RISE (Recovery, Information, Support and Empowerment): Feasibility of a clinician-supported SMS intervention for individuals at risk of poor recovery after acute whiplash injury

RISE SMS intervention RISE is a clinician-supported, tailored text message–based intervention designed to support recovery in people with acute whiplash-associated disorder following a road traffic crash. The intervention is delivered over approximately 3 weeks + optional 3 days. All text scheduling and storage (in both treatment and comparator conditions) occurs within The University of Queensland’s research infrastructure; text messages (both sent and received) will briefly held on CellCast’s infrastructure using a dedicated study telephone number. Onboarding phase (7 days): Participants receive welcome text messages (approximately 3 separate messages due to text limits) and are then contacted by telephone to nominate their preferred message delivery times and, where applicable, arrange delivery of a wearable device (Garmin or Empatica EmbracePlus). Participants will also have the option to receive two 30-minute clinician support sessions (telephone or email) with a psychologist and physiotherapist if they wish; this session will be delivered at the participant's preferred time anytime during the 3-week intervention period. Participants will then receive onboarding messages ( (approximately 5 separate messages due to text limits) to inform them about the intervention process, two-way messaging and other features. RISE text message delivery (3 weeks, with optional 3-day extension): Participants receive approximately one text message per day for 3 weeks. Messages are written in simple language and target stress symptom management and pain coping. Content is based on prior co-design work and organised into four RISE domains: 1. Recovery focused messages that provide reassurance, encouragement, and emotion support. 2. Informational support providing education on whiplash injury and pain, and what to expect during recovery. 3. Support targeted to foster behaviour change, including cognitive-behavioural psychological techniques. 4. Empowering and motivational messages to enhance patient confidence in managing their pain and recovery. Participants may opt to receive additional messages for a further 3 days; they will be notified of this option at the end of week 3. All participants receive access via text message link to evidence-based advice and physiotherapy exercises on the My Whiplash Navigator website (https://mywhiplash.com.au/node/77). The exercises include: Range of motion/movement Front of neck (neck flexors) Back of neck (neck extensors) Shoulder area (shoulder girdle). Neck and shoulder exercises are grouped into beginner, intermediate and advanced exercises, indicated by the different icons. RISE intervention personalisation The intervention includes features to tailor message content and delivery over the intervention period. These include the following. Preferred message timing: Participants nominate their preferred time of message delivery during onboarding. Optional clinician sessions: Participants may receive one 30-minute session with a psychologist and one 30-minute session with a physiotherapist during the intervention period. This is discussed during onboarding and scheduled if requested. On-demand messages: Participants can request messages at any time by texting a keyword (e.g., CALM, ACTIVATE). Message frequency options: At the end of week 1, participants receive a prompt to review message frequency and may choose to reduce frequency for a 24-hour period. Participants can also reduce message frequency at any time by texting SNOOZE. Baseline-triggered messages: Messages are delivered during weeks 1–3 based on baseline survey responses (e.g., sleep disturbance, concentration difficulties). Two-way SMS check-ins: During weeks 1–3, participants receive two-way messages to rate pain, stress, and perceived support. Weekly diary: Participants are invited to complete a weekly diary to reflect on their experiences. Short extension option: At the end of week 3, participants may choose to receive messages for an additional 3 days. Clinician support session/s: Participants may opt to receive up to two optional clinician support sessions during the intervention period: one 30-minute session with a psychologist and one 30-minute session with a physiotherapist. Uptake of these sessions is at the participant’s discretion. The psychologist session focuses on reviewing progress, providing psychological support, and assisting with goal setting. The physiotherapist session focuses on activity and exercise education, advice, and goal setting. Responses to two-way messages will be monitored and will be used to assess intervention engagement. Participants who received a smart watch as part of the study will return them via post once they have completed the 3-week intervention.