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Original research
Back pain Knowledge and beliefs Survey (BacKS): development and assessment of measurement properties
  1. Leticia Amaral Corrêa1,
  2. Mark Hancock2,
  3. Stephanie Mathieson3,
  4. Arianne Verhagen4,
  5. Ben Darlow5,
  6. Paul William Hodges6,
  7. Simon French1
  1. 1Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
  2. 2Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
  3. 3Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  4. 4Graduate School of Health, Physiotherapy, University of Technology Sydney, Sydney, New South Wales, Australia
  5. 5Department of Primary Health Care and General Pratice, University of Otago Wellington, Wellington, New Zealand
  6. 6NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
  1. Correspondence to Dr Leticia Amaral Corrêa; leticia.correa{at}mq.edu.au

Abstract

Objective To develop and evaluate a new patient-reported outcome measure (PROM) to assess people’s knowledge and beliefs about low back pain.

Methods This study followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. An 18-item preliminary version of the Back pain Knowledge and beliefs Survey (BacKS) was generated based on evidence-based key messages and current clinical guidelines for low back pain. Four items were added following input from three consumers and seven experts. Focus groups (n=9) confirmed content validity. The 22-item version was completed by 258 Australian-based adults (>18 years) with self-reported low back pain. A follow-up survey was sent 1 week later. The following measurement properties were evaluated to produce, and then assess the final version of BacKS: structural validity (exploratory factor analysis); internal consistency (Cronbach’s alpha); test–retest reliability (intraclass correlation coefficient); measurement error (Smallest Detectable Change); construct validity (hypothesis tested: moderate positive Pearson correlation between BacKS and Back Beliefs Questionnaire); plus, interpretability and feasibility.

Results The final BacKS comprised 20 items with a 2-factor structure (biomedical factor: 9 items, score ranging from 9 to 45, and self-care factor: 11 items, score ranging from 11 to 55). Internal consistency and reliability were adequate (>0.70) for each factor. Smallest detectable change was 4.4 (biomedical factor) and 7.0 (self-care factor). Our construct validity hypothesis was confirmed (Pearson correlation=0.53). No floor or ceiling effects were detected.

Conclusion The BacKS is a valid, reliable and feasible PROM to measure knowledge and beliefs about low back pain in clinical practice and research settings.

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Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/bjsports-2024-108364

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • X @LeticiaAmaralC, @ArianneianneVerhagen, @BenD_NZ

    • Correction notice This article has been corrected since it published Online First. Box 1 has been corrected.

    • Contributors LAC, MH, SM and SF contributed to the study conception and design, data collection, data analysis and writing up of the study. AV, BD and PWH contributed to the study design and writing up of the study. All authors revised the work for important intellectual content, accuracy and integrity and approved the final version to be published. LAC and SF are the guarantor.

    • Funding This work was supported by an International Macquarie University Research Excellence Scholarship (iMQRES) for LAC.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.