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Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting.

Publication ,  Journal Article
George, SZ; Teyhen, DS; Wu, SS; Wright, AC; Dugan, JL; Yang, G; Robinson, ME; Childs, JD
Published in: Eur Spine J
July 2009

The general population has a pessimistic view of low back pain (LBP), and evidence-based information has been used to positively influence LBP beliefs in previously reported mass media studies. However, there is a lack of randomized trials investigating whether LBP beliefs can be modified in primary prevention settings. This cluster randomized clinical trial investigated the effect of an evidence-based psychosocial educational program (PSEP) on LBP beliefs for soldiers completing military training. A military setting was selected for this clinical trial, because LBP is a common cause of soldier disability. Companies of soldiers (n = 3,792) were recruited, and cluster randomized to receive a PSEP or no education (control group, CG). The PSEP consisted of an interactive seminar, and soldiers were issued the Back Book for reference material. The primary outcome measure was the back beliefs questionnaire (BBQ), which assesses inevitable consequences of and ability to cope with LBP. The BBQ was administered before randomization and 12 weeks later. A linear mixed model was fitted for the BBQ at the 12-week follow-up, and a generalized linear mixed model was fitted for the dichotomous outcomes on BBQ change of greater than two points. Sensitivity analyses were performed to account for drop out. BBQ scores (potential range: 9-45) improved significantly from baseline of 25.6 +/- 5.7 (mean +/- SD) to 26.9 +/- 6.2 for those receiving the PSEP, while there was a significant decline from 26.1 +/- 5.7 to 25.6 +/- 6.0 for those in the CG. The adjusted mean BBQ score at follow-up for those receiving the PSEP was 1.49 points higher than those in the CG (P < 0.0001). The adjusted odds ratio of BBQ improvement of greater than two points for those receiving the PSEP was 1.51 (95% CI = 1.22-1.86) times that of those in the CG. BBQ improvement was also mildly associated with race and college education. Sensitivity analyses suggested minimal influence of drop out. In conclusion, soldiers that received the PSEP had an improvement in their beliefs related to the inevitable consequences of and ability to cope with LBP. This is the first randomized trial to show positive influence on LBP beliefs in a primary prevention setting, and these findings have potentially important public health implications for prevention of LBP.

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Published In

Eur Spine J

DOI

EISSN

1432-0932

Publication Date

July 2009

Volume

18

Issue

7

Start / End Page

1050 / 1058

Location

Germany

Related Subject Headings

  • Young Adult
  • Surveys and Questionnaires
  • Social Support
  • Patient Education as Topic
  • Patient Compliance
  • Outcome Assessment, Health Care
  • Orthopedics
  • Military Personnel
  • Military Medicine
  • Male
 

Citation

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George, S. Z., Teyhen, D. S., Wu, S. S., Wright, A. C., Dugan, J. L., Yang, G., … Childs, J. D. (2009). Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting. Eur Spine J, 18(7), 1050–1058. https://doi.org/10.1007/s00586-009-1016-7
George, Steven Z., Deydre S. Teyhen, Samuel S. Wu, Alison C. Wright, Jessica L. Dugan, Guijun Yang, Michael E. Robinson, and John D. Childs. “Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting.Eur Spine J 18, no. 7 (July 2009): 1050–58. https://doi.org/10.1007/s00586-009-1016-7.
George SZ, Teyhen DS, Wu SS, Wright AC, Dugan JL, Yang G, et al. Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting. Eur Spine J. 2009 Jul;18(7):1050–8.
George, Steven Z., et al. “Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting.Eur Spine J, vol. 18, no. 7, July 2009, pp. 1050–58. Pubmed, doi:10.1007/s00586-009-1016-7.
George SZ, Teyhen DS, Wu SS, Wright AC, Dugan JL, Yang G, Robinson ME, Childs JD. Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting. Eur Spine J. 2009 Jul;18(7):1050–1058.
Journal cover image

Published In

Eur Spine J

DOI

EISSN

1432-0932

Publication Date

July 2009

Volume

18

Issue

7

Start / End Page

1050 / 1058

Location

Germany

Related Subject Headings

  • Young Adult
  • Surveys and Questionnaires
  • Social Support
  • Patient Education as Topic
  • Patient Compliance
  • Outcome Assessment, Health Care
  • Orthopedics
  • Military Personnel
  • Military Medicine
  • Male