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Health Education Research, Vol. 11, No. 4, 535-541, 1996
© 1996 Oxford University Press

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An interactive videodisc program for low back pain patients

B.S. Spunt1, R.A. Deyo1, V.M. Taylor1,4,, K.M. Leek1, H.I. Goldberg1,2 and A.G. Mulley5

1Departments of Health Services, University of Washington Seattle, WA 98105
2Departments of Medicine, University of Washington Seattle, WA 98105
3Northwest Health Services Research and Development Field Program, Seattle Veterans Affairs Medical Center Seattle, WA 98108
4Fred Hutchinson Cancer Research Center Seattle, WA 98104
5Massachusetts General Hospital/Harvard Medical School Boston, MA 02114, USA

Correspondence to: V. Taylor

Decisions about back pain treatment are often made in the presence of both physician and patient uncertainty. Therefore, we developed a computerized, interactive video program to help patients make informed decisions about undergoing low back surgery. Program development was guided by the shared decision-making model, a comprehensive literature synthesis, information from administrative databases, and focus groups of patients and physicians. Core segments are tailored to each patient's age and diagnosis; and include a narrative, excerpts from patient interviews, animated graphics illustrating spinal anatomy, and tabular summaries of the benefits and risks of both surgical and non-surgical treatment. As part of a multifocal information dissemination effort, interactive videodiscs were placed in five medical facilities in two Washington State counties. Patients (N = 239) who viewed the video program completed short evaluation forms. The majority rated the video's understandability (84%) and interest (64%) as very good or excellent. Most patients felt the amount of information provided was appropriate (75%) and over half (56%) believed the discussion of surgical versus non-surgical treatment was completely balanced. Fewer patients (17%) remained undecided about therapy after watching the program than before (29%). We conclude that interactive videodisc technology offers substantial promise as a means of involving patients in their own medical decision making.


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