1. Matt Downton Workplace Health Specialist Welsh Assembly Government
WELSH BACKS ‘an evidenced based initiative to tackle the burden of back pain on Wales’
Matt Downton
Workplace Health Specialist
Welsh Assembly Government

2. Overview Cost / context Successful campaigns Development research
3 pronged approach
Evaluation

3. 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

4. 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
Displace commonly held believes about back pain that are damaging to recovery:
Hurt means harm
Rest is best
HCW - the nations challenge to improve health; WB provides individuals, employers and GPs with an opportunity to respond to this

5. 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

6. Successful campaigns Successful campaigns with ‘stay active’ message:
Australian WorkCover campaign
Working Backs Scotland
Population - based survey of back pain beliefs in Canada
2 good examples of using a variety of media to change attitudes and beliefs about back pain
In addition - the recent survey of back pain beliefs in Canada confirms the need for re education

7. 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

8. 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

9. 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 participants in each group
Factors considered - age, gender, social-economic grouping, back pain and work experience, language
Omnibus questions:
Survey questions:
Back pain in the last 12 months (from mild, self-reported pain to slipped disc, sciatica and the like)
Those with back pain - what did they do about it
For those seeking medical/professional advice/help - from whom did they seek medical advice/help and what were they advised to do
All - seen or heard anything about back pain in the media
Four statements about back pain - agree/disagree

10. 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’

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

12. 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

13. 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
Media campaign
Launched Oct TV ads prime time slots, website went live, posters and leaflets to GP surgery’s and pharmacy’s
Some examples to give you a flavour of the overall campaign

16. Research and Evaluation
On going monitoring via Omnibus
Evaluation of desk aid
Campaign appearance
Uptake of resources

17. 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

18. Contact Matt Downton - 02920 826324 matt.downton@wales.gsi.gov.uk
Ref
Waddel, G. et al (2006) A population-based survey of back beliefs in Canada. SPINE Vol.31, Number 18, pp
Buchbinder & Jolley (2001) Population based intervention to change back pain beliefs and disability: 3 part evaluation. BMJ Vol 322: