
Overview
Background
Dr Nathalia Costa is a Senior Research Fellow at the University of Queensland's cLinical TRials cApability (ULTRA), located within the Centre for Clinical Research in Herston. Her career goal is to enhance the evidence base from clinical trials and deepen the understanding of healthcare issues through qualitative and mixed methods, with a focus on theoretically grounded, critical, reflexive and collaborative approaches. She is passionate about bringing different types of knowledge and stakeholders together to generate perspectives that create change and make research, practice and education more inclusive and nuanced. She advocates for pluralist inquiries and believes research should go beyond the dualism “quantitative/qualitative” to achieve the intersubjective understandings needed for impactful collective action. Her methodological expertise includes:
- Systematic, scoping and rapid reviews
- A range of qualitative methods and methodologies including but not limited to interviews, photo-elicitation, ethnography, Delphi studies, surveys, focus groups, document and policy analysis, thematic analysis, content analysis, and discourse analysis
- Embedding qualitative research in feasibility trials to inform large-scale clinical trials
- Conducting qualitative research to inform the development of implementation strategies
- Use of systems-thinking frameworks to identify opportunities for interdisciplinary and intersectoral action to target health problems
- Applying social theory to deepen understanding of healthcare and health more broadly
- Participatory and collaborative research with key stakeholders (e.g., patients, clinicians, academics, policymakers)
Her publications (55+) span a diverse range of themes, including musculoskeletal conditions, pain, policy, sociology and culturally responsive care. She has also taught across a range of disciplines, including research methods, musculoskeletal physiotherapy, sociology applied to health, fundamentals of physiotherapy, fundamentals of health care, health policy, health economics and health systems finance.
Her research focuses on aspects of low back pain - from exploring ways to navigate uncertainty in low back pain care to identifying avenues to improve it within the Australian healthcare system. She is currently investigating how to optimise recruitment within the FORENSIC trial, which aims to evaluate if lumbar fusion surgery is more beneficial than continuing with best conservative care for patients with persistent severe low back pain who have already undergone non-surgical treatment.
Alongside collaborators, Nathalia has garnered grants (AUD$7.5M) and awards, including an international award for one of her PhD studies, awarded by the International Society for the Study of the Lumbar Spine – the 2021 ISSLS Prize for Lumbar Spine Research (Clinical Science).
Prior to her current appointment, she was a Post-doctoral Research Fellow at the School of Health and Rehabilitation Sciences (UQ - 2021), a Post-doctoral Research Associate at the Sydney School of Public Health (The University of Sydney, 2021-2022), and a Lecturer in Physiotherapy at the Sydney School of Health Sciences (The University of Sydney, 2023). Nathalia serves as an Associate Editor for Qualitative Health Research and the Journal of Humanities in Rehabilitation.
Availability
- Dr Nathalia Costa is:
- Available for supervision
Fields of research
Qualifications
- Bachelor of Physiotherapy, Institution to be confirmed
- Doctor of Philosophy, The University of Queensland
Research impacts
In her PhD, Costa produced innovative and ground-breaking research that considered the meaning of, and the risk factors for, low back pain flares. She has led a multiphase process with a range of stakeholders (>70 experts and consumers) and produced the first rigorous definition of low back pain flare. That research has significantly influenced how low back pain flares are identified in epidemiological investigations (e.g., FLAReS, PMID: 35449043) and clinical trials (e.g., Back to living well, PMID: 34167584), and informed a successful National Institute of Health (United States) grant (AUD$3.5 million, 2022). Her research has also shown that the risk of low back pain flares is increased by transient exposure to greater sedentary behaviour and poor sleep quality, whereas being more physically active and having better sleep quality was associated with decreased risk. These findings identified potentially modifiable factors that can be targeted with interventions for low back pain.
Costa's postdoctoral research at the interface of micro and macro aspects of low back pain care has informed the training of established and pre-licensure health professionals and has also identified avenues for systemic changes for improving low back pain care in the Australian healthcare system. By integrating individual experiences with broader policy aspects, Costa's work has promoted ways to make low back pain care in Australia more nuanced, equitable and better aligned with current evidence. At an international level, her research has been adopted by the world's leading forum on pain (International Association for the Study of Pain - IASP) in an online Fact Sheet (July 2023).
Her reputation is demonstrated by her >40 presentations at national and international conferences, including presentations as an invited speaker at international conferences (e.g., World Physiotherapy Congress).
