Is knowledge a barrier to implementing low back pain guidelines? Assessing the knowledge of Israeli family doctors.
OBJECTIVE
To measure knowledge of Israeli low back pain (LBP) clinical practice guidelines among different subgroups of primary care doctors, prior to designing an intervention programme to enhance guideline adherence in practice.


METHODS
Confidential mailed survey questionnaire.


METHODS
Family practices in the Haifa and western Galilee district, Israel.


METHODS
Random sample of 163 primary care doctors. A total of 134 doctors (82%) completed the questionnaire.


METHODS
A Multiple Choice Questionnaire measuring knowledge of the LBP guidelines. Instrument reliability and inter-item reliability were tested in a pilot phase. Content validity was assured by having the Israeli LBP guideline authors involved in a consensus procedure.


RESULTS
Distribution of test scores significantly differentiated professional levels and background variables, demonstrating the instrument reliability. Cronbach's alpha was above 0.91. The average test score was 67.7 [standard deviation (SD) 16.2], family doctors had average scores of 75.2 (SD 9.8), general practitioners (GPs) 57.9 (SD 19) and family practice residents 67.4 (SD 13.2). The difference between the test average scores of family doctors, GPs and residents was significant (P < 0.001). Significant differences were also found for specific variables including the doctor's age, country of medical training and self-report familiarity with the LBP guidelines.


CONCLUSIONS
Striking differences exist between subgroups of primary care doctors regarding their knowledge of LBP guidelines. These differences will require the design of multiple interventions tailored to each subgroup.
Dahan
Rachel
R
Department of Family Medicine, The B. RAppaport Faculty of Medicine, The Technion - Israel Institute of Technology, Haifa, Israel. mrdahan@netvision.net.il
Reis
Shmuel
S
Borkan
Jeffry
J
Brown
Judith-Bell
JB
Hermoni
Doron
D
Mansor
Nadia
N
Harris
Stewart
S
D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement; D019317:Evidence-Based Medicine / Q000193:education; D005260:Female; D019983:Guideline Adherence / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007557:Israel; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010821:Physicians, Family / Q000193:education* / Q000458:organization & administration / Q000523:psychology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires