Abstract
BACKGROUND: In Denmark, the organization and content of rehabilitation for people with back problems vary by municipality. Furthermore, there is no systematic evaluation of the overall effect and quality of municipal rehabilitation efforts. Since individuals with long-lasting back problems often receive multiple interventions delivered by various professionals, departments, and sectors, a coordinated effort is essential within complex systems, like municipal organizations. Therefore, the Municipality of Svendborg, the University of Southern Denmark, and UCL University College aim to co-design an improved municipal rehabilitation program with and for individuals with back problems, within the existing municipal context. The new practices developed in the program seek to better support individuals to manage everyday life with back problems, develop effective rehabilitation practices, and decrease the associated municipal costs. METHODS: My Back is a mixed-method research study, utilizing a Plan-Do-Study-Act (PDSA) approach to ensure iterative development and continuous improvement of municipal rehabilitation practices. This study is structured into several work packages (WPs) that focus on identifying experiences (WP 1), mapping current practices (WP 2), summarizing relevant literature (WP 3), conducting co-design workshops (WP 4), and the development and implementation of new rehabilitation practices via PDSA cycles (WP 5). These WPs will inform the development and implementation of new rehabilitation practices, which will be evaluated for quality and effectiveness (WP 6), and system-level changes (WP 7), followed by dissemination of results (WP 8). DISCUSSION: Through a local co-design process involving individuals with back problems, municipal professionals, and leaders, we expect strong relevance and engagement, ensuring successful implementation. The new practices aim to better support people with back problems to manage everyday life through improved rehabilitation and interdisciplinary collaboration among municipal social and health professionals. A platform model for monitoring local rehabilitation will be introduced to evaluate workability and economic implications within the target population. The knowledge and results from this study can be disseminated and adapted to public contexts throughout Denmark and potentially other countries with similar municipal healthcare structures. Sharing best practices and lessons learned from the implementation process can inform rehabilitation practices in different international settings.