{
  "abstract": "Aims\n\nComplex lower-limb trauma is associated with substantial long-term physical and psychological morbidity. Access to integrated psychological support remains inconsistent. This study describes the development of Pain Rehabilitation to Optimize Major Orthopaedic Trauma REcovery (PROMOTE), a theory-based, hybrid (website plus one-to-one support) biopsychosocial intervention.Methods\n\nDevelopment followed the Medical Research Council framework for complex interventions and is reported in accordance with the GUIDance for the rEporting of intervention Development (GUIDED) checklist. This included: 1) an evidence review to identify modifiable psychosocial risk factors and theoretical models; 2) content coproduction with an expert advisory group including multidisciplinary clinicians and patient representatives, alongside independent patient interviews; and 3) iterative development and user testing of a low-intensity, scalable intervention. The intervention integrates the Common-Sense Model of Self-Regulation with cognitive behavioural therapy.Results\n\nPROMOTE comprises four brief healthcare professional contact sessions delivered over eight weeks and an interactive, personalized website. The website is structured into five sections: 1) psychoeducation about the injury, pain, stress, and recovery; 2) cognitive behavioural techniques; 3) coping strategies; 4) recovery planning; and 5) a personalized profile. Content includes multimedia resources, interactive exercises, and personalized feedback. Iterative feedback from patients and clinicians led to improvements in navigation, language, pacing, and engagement.Conclusion\n\nPROMOTE is a coproduced, theory-informed, scalable biopsychosocial intervention designed to address unmet psychological needs following complex lower-limb trauma. The intervention was evaluated in a feasibility randomized controlled trial to assess acceptability and engagement.",
  "abstract_shown": true,
  "affiliations": [
    "Kadoorie Institute of Trauma, Emergency & Critical Care, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.",
    "Oxford Major Trauma Centre, Oxford University John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.",
    "Oxford Major Trauma Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.",
    "NDORMS Patient and Public Involvement and Engagement group, Oxford, UK.",
    "Trauma and Major Trauma Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.",
    "Oxford University Hospitals NHS Foundation Trust, Oxford, UK.",
    "University of Oxford, Oxford, UK."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
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        0
      ],
      "name": "Beth Fordham",
      "orcid": "0000-0001-5996-3563"
    },
    {
      "affs": [
        1
      ],
      "name": "Louise M Quarmby"
    },
    {
      "affs": [
        2
      ],
      "name": "Emma Evans"
    },
    {
      "affs": [
        0
      ],
      "name": "Jonathon Merrill"
    },
    {
      "affs": [
        0
      ],
      "name": "Duncan Appelbe"
    },
    {
      "affs": [
        3
      ],
      "name": "Jenny Gould"
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    {
      "affs": [
        3
      ],
      "name": "Dominic Burton"
    },
    {
      "affs": [
        4
      ],
      "name": "Julie Wright"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Jane Quinlan"
    },
    {
      "affs": [
        0
      ],
      "name": "Juul Achten"
    },
    {
      "affs": [
        0
      ],
      "name": "Elizabeth Tutton",
      "orcid": "0000-0003-3973-360X"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthew L Costa"
    },
    {
      "affs": [
        0
      ],
      "name": "David J Keene"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1c6h3fp55627n.bib",
  "cited_by": 0,
  "doi": "10.1302/2633-1462.711.bjo-2026-0153.r1",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727322/?tool=EBI",
  "id": "1c6h3fp55627n",
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  "landing_url": "https://europepmc.org/article/PMC/PMC13727322",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Composite Fixation"
    ],
    [
      "heading",
      "Infected Gap Nonunion"
    ],
    [
      "heading",
      "Locking Plate"
    ],
    [
      "heading",
      "Monorail Fixator"
    ],
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      "heading",
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      "heading",
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    [
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      "3202|Digital Mental Health Interventions"
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  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727322/pdf/?tool=EBI",
  "pmcid": "PMC13727322",
  "pmid": "42971248",
  "published": "2026-11-01",
  "publisher": "British Editorial Society of Bone and Joint Surgery",
  "ris": "https://research.draconitic.com/paper/1c6h3fp55627n.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
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      "native_id": "PMC13727322",
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      "url": "https://doi.org/10.1302/2633-1462.711.bjo-2026-0153.r1"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Total Knee Arthroplasty Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Development of a biopsychosocial hybrid intervention to support patients following a complex lower-limb trauma : the PROMOTE study",
  "title_text": "Development of a biopsychosocial hybrid intervention to support patients following a complex lower-limb trauma : the PROMOTE study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:23:01Z",
  "url": "https://research.draconitic.com/paper/1c6h3fp55627n",
  "venue": "Bone & joint open",
  "versions": []
}