The objective was to determine the effectiveness of a moderated Internet discussion group with supporting materials in improving health status and health care utilization. Subjects were randomized to an email list where all members received the posts of all other members, or a control group that received a magazine subscription. Recruitment included, 1) reaching the study web page, 2) completing a questionnaire to determine eligibility, 3) reading and submitting an informed consent and 4) completing a baseline questionnaire. All activities occurred online. The subjects were from 49 states, 62% male, mean age 45.3 years (SD=11.6) and mean education 16.6 (SD=2.8) years. During the 1-year study there were approximately 2500 posts with 68% of the subjects posting at least once. At one year 190 (69%) treatment subjects compared to 232 (89%) control subjects demonstrated less disability, health distress, and interference in their daily activities; increased self-efficacy to manage their symptoms, and increased orientation toward self-care (all p<.01). There was a trend toward fewer back related MD visits (p=.07). Results suggest that a moderated email discussion group can have effects on health status and may reduce health care utilization. These effects are in addition to those received from traditional medical care.

Learning Objectives:

• Identify the outcomes of a randomized Internet based back pain study
• Identify two major problems encountered during the study.
• The most successful means of recruiting study participants.