Works
Search Professor Nathalia Costa’s works on UQ eSpace
2020
Journal Article
Potential unintended effects of standardized pain questionnaires: A qualitative study
De Silva, Theresa, Hodges, Paul W., Costa, Nathalia and Setchell, Jenny (2020). Potential unintended effects of standardized pain questionnaires: A qualitative study. Pain Medicine , 21 (2), e22-e33. doi: 10.1093/pm/pnz252
2020
Journal Article
What triggers an LBP flare? A content analysis of individuals' perspectives
Costa, Nathalia, Hodges, Paul W., Ferreira, Manuela L., Makovey, Joanna and Setchell, Jenny (2020). What triggers an LBP flare? A content analysis of individuals' perspectives. Pain Medicine, 21 (1), 13-20. doi: 10.1093/pm/pnz021
2020
Journal Article
Low back pain websites do not meet the needs of consumers: A study of online resources at three time points
Costa, Nathalia, Nielsen, Mandy, Jull, Gwendolen, Claus, Andrew P. and Hodges, Paul W. (2020). Low back pain websites do not meet the needs of consumers: A study of online resources at three time points. Health Information Management Journal, 49 (2-3), 137-149. doi: 10.1177/1833358319857354
2020
Journal Article
Working with potential tensions in individual’s interactions with online consumer health education about back pain: Findings from a photo-elicitation and observational study
Setchell, Jenny, Turpin, Merrill, Costa, Nathalia and Hodges, Paul (2020). Working with potential tensions in individual’s interactions with online consumer health education about back pain: Findings from a photo-elicitation and observational study. JMIR Rehabilitation and Assistive Technologies, 7 (1) e17130, e17130. doi: 10.2196/17130
2019
Journal Article
Impact of flare-ups on the lives of individuals with low back pain: A qualitative investigation
Tan, Dominique, Hodges, Paul W., Costa, Nathalia, Ferreira, Manuela and Setchell, Jenny (2019). Impact of flare-ups on the lives of individuals with low back pain: A qualitative investigation. Musculoskeletal Science and Practice, 43, 52-57. doi: 10.1016/j.msksp.2019.06.003
2019
Journal Article
What decreases low back pain? A qualitative study of patient perspectives
Setchell, Jenny, Costa, Nathalia, Ferreira, Manuela and Hodges, Paul W. (2019). What decreases low back pain? A qualitative study of patient perspectives. Scandinavian Journal of Pain, 19 (3), 597-603. doi: 10.1515/sjpain-2019-0018
2019
Journal Article
A definition of flare in low back pain (LBP): A multiphase process involving perspectives of individuals with LBP and expert consensus
Costa, Nathalia, Ferreira, Manuela L., Setchell, Jenny, Makovey, Joanna, Dekroo, Tanya, Downie, Aron, Diwan, Ashish, Koes, Bart, Natvig, Bard, Vicenzino, Bill, Hunter, David, Roseen, Eric, Rasmussen-Barr, Eva, Guillemin, Francis, Hartvigsen, Jan, Bennell, Kim, Costa, Leonardo, Macedo, Luciana, Pinheiro, Marina, Underwood, Martin, Van Tulder, Mauritus, Johansson, Melker, Enthoven, Paul, Kent, Peter, O'Sullivan, Peter, Suri, Pradeep, Genevay, Stephane and Hodges, Paul W. (2019). A definition of flare in low back pain (LBP): A multiphase process involving perspectives of individuals with LBP and expert consensus. The Journal of Pain, 20 (11), 1267-1275. doi: 10.1016/j.jpain.2019.03.009
2018
Journal Article
How is symptom flare defined in musculoskeletal conditions: a systematic review
Costa, Nathalia, Ferreira, Manuela L., Cross, Marita, Makovey, Joanna and Hodges, Paul W. (2018). How is symptom flare defined in musculoskeletal conditions: a systematic review. Seminars in Arthritis and Rheumatism, 48 (2), 302-317. doi: 10.1016/j.semarthrit.2018.01.012
2017
Journal Article
Individuals' explanations for their persistent or recurrent low back pain: a cross-sectional survey
Setchell, Jenny, Costa, Nathalia, Ferreira, Manuela, Makovey, Joanna, Nielsen, Mandy and Hodges, Paul W. (2017). Individuals' explanations for their persistent or recurrent low back pain: a cross-sectional survey. BMC Musculoskeletal Disorders, 18 (1) 466. doi: 10.1186/s12891-017-1831-7
2017
Journal Article
What constitutes back pain flare? A cross sectional survey of individuals with low back pain
Setchell, Jenny, Costa, Nathalia, Ferreira, Manuela, Makovey, Joanna, Nielsen, Mandy and Hodges, Paul W. (2017). What constitutes back pain flare? A cross sectional survey of individuals with low back pain. Scandinavian Journal of Pain, 17 (1), 294-301. doi: 10.1016/j.sjpain.2017.08.003
Supervision
Availability
- Dr Nathalia Costa is:
- Available for supervision
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Supervision history
Current supervision
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Doctor Philosophy
Wearable Sensor Informed Activity Workloads and Quantified Return to Play Following Upper Limb Injury in Elite Female Waterpolo
Associate Advisor
Other advisors: Professor Bill Vicenzino, Dr Raimundo Sanchez, Associate Professor Michelle Smith
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Doctor Philosophy
Wearable Sensor Informed Movement Monitoring in Elite Women¿s Water Polo
Associate Advisor
Other advisors: Professor Bill Vicenzino, Dr Raimundo Sanchez, Associate Professor Michelle Smith
-
Doctor Philosophy
Adolescents with patellofemoral pain: characteristics, preferences and footwear interventions
Associate Advisor
Other advisors: Professor Bill Vicenzino, Dr Melinda Smith, Associate Professor Natalie Collins
-
Doctor Philosophy
Comparing and contrasting the physical therapies.
Associate Advisor
Other advisors: Dr Roma Forbes
-
Doctor Philosophy
Adolescents with patellofemoral pain: characteristics, preferences and footwear interventions
Associate Advisor
Other advisors: Professor Bill Vicenzino, Dr Melinda Smith, Associate Professor Natalie Collins
Completed supervision
-
2025
Doctor Philosophy
Adolescents with patellofemoral pain: characteristics, preferences and footwear interventions
Associate Advisor
Other advisors: Professor Bill Vicenzino, Dr Melinda Smith, Associate Professor Natalie Collins
Media
Enquiries
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