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. 2001 Jun 23;322(7301):1516-20.
doi: 10.1136/bmj.322.7301.1516.

Population based intervention to change back pain beliefs and disability: three part evaluation

R Buchbinder  1 , D Jolley, M Wyatt
Affiliations

Population based intervention to change back pain beliefs and disability: three part evaluation

R Buchbinder et al. BMJ. .

Abstract

Objective: To evaluate the effectiveness of a population based, state-wide public health intervention designed to alter beliefs about back pain, influence medical management, and reduce disability and costs of compensation.

Design: Quasi-experimental, non-randomised, non-equivalent, before and after telephone surveys of the general population and postal surveys of general practitioners with an adjacent state as control group and descriptive analysis of claims database.

Setting: Two states in Australia.

Participants: 4730 members of general population before and two and two and a half years after campaign started, in a ratio of 2:1:1; 2556 general practitioners before and two years after campaign onset.

Main outcome measures: Back beliefs questionnaire, knowledge and attitude statements about back pain, incidence of workers' financial compensation claims for back problems, rate of days compensated, and medical payments for claims related to back pain and other claims.

Results: In the intervention state beliefs about back pain became more positive between successive surveys (mean improvement in questionnaire score 1.9 (95% confidence interval 1.3 to 2.5), P<0.001 and 3.2 (2.6 to 3.9), P<0.001, between baseline and the second and third survey, respectively). Beliefs about back pain also improved among doctors. There was a clear decline in number of claims for back pain, rates of days compensated, and medical payments for claims for back pain over the duration of the campaign.

Conclusions: A population based strategy of provision of positive messages about back pain improves population and general practitioner beliefs about back pain and seems to influence medical management and reduce disability and workers' compensation costs related to back pain.

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Figures

Figure 1
Figure 1
Change in numbers of claims over time by type of claim, Victorian WorkCover database, 1993-4 to 1999-2000. Both series indexed to number of claims in 1996-7
Figure 2
Figure 2
Change over time in rates per 1000 claim days of days compensated and medical payment, by type of claim, Victorian WorkCover Authority database, Victoria, August 1997 to December 1999. Smoothed local regression lines fitted with loess procedure
See this image and copyright information in PMC

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