Study design: Public and professional health education campaign.
Objective: To change public beliefs about the management of back pain.
Summary of background data: Within the past decade, there has been a reversal in the strategy of management of back pain, from rest to staying active. There is only one previous public health education campaign on back pain, in a workers compensation setting in Australia.
Methods: A multimedia campaign was based around 1777 radio advertisements, which were heard by 60% of adults. Information leaflets were prepared for people with back pain, for all health professionals who treat back pain, and for employers. A Web site was set up: www.workingbacksscotland.com. Structured monthly samples of 1000 adults were surveyed on their beliefs about rest or staying active, professional help sought and advice received for 2 months before the campaign and over the following 3 years. Royal Mail sickness absence rates and new awards of social security benefits for back pain were compared in Scotland versus the rest of the United Kingdom, before and after the campaign.
Results: There was a significant (P < 0.001) change in the balance of beliefs, from about 55% rest versus 40% staying active to about 30% rest versus 60% staying active. This occurred within 1 month of the launch and was maintained over 3 years. There was a comparable change in professional advice. There was no change in advice about work or the number who said they stayed off work. There was no effect on sickness absence or new awards of social security benefits for back pain.
Conclusion: There was a major shift in public beliefs and professional advice but no change in work-related outcomes.