From information to action; co-designing pain neuroscience education for adolescents with low back pain: Focus group insights

INTRODUCTION: Low back pain (LBP) is a common health problem among adolescents. Adolescents with pain report higher stress, more school absenteeism, poorer academic performance, and frequent healthcare use. LBP during adolescence may increase the risk of pain in adulthood, underscoring the importance of supporting young people in developing strategies to understand and manage pain. OBJECTIVE: To develop educational material based on pain neuroscience education (PNE) through co-design with adolescents experiencing LBP. METHODS: Adolescents 15-19 years old were recruited to review an initial prototype developed by the authors. Four focus group discussions involving 15 participants were conducted and analyzed using Krueger's analysis framework. The findings guided the development of a refined prototype, which was then further improved through an additional focus group with six participants to validate interpretations and adjust content. RESULTS: Four themes captured adolescents' needs in relation to pain education. Need for recognition: "This is about me" emphasized relatable, back-specific information. Need for practical tools and support: "What can I do myself?" reflected adolescents' desire for actionable strategies. A format that sparks interest: "Otherwise I will stop reading" highlighted the importance of engaging, concise content adapted to young people. The pathway from information to useful support: "It must be easy to find" underlined the value of structure and simple navigation. Participants confirmed the relevance of the prototype and suggested adjustments, which guided further refinement. Based on these insights, the final Back To Move prototype was developed as a complement to healthcare services. CONCLUSION: Adolescents with LBP value PNE that is back-specific, practical, trustworthy, and presented in a format adapted to their preferences. When evidence-based knowledge is combined with language and design tailored to the target group, educational material becomes more engaging and supportive. These findings highlight the importance of involving young people as active co-designers of health information.