• Rachel Dahan, Shmuel Reis, Jeffry Borkan, Judith-Bell Brown, Doron Hermoni, Nadia Mansor, and Stewart Harris.
• Department of Family Medicine, The B. RAppaport Faculty of Medicine, The Technion - Israel Institute of Technology, Haifa, Israel. mrdahan@netvision.net.il
• J Eval Clin Pract. 2008 Oct 1;14(5):785-91.

ObjectivesTo 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.Study DesignConfidential mailed survey questionnaire.SettingFamily practices in the Haifa and western Galilee district, Israel.ParticipantsRandom sample of 163 primary care doctors. A total of 134 doctors (82%) completed the questionnaire.Main Outcome MeasuresA 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.ResultsDistribution 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.ConclusionsStriking 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.

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