Home › Low Back Pain › NCT07290361
Stratified Targeted Engagement From Primary Care to Physical Therapy (STEPPT)
Stratified Targeted Engagement From Primary Care to Physical Therapy (STEPPT): A Pragmatic Stepped Wedge Cluster Randomized Trial
Who can join
Ages 18 and older · All sexes
Full eligibility criteria
Inclusion Criteria * 18 years or older. * Identify as either Hispanic or Non-Hispanic ethnicity, inclusive of all races. * Seeking care for spine pain at an Adult or Adult Walk-in primary care clinic within the participating Federally Qualified Health Center (FQHC). * New or existing spine pain problem: A new spine pain problem is defined by a new ICD code for neck or back pain added to the problem list during a visit with a primary care physician. An existing spine pain problem is defined by an existing ICD code for neck or back pain on the problem list that is associated with a physician referral for any service during the visit related to the neck or back pain problem. * Signed a broad consent for the use of de-identified health information for research at the participating FQHC. Exclusion Criteria: * Spine pain associated with a non-musculoskeletal etiology (e.g., infection, cancer, urological disorders, pregnancy, etc.) * Patients requiring urgent medical intervention (e.g., fracture, cauda equina syndrome, etc) * Active physical therapy referral for spine pain at the time of the index encounter. * Previously referred to physical therapy through the STEPPT Care Pathway. * Physical therapy referrals external to the FQHC will be excluded from the analysis of physical therapy adherence
About the study
The goal of this clinical trial is to learn if a health system intervention called "Stratified Targeted Engagement from Primary Care to Physical Therapy (STEPPT)" can improve how often doctors refer Hispanic patients with spine pain to physical therapy (referral rate) and how often patients attend physical therapy after being referred (adherence rate). The main questions this study aims to answer are 1) does STEPPT improve physical therapy referral and adherence rates compared to usual care for Hispanic patients with spine pain who seek care in a Federally Qualified Health Center (FQHC) serving low income communities, and 2) how consistently do FQHC providers and staff deliver STEPPT to patients who may benefit? STEPPT will train doctors and other health care providers to educate participants on the benefits of physical therapy for spine pain and participants will receive culturally tailored handouts and videos to teach them about their spine pain and what to expect in physical therapy. Patients will also receive personalized assistance to schedule their physical therapy appointment and address potential barriers for attending the appointment.
What is being tested
- Engagement of clinic leadership (System Intervention - Usual Care) (behavioral)
- Engagement of clinic leadership (System Intervention - STEPPT) (behavioral)
- Patient Registry (System Intervention - STEPPT) (behavioral)
- Delivery of Patient Education Materials (System Intervention - Usual Care) (behavioral)
- Delivery of Patient Education Materials (System Intervention - STEPPT) (behavioral)
- Referral Specialist Training (System Intervention - Usual Care) (behavioral)
Sponsor: San Diego State University · Participants: 17,587 · Started: Dec 1, 2025
Contact the study team
- Cheenee R Real, BSN, MPH, MSOL · Phone: 323-508-6312
- Shadia Assi, BS, MPH · Phone: 619-515-2300
Official record on ClinicalTrials.gov — NCT07290361
Locations in the U.S.
| California | Family Health Centers of San Diego, San Diego |
Conditions
From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.