Effects of a media campaign on back beliefs is sustained 3 years after its cessation

Study Design. Quasi- experimental, nonrandomized, nonequivalent, parallel group- controlled study involving before and after telephone surveys of the general population. Objective. To measure the magnitude of any sustained change in population beliefs about back pain 3 years after cessation of a population- based intervention designed to alter beliefs about back pain. Summary of Background Data. A media campaign, which ran between September 1997 and December 1999 in Victoria, Australia, provided simple evidence- based advice about back pain. Following the campaign, there were significant improvements in both community and physicians' beliefs about back pain, as well as a decline in number of workers' compensation back claims. Methods. The campaign's impact on population beliefs about back pain and fear- avoidance beliefs was measured using telephone surveys. Demographically identical population groups in Victoria and the adjacent control state, New South Wales, were surveyed at 4 times: before, during, immediately after, and 3 years after the media campaign in Victoria ( surveys 1 - 4, respectively). Back beliefs were measured using the Back Beliefs Questionnaire ( BBQ) ( possible score 9 - 45, for which a higher score indicates a more positive belief about low back trouble). Fear- avoidance beliefs were measured using the Fear-Avoidance Beliefs Questionnaire consisting of 2 subscales for physical activity and work activity ( possible scores 0 - 24 and 0 - 36, respectively), for which a lower score indicates fewer fear- avoidance beliefs. Results. A total of 6230 individuals in the general population completed the surveys. Large statistically significant improvements in population beliefs about back pain were still observed in Victoria 3 years after cessation of the campaign ( mean scores on the BBQ were 26.5, 28.4, 29.7, and 28.8 for surveys 1 - 4, respectively). No changes were observed in New South Wales ( mean scores on the BBQ were 26.3, 26.2, 26.3, and 26.1 for surveys 1 - 4, respectively). Of those individuals who reported back pain during the previous year, fear- avoidance beliefs about physical activity in Victoria were also significantly better than at baseline ( mean scores on the Fear- Avoidance Beliefs Questionnaire for physical activity were 14.0, 12.5, 11.6, and 12.3 for surveys 1 - 4, respectively). Conclusions. Significant sustained improvements in population beliefs about back pain were observed 3 years after cessation of a media campaign of provision of positive messages about back pain. This result provides further evidence that a primary preventive strategy of altering population beliefs about back pain may be a highly effective way for reducing back- related disability.