welsh backs an evidenced based initiative to tackle the burden of back pain on wales matt downton...

WELSH BACKS

‘an evidenced based initiative to tackle the burden of back pain on Wales’

Matt DowntonWorkplace Health SpecialistWelsh Assembly Government

Overview

• Cost / context• Successful campaigns• Development research• 3 pronged approach• Evaluation

Why Welsh Backs?

In Wales:

• 80% will suffer with back pain

• Incapacity benefits £90M

• Health care costs £150M

• Employers’ costs in sickness absence £250M

Similar picture across the UK

Why Welsh Backs?

• Negative beliefs and attitudes towards back pain can influence recovery

• Medical guidelines and advice have changed - need for re-education

• Work can be part of recovery

Key Messages

• 95% of back pain is mechanical/simple

• ‘Don’t take back pain lying down’

• Keeping active with back pain will lead to a quicker recovery

• Don’t rest for prolonged periods

• Try to stay in Work

Successful campaigns

• Successful campaigns with ‘stay active’ message:

– Australian WorkCover campaign– Working Backs Scotland

– Population - based survey of back pain beliefs in Canada

Partnership approach

– WAG, HSE, WCH and NHS Direct– Leading experts– Stakeholder engagement

AIM– To minimise the financial, personal, and psychosocial effects of

back pain on Wales by:– Supporting people to overcome back pain by promoting the

‘stay active’ message and providing information and advice- Encouraging employers to actively engage in

rehabilitation- Providing guidance to health professionals to reduce

the burden of back pain on health services

Developmental Research - Aims

– To investigate;– individuals understanding and beliefs regarding

back pain and the management of it– individuals understanding of the messages

provided by various healthcare professionals in relation to the management of back pain

– to provide baseline data on individuals’ attitudes and response to back pain

Developmental research - Methods

– Quantitative study– questions based on the Scottish Backs survey included in the

Beaufort November 2005 Omnibus survey– survey sample selected with probability proportional to resident

population using quotas set to reflect the demographic profile of Welsh residents.

– 1018 face-to-face interviews conducted with adults 16+ in their homes

– Qualitative study– 12 focus groups with 8 - 10 participants in each group– Factors considered - age, gender, social-economic grouping, back

pain and work experience, language

Impact on Welsh Backs

• Greater emphasis on engaging primary care and employers

• ‘Softening’ the stay active messages• Ownership - own branding• Must engage non sufferers• Health professionals, employers and public • ‘ balance concern, sympathy and empathy with

practical help, advice and information’

Employers

• ‘Better Backs’ - packs• Prevention• Return to work - reasonable adjustments• Champion good practice• Inspection campaign• Workplace Health Connect• Event 21st March

Health Professionals

• Engage GPs in the wider campaign• Desk aid designed to:

- Reinforce stay active and stay in work messages

- Involve GPs in campaign

- Patient resources (leaflet, website etc)

• Further developments

Public Awareness

• Engage with sufferers and non sufferers

• Non suffers - low level of interest, but…..!

• Sufferers - require more detailed information

• Multi media must effectively target both

Research and Evaluation

– On going monitoring via Omnibus– Evaluation of desk aid– Campaign appearance– Uptake of resources

Early findings…………..– If you have back pain, you should try and stay active?

52% - 66%– If you have back pain you should rest until you get

better?

50% - 42%– Most back pain settles quickly and you can get on

with normal activities such as going to work?

37% - 51%• Of those visiting GPs with their back pain 32 % were

told to rest pre campaign and 20% after

Contact• Matt Downton - 02920 826324

• matt.downton@wales.gsi.gov.uk

• www.welshbacks.comRef• Waddel, G. et al (2006) A population-based survey of back

beliefs in Canada. SPINE Vol.31, Number 18, pp2142-2145• Buchbinder & Jolley (2001) Population based intervention to

change back pain beliefs and disability: 3 part evaluation. BMJ Vol 322: 1516-20