The Back Injury Prevention Project was a pilot study of "Back Attack," an educational program designed to prevent back injuries among nurses, nurses' aides, and orderlies. The pilot tested program feasibility, developed and tested instruments, and generated preliminary data measuring program effectiveness. Fifty-five nurses, aides, and orderlies on two medical/surgical units at two Kaiser Permanente medical centers in Portland, Oregon participated in the study. Intervention group scores on the composite back pain and composite fatigue scales decreased relative to the control group, but this did not reach statistical significance. A 19% improvement in scores for quality of patient transfer was observed for the intervention group (P < .0003), while the control group did not show any significant improvement during the same time period. Results of the pilot suggest that the Back Attack program changes behavior at least in the short term. Further study will be necessary to determine if the behavior change persists and back pain and injury rates are subsequently reduced.