Barriers and facilitators of engagement with app-based pain self-management strategies among chronic pain patients (CPPs)

This study explored barriers and facilitators to digital self-management engagement among individuals with chronic pain. Semi-structured interviews were conducted with 24 participants, guided by a 32-item schedule informed by digital health adoption literature and the Capability, Opportunity, Motivation and Behaviour (COM-B) model. Reflexive thematic analysis identified key influences on engagement, which were then mapped onto the COM-B framework to inform intervention design. Barriers were linked to physical and cognitive limitations, information access, financial constraints, self-efficacy and individual differences. Facilitators included social connection, enhanced pain awareness, autonomy and accessibility. While themes aligned with most COM-B components, no clear influences were mapped to Automatic Motivation. Findings provide nuanced insights into the behavioural and contextual factors shaping engagement with app-based interventions. By applying the COM-B model, this study offers a theoretically grounded understanding of digital self-management uptake, supporting the development of more responsive and accessible interventions for people living with chronic pain.