Buchbinder Rachelle, Jolley Damien
Department of Clinical Epidemiology, Cabrini Hospital and Monash University, Australia.
Spine (Phila Pa 1976). 2005 Jun 1;30(11):1323-30. doi: 10.1097/01.brs.0000164121.77862.4b.
Quasi-experimental, nonrandomized, nonequivalent, parallel group-controlled study involving before and after telephone surveys of the general population.
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.
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.
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.
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).
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.
准实验性、非随机、非等效、平行组对照研究，涉及对普通人群进行电话前后调查。
在一项旨在改变对背痛看法的基于人群的干预措施停止3年后，衡量人群对背痛看法的任何持续变化程度。
1997年9月至1999年12月在澳大利亚维多利亚州开展的一项媒体宣传活动，提供了关于背痛的简单循证建议。宣传活动之后，社区和医生对背痛的看法都有显著改善，同时工伤赔偿背痛索赔数量有所下降。
通过电话调查衡量该宣传活动对人群对背痛看法及恐惧回避信念的影响。在维多利亚州和相邻对照州新南威尔士州，对人口统计学特征相同的人群进行了4次调查：在维多利亚州媒体宣传活动之前、活动期间、活动刚结束后以及活动结束3年后（分别为调查1 - 4）。使用背痛信念问卷（BBQ）测量背痛信念（可能得分9 - 45分，得分越高表明对下背痛问题的信念越积极）。使用恐惧回避信念问卷测量恐惧回避信念，该问卷由身体活动和工作活动两个分量表组成（可能得分分别为0 - 24分和0 - 36分），得分越低表明恐惧回避信念越少。
共有6230名普通人群个体完成了调查。在宣传活动停止3年后，维多利亚州人群对背痛的看法仍有显著的统计学意义上的改善（调查1 - 4中BBQ的平均得分分别为26.5、28.4、29.7和28.8）。新南威尔士州未观察到变化（调查1 - 4中BBQ的平均得分分别为26.3、26.2、26.3和26.1）。在过去一年中报告有背痛的个体中，维多利亚州对身体活动的恐惧回避信念也显著优于基线水平（调查1 - 4中身体活动恐惧回避信念问卷的平均得分分别为14.0、12.5、11.6和12.3）。
在提供关于背痛的积极信息的媒体宣传活动停止3年后，观察到人群对背痛的看法有显著的持续改善。这一结果进一步证明，改变人群对背痛看法的一级预防策略可能是减少与背部相关残疾的一种非常有效的方法。
