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Evaluating a primary prevention program in a multicultural population: the importance of representations of back pain
C Cedraschi1, E Perrin, W Fischer
1Division of Rheumatology, University Cantonal Hospital, Geneva, Switzerland.
Objective:
This study was carried out during 4 years of longitudinal research assessing back pain problems and the impact of a back pain primary prevention program on the employees of a food and non-food chain store. The impact of the teaching program was reevaluated in a secondary analysis, taking into account subjects' prior representations of back pain.
Methods:
Subjects were grouped according to their cultural origins and socioprofessional levels. Their representations were assessed by means of open questions before and after the teaching program.
Results:
The teaching program reinforced pre-existing representations in those participants socioculturally nearest the teachers; it had a weak or even disturbing impact on those furthest removed from the teachers in sociocultural terms.
Conclusion:
The differential impact of the teaching program in this study indicates that participants' prior representation play a role in the outcome of a Back School teaching program. Thus, the participants' representations should be taken into account when designing the program and when assessing participants' suitability for such programs, their adherence, and the outcome.