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

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 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

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 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

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 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

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 Media campaign Launched Oct 2006 - 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

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.com Ref 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