Back care programs for health promotion—representative user profiles and correlates of participation in Germany

Background. In response to the growing incidence of back pain, there is an increasing emphasis on individualized preventive measures such as back care programs. The purpose of the present study was to investigate representative participation rates and their correlates in the German general population. Methods. The first National Health Survey was carried out in the Federal Republic of Germany from the period of October 1997 to March 1999. It comprised a representative, cross-sectional study of the population with a total sample of 6,159 participants between the ages of 18 and 79. Results. Approximately one in six Germans (16%) has ever participated in a back care program. For 6% of the total, participation took place within the past year. After making adjustments for subjective back pain in the multiple analyses, the 1-year participation rate was significantly lower in men, full-time-workers, one-member households, and those with an unhealthy lifestyle (physically inactive subjects with an unhealthy diet and poorly developed preventive behavior patterns). Conclusions. The user profile for back care programs on a nationwide scale indicates that genuine needs are not being met and the target group is not being reached. A “preaching to the converted” phenomenon is evident, as indicated by the fact that the user group is made up of individuals who already have a healthy lifestyle and few risks, while the population group most likely to develop back pain is significantly less likely to participate in preventive back care programs.