title: Working Backs Project--implementing low back pain guidelines.
abstract: BACKGROUND
  The St Vincent's Working Backs Project (WBP) represents a strategy for the implementation of the UK Faculty of Occupational Medicine guidelines for the management of low back pain (LBP) in the workplace (Carter J, Birrell L. Occupational Health Guidelines for the Management of Low Back Pain at Work-Principal Recommendations. London: Faculty of Occupational Medicine, 2000).
  
  
  OBJECTIVE
  To evaluate the efficacy of the St Vincent's WBP.
  
  
  METHODS
  Questionnaire survey of staff and managers before and after the WBP intervention together with review of Occupational Health Department (OHD) data. The intervention included changes to LBP management pathways and protocols, combined with a guideline-based health promotion campaign. Outcomes included WBP awareness, LBP-related sickness absenteeism, staff back beliefs, intended management of LBP and manager attitudes towards LBP and it management.
  
  
  RESULTS
  Following the WBP intervention, 85% (n=46) of managers and 57% (n=124) of staff reported having heard of the WBP. LBP-related sickness absenteeism in the previous year had not decreased significantly (95% confidence interval: -0.03 to 0.06). Among staff, a mean improvement of 1.8 had occurred on the Back Beliefs Questionnaire score. More staff (36%) reported that they would try to stay active (P<0.05) with LBP and would choose to attend the OHD if they required treatment. More managers demonstrated guideline-consistent attitudes.
  
  
  CONCLUSIONS
  Following the WBP, staff and manager attitudes and beliefs towards LBP and its management were more consistent with the LBP guidelines although LBP-related sickness absenteeism did not decrease significantly. Future occupational guideline implementation strategy studies are required which should include a control worksite and rely on pre- and post-intervention organizational data.
authors.affiliation: School of Physiotherapy and Performance Science, Health Science Centre, University College Dublin, and Occupational Health Department, St Vincent's University Hospital, Dublin, Ireland. caitriona.g.cunningham@ucd.ie
authors.forename: Caitriona G
authors.initials: CG
authors.lastname: Cunningham
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Flynn
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Toole
authors.forename: Robert G
authors.initials: RG
authors.lastname: Ryan
authors.forename: Paul W J
authors.initials: PW
authors.lastname: Gueret
authors.forename: Siobhan
authors.initials: S
authors.lastname: Bulfin
authors.forename: Orla
authors.initials: O
authors.lastname: Seale
authors.forename: Catherine
authors.initials: C
authors.lastname: Blake
mesh_terms: D016009:Chi-Square Distribution; D005260:Female; D006293:Health Promotion; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000628:therapy*; D008297:Male; D009784:Occupational Diseases / Q000523:psychology / Q000628:therapy*; D016272:Occupational Health; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D018582:Sick Leave / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome