Changing patients’ beliefs about acupuncture: testing the effects of a new educational website

Abstract

Background: Acupuncture is a popular alternative therapy for musculoskeletal pain. However, misconceptions may deter treatment-seeking and impact informed consent. Furthermore, positive beliefs about acupuncture may enhance its effectiveness. We aimed to develop and test an intervention to improve acupuncture knowledge and beliefs among people with musculoskeletal pain. Methods: An educational website was developed using a combination of person-based, evidence-based, and theory-based approaches. Qualitative think aloud interviews with 10 adult volunteers were used to make the website accessible, engaging, and persuasive. An online experiment recruited 350 adults with back pain from general practices (55% acupuncture naïve, mean age 48yrs, 56% female). Participants were randomised to view our new website or a control website (based on standard patient information leaflets for acupuncture) before completing validated measures of knowledge, informed choice and beliefs about acupuncture. Findings: Compared to the control website, viewing the new website led to significantly better acupuncture knowledge (F(1,315)=37.925, p<.001) and more participants making an informed choice about acupuncture use (Chi-squared(1)=5.141, p=.023). The new website had no effect on concerns about acupuncture (F(1,347)=.01, p=.908), or perceptions of acupuncture’s credibility (F(1,346)=2.472, p=.117), effectiveness (F(1,342)=3.231, p=.073) or personal suitability (F(1,331)=0.787, p=.376). Discussion: A psychologically-informed educational website can significantly improve potential patients’ knowledge of acupuncture and ability to make an informed choice about using acupuncture. The lack of commensurate changes in patients’ beliefs suggests that factors other than knowledge shape patients’ beliefs about acupuncture. More interactive and/or personal approaches might be needed to allay patients’ concerns about acupuncture and enhance their beliefs.