# Feasibility of Goal Attainment Scaling as an Outcome Measure for Patients with Chronic Low Back Pain receiving Physical Therapy

> **NIH AHRQ R03** · UNIVERSITY OF SOUTH FLORIDA · 2020 · $43,268

## Abstract

Project Summary
Background: Clinical outcomes used for patients with low back pain (LBP), often fail to incorporate
patient-centeredness and may not fully reflect the scope of a patient’s individual needs. Goal Attainment
Scaling (GAS), where patients initiate and identify his/her particular goal(s), may better reflect goals that
are important for individual treatment success. GAS has been inadequately developed and validated for
patients with chronic LBP receiving physical therapy. Objectives/Specific Aims: The primary objective of
this proposal is to establish feasibility in a pilot test that develops a reliable and valid application of GAS
for patients with chronic LBP receiving physical therapy. Specific Aim 1: To develop a new application of
GAS procedures to be used by physical therapists treating patients with chronic LBP. Design: Pilot
prospective cohort study. Population: For phase 1, we will recruit 30 adults with a history of non-specific
chronic LBP. For phase 2, we will recruit 30 patients with chronic LBP seeking physical therapy from the
USF Morsani Center for Advanced Healthcare. Methods: In Phase 1, we will conduct a qualitative study,
centered on grounded theory by conducting focus groups of patients with chronic LBP to identify an inventory
of goals, which will be used to generate a series of questions to assist the patient in generating goals in Phase
2. In Phase 2, we will pilot-test GAS in patients with chronic LBP to determine its feasibility in a clinical setting.
Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), Minimum Dataset, and GAS will be obtained
prior to and following care. Two physical therapists will administer GAS along with usual care for each patient
prior to and following care. A third physical therapist will observe the outcome collection to establish feasibility,
fidelity, and reliability.Data Analysis: Sub-aim 1a: Following the transcription of field notes, participant
views will be examined to identify emerging themes and an interpretive analysis will be performed to
explain the findings. The researchers will analyze those themes and researcher triangulation will be used
to establish validity, or trustworthiness. Sub-aim 1b: Descriptive data for all variables will be calculated.
GAS process, feasibility, and fidelity, will be evaluated by measuring the time to administer GAS, checklist
adherence, and nature of the goals identified. Inter-rater reliability and criterion validity of GAS scores will
be assessed using a Spearman rank correlations to examine the association between two independent
examiners and between GAS and ODI scores, respectively. Responsiveness will be assessed by
comparing standardized response means (SRMs) for the NRS, ODI, and GAS, while Chi square analyses
will be used to determine if differences exist between the tests. Impact: GAS will enhance the
measurement of outcomes for not only patients with chronic LBP, but for other patients receiving physical
therapy, thereby...

## Key facts

- **NIH application ID:** 9920649
- **Project number:** 5R03HS025288-02
- **Recipient organization:** UNIVERSITY OF SOUTH FLORIDA
- **Principal Investigator:** Douglas Haladay
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $43,268
- **Award type:** 5
- **Project period:** 2019-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9920649

## Citation

> US National Institutes of Health, RePORTER application 9920649, Feasibility of Goal Attainment Scaling as an Outcome Measure for Patients with Chronic Low Back Pain receiving Physical Therapy (5R03HS025288-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9920649. Licensed CC0.

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