A health behavior screening tool for non-specific neck pain in office workers: A 1-year prospective cohort study

Objective: One effective strategy for management of musculoskeletal disorders is self-management based on the biopsychosocial model. Self-management requires patients to have adequate health literacy, defined as the individual's ability to seek, understand, and utilize health information. Recently, the neck painspecific health behavior for office workers (NHBOW) questionnaire was developed based upon a conceptual framework of health literacy. The content in the NHBOW relates to the work and exercise behaviors of office workers. The primary aim of this study was to evaluate the predictive validity of the NHBOW. Methods: At baseline, 342 healthy participants filled out a series of questionnaires, including the NHBOW. The incidence of neck pain was prospectively recorded every month over a 12- month period. Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the receiver operating characteristics curve (AUC) were calculated. Results: There were 103 (30.7%) incidents of non-specific neck pain among 335 office workers during the 12-month period, and seven participants were lost to follow-up. For the NHBOW, a cut-off score of less than or equal to 8 points (lower scores indicate poorer health behavior) had a sensitivity of 57.3% and a specificity of 96.6%. The positive and negative predictive values were 88.1% and 83.6%, respectively. The AUC was 0.769 (95% CI: 0.706 to 0.832). Conclusion: The NHBOW was an acceptable screening tool for predicting nonspecific neck pain in office workers during the 1-year follow-up period, and can be used in occupational and primary care settings.