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Evaluating the optimisation and impact of the BOOST programme: an implementation study

Trial Status: Closed to recruitment - in follow up

A recent randomised controlled trial found the BOOST programme significantly improved walking ability and reduced falls risk at 12 months in people with symptomatic lumbar spinal stenosis (LSS). The programme consisted of an individual session and 12 group-based sessions of education and exercise. Before widespread implementation of the BOOST programme, we want to optimise it to achieve maximum effectiveness on clinical outcomes and uptake by healthcare providers. We have formed a ‘community of practice’ with patients and health professionals to provide feedback on the original programme and to iteratively coproduce content for optimisation.
This protocol describes two sequential observational studies with imbedded interview studies. The first study aims to evaluate the clinical effectiveness of the optimised BOOST programme. To do this, we will collect data from patients before they start the optimised BOOST programme and in six months’ time. We will measure pain-related disability, quality of life, walking capacity, and satisfaction. We will interview the health professionals delivering the optimised programme to understand their experiences. Data from the first study will inform the wider implementation in stage two.
In stage two, we will develop a digital resource to provide health professionals with knowledge, skills, and tools to implement the BOOST programme. We will evaluate learning and implementation outcomes to ensure the digital resource is effective. For a subset of health professionals delivering BOOST to patients, we will collect the same patient data (pain-related disability, quality of life, walking capacity, and satisfaction) at baseline and six months. Health professionals, or level four exercise therapists, treating people with LSS can take part in the digital resource evaluation. Patients taking part in the clinical evaluation will have been referred for NHS physiotherapy and have symptoms of LSS. The BOOST programme can be delivered in an NHS or community setting, in partnership with an NHS Trust.