable. Feedback from patients and clinic staff will be used to inform intervention modifications for a larger clinical trial. Effect sizes for the pilot STEPPT intervention (intervention) in comparison to standard care (control) will be assessed by evaluating changes in ethnic disparities (Hispanic vs. Non-Hispanic White) in physician referral to physical therapy and patient adherence to physical therapy referral for the treatment of spine pain before and after implementation of the pilot STEPPT intervention. In comparison to standard care, the investigators expect STEPPT to reduce ethnic disparities in referral and adherence outcomes.

Eligibility Criteria

Inclusion Criteria

  • Age: 18 years or older.
  • Patients seeking care within the designated Federally Qualified Health System Adult or Adult Walk-in primary care clinic
  • Ethnicity/Race: Participants must identify as either Hispanic or Non-Hispanic White ethnicity/race.
  • Consent: Participants must have signed a broad consent for the use of de-identified health information for research.
  • Spine Pain: Participants must meet one of the following:
  • New Spine Pain Problem: A new ICD code for neck or back pain added to the problem list during a visit with a primary care physician.
  • Existing Spine Pain Diagnosis: An existing ICD code for neck or back pain on the problem list that is associated with a physician referral for any service during the visit related to the neck or back pain problem.

Exclusion Criteria

  • Non-Musculoskeletal Spine Pain: Participants with spine pain due to a non-musculoskeletal etiology (e.g., infection, cancer, urological disorders, pregnancy) are excluded.
  • Urgent Medical Conditions: Patients requiring urgent medical intervention (e.g., fracture, cauda equina syndrome) are excluded.
  • Patients with a physical therapy referral external to the healthcare system are excluded from the analysis of physical therapy adherence
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT06835439). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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