Very happy that our May DHIN feature is Emma Ho. Emma is a physiotherapist and researcher who is passionate about the prevention and management of chronic diseases.
Please tell us a little about yourself. I am an early career researcher at the University of Sydney, currently completing the third year of my doctoral research degree at the Faculty of Medicine and Health. I have a clinical background in physiotherapy and am currently the research co-ordinator of the Charles Perkins Centre Musculoskeletal Research Hub. I am also a member of the DHIN ECR Community Working Group. I am involved in numerous randomised controlled trials and observational studies which primarily focus on improving musculoskeletal health outcomes and physical activity levels in people living with chronic low back pain. Increasingly, my projects are employing a range of digital health-supported solutions to recruit participants and deliver trial interventions. I am particularly interested in understanding the patterns and costs associated with care-seeking behaviours for low back pain and innovating with digital health technologies to better support patients in achieving positive health outcomes.
What is your research on? Many people improve following treatment for low back pain, however, one in five people will experience recurrence of symptoms after discharge from care and seek further health treatment (i.e., increase medication intake, re-enter the hospital system, undergo surgery). This can be costly and burdensome to patients and the health care system. The lack of support available for patients after discharge from treatment is a strong driving factor for this cyclical pattern.
My PhD focuses on exploring why people seek care for low back pain and evaluating whether lifestyle interventions can support people with low back pain to self-manage their condition and maintain positive health behaviours. To achieve this, I have conducted a series of studies to identify the demographic, symptom, health, and lifestyle factors which are associated with seeking care for the condition. I am also conducting a systematic review with network meta-analysis to compare the effectiveness of different psychological interventions for managing chronic low back pain. Part of this project involves investigating whether the delivery format of psychological interventions (i.e., face-to-face, online/digital) influences treatment effectiveness.
My PhD also involves a large randomised controlled trial (Get Back to Healthy trial) investigating whether a coordinated support system, introduced at discharge from hospital-based physiotherapy treatment for chronic low back pain, can help people to remain physically active and reduce the use of hospital, medical, and health services for the condition. The support system involves referring patients to a digital-health intervention (telephone-based health coaching program) delivered by the Get Healthy Service®. The support system will be compared to the usual care provided to patients at discharge from hospital-based physiotherapy treatment.
What are the real world consequences of your research? The overarching goal of my research is to better understand what influences people to seek care for low back pain. Understanding these factors can help us to better tailor interventions to support people in self-managing their health and potentially reduce the need for further treatment. My research will also address an important gap in the literature. Whilst clinical guidelines consistently endorse the inclusion of psychological interventions in the management of people with chronic low back pain, the specific type of psychological interventions which should be recommended to patients remains unknown. My research will provide evidence for the most effective type of psychological intervention for improving pain intensity and physical function for people with chronic low back pain, to better support clinical decision-making. Finally, the Get Back to Healthy trial will evaluate the effect of the support system (involving a digital-heath intervention) on the future use of hospital, medical, and health services for low back pain, in people recently discharged from hospital outpatient physiotherapy treatment for chronic low back pain. If positive, findings will inform the development of an implementation plan for scaling-up this approach across health districts in New South Wales, South Australia, and Queensland.
What does digital health mean to you? For me, digital health represents an evolving opportunity to enhance the efficiency and flexibility of health care delivery. Digital health also opens the door for advancements in diagnosis, prevention, and management of health conditions, by allowing for improved integration of health information system technologies with data on health care utilisation and long-term patient outcomes. Harnessed effectively, digital health can expand our ability to deliver health information directly to the general population. Importantly, digital health offers a promising avenue to overcome barriers to equitable health care access, such as geographical location and lack of physical infrastructure. I love working in the digital health space and hope to continue pushing the boundaries to better understand how digital health can be used to improve population health outcomes.