BacKS tool
Back pain Knowledge and beliefs Survey (BacKS): A contemporary questionnaire to assess people’s knowledge and beliefs about low back pain.
Why was the BacKS developed?
Patient-centred interventions, such as advice to remain active, self-management strategies, reassurance, and education, are commonly recommended in clinical guidelines for the management of low back pain. Patient knowledge and beliefs about low back pain that are aligned with scientific evidence has been highlighted as important for the management of low back pain.
Although identifying people’s knowledge and beliefs about pain is relevant to patient-centred treatment, a recent systematic review conducted by our group identified that there was no high-quality contemporary evidence-based measurement tool available to quantify knowledge and beliefs about low back pain – until the Back pain Knowledge and beliefs Survey (BacKS).
This page contains information about the development of the BacKS, official translations available, and details for their use and reproduction.
What is the BacKS?
The BacKS was developed at the Spinal Pain Research Centre at Macquarie University by Corrêa et al. in 2024.
The BacKS is a 20-item questionnaire which offer reliable insights into two key areas: biomedical understanding and self-care practices. Each item has a five point Likert Scale where responders indicate the extent they agree with the item, anchored based on international guideline recommendations for low back pain. Higher scores indicate a higher level of knowledge aligned with current evidence.
By ensuring accurate and meaningful assessment of low back pain knowledge and beliefs, the BacKS is a valuable tool for both clinical practice and research and can be used to inform and enhance individualised and patient-centred pain education treatments.
How was the BacKS developed?
BacKS was developed and extensively tested using a robust method and following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. BacKS items were developed based on current clinical guidelines for the management of low back pain, a Delphi study which identified key messages for people with low back pain, and by input from consumers and experts during focus groups.
BacKS measurement properties (including content validity, structural validity, internal consistency, test-retest reliability, measurement error, and construct validity via hypothesis-testing), interpretability and feasibility were tested and confirmed.
The development and measurement properties assessment of the original version of the BacKS is described in detail in this paper in the British Journal of Sports Medicine.
Licensing and terms of use
All use of BacKS requires licensing. The development of the BacKS was funded by an International Macquarie University Research Excellence Scholarship (iMQRES) for Leticia Corrêa. The copyright (©2024) of the BacKS tool and associated materials is owned by Macquarie University.
The survey may not be modified. Registered users have permission to utilise the questionnaire in the original format or to create an electronic version of the questionnaire for data collection, as long as the electronic version is appropriately identified, including:
- reference to the original source
- appropriate copyright acknowledgements
- a link to the BacKS website (this page).
Non-commercial use
The BacKS is freely available for non-commercial clinical (within a healthcare setting, such as hospitals, clinics, or for direct patient care) and non-commercial research (university research projects, government-funded studies, or non-profit organisation research) use, but requires a licence.
Register for non-commercial use and obtain access to the BacKS
Commercial use
Commercial use requires a paid licence and agreements will be developed on a case-by-case basis. Examples of commercial use includes, but are not limited to, developing for-profit products or services based on the survey data or incorporating the survey into a commercial research project or marketing materials that aims to develop and sell a product.
Contact Dr Leticia Corrêa at leticia.correa@mq.edu.au for more information about commercial use licensing.
Requests to translate the BacKS
We will review requests to translate the BacKS on a case-by-case basis considering the following conditions:
- The translation process will be conducted following established guidelines
- The translation process must include a back translation into English, which the original author will review and provide feedback to ensure accuracy in the translation of concepts
- To ensure the accuracy and integrity of the questionnaire, any research involving BacKS translation into other languages must include the original author as a collaborator. This collaboration is essential to maintain the original intent and quality standards of the questionnaire
- The translation version of the BacKS will be freely available for non-commercial purposes and distributed internationally via the BacKS website
- Translators are free to use the formatted version or collect data using online tools as long as the electronic version is appropriately identified, including reference to the original source, appropriate copyright acknowledgements, and a link to the BacKS website (this page).
Note: The translator is required to sign an Assignment of IP in Translation deed which will be provided during the translation process.
To advise of your request to translate the questionnaires and seek formal permission from the author, contact Dr Leticia Corrêa at leticia.correa@mq.edu.au.