title: Back posture education in elementary schoolchildren: stability of two-year intervention effects.
abstract: OBJECTIVE
  The study's first objective was to evaluate class teachers' efforts to promote good body mechanics after a structured back education program was finished and to evaluate whether their support during follow-up resulted in better intervention effects at 1-year follow-up. Secondary, the stability of intervention effects on children's back posture knowledge, fear-avoidance beliefs and back pain reports following a 2-school-year multi-factorial back education program was evaluated at 1-year follow-up. An additional focus was put on what young children learned about good body mechanics in the obligatory school curriculum compared to intensive back posture promotion.
  
  
  METHODS
  The quasi-experimental study included at baseline 398 elementary schoolchildren aged 8-11 years. The back education program consisted of 13 h back education and the stimulation of postural dynamism in the class through support and environmental changes lasting 2 school-years. Controls received the obligatory curriculum, not including back education. Evaluation consisted of a questionnaire, which was filled out by 121 intervention children and 124 controls at baseline, post-test and follow-up. Teachers were interviewed at the end of the follow-up school-year.
  
  
  RESULTS
  Teachers continued with initiatives to increase postural dynamism in the class when they had been instructed about that matter. However, teachers' efforts to continue the promotion of good body mechanics showed no additional effect on children's knowledge. Improved back posture knowledge demonstrated stability at 1-year follow-up. Whereas the obligatory curriculum provided children with fundamental postural knowledge, the back posture program added important aspects. Fear-avoidance beliefs and self-reported pain were not increased at 1-year follow-up.
  
  
  CONCLUSIONS
  The stable intervention effects point out that intensive implementation of a structured multifactorial back education program in the elementary school curriculum is effective.
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Gent, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Geldhof
authors.forename: G
authors.initials: G
authors.lastname: Cardon
authors.forename: I
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.forename: D
authors.initials: D
authors.lastname: De Clercq
mesh_terms: D000328:Adult; D001416:Back Pain / Q000517:prevention & control*; D002648:Child; D006804:Ergonomics; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011187:Posture / Q000502:physiology*; D015397:Program Evaluation; D012574:Schools; D013997:Time Factors