title: Are parents and adolescents in agreement on reporting of recurrent non-specific low back pain in adolescents? A cross-sectional descriptive study.
abstract: BACKGROUND
  Non-specific low back pain is a prevalent symptom in adolescents and is recurrent in some instances. Recent studies have highlighted the marked impact the condition has on daily life of adolescents. However, it is unclear if parents of adolescents reporting recurrent non-specific low back pain know about their child's status. The purpose of the study was to determine the level of agreement between adolescents and their parents in reporting recurrent non-specific low back pain in Harare, Zimbabwe.
  
  
  METHODS
  This cross-sectional study formed part of a large study carried out to ascertain the prevalence of non-specific low back pain in Zimbabwean adolescents. Six hundred and twenty (n = 620) Medical Health Questionnaires were sent to parents. School-children with returned questionnaires and informed consents signed were subsequently eligible to participate. A reliable and validated low back pain study questionnaire was administered to 544 adolescents between the ages of 13 and 19 years randomly selected from government-administered schools. The questionnaire sought to determine adolescents with recurrent NSLBP. The Kappa statistic (k) was used to analyse agreement between adolescents and parental reports on recurrent NSLBP status.
  
  
  RESULTS
  Parental and school-children response rates were acceptable (90.3 and 97.8 %, respectively). The prevalence of recurrent NSLBP was 28.8 % [95 % Confidence Interval, CI = 26.0-31.6]. Both sexes were equally affected [χ (2) (1) =0.19, p = 0.67]. The prevalence increased with age in both sexes [χ (2) trend =90.9, p < 0.001]. Parental reports agreed in 16.3 and 98.7 % for the adolescents with and without recurrent NSLBP respectively. The value of kappa (k) was 0.20 [SE = 0.04; 95 % CI, 0.13-0.27] with a prevalence index and bias index of -0.65 and 0.23, respectively. These results suggest poor strength of the agreement.
  
  
  CONCLUSIONS
  Recurrent non-specific low back pain is relatively common among Zimbabwean adolescents. Most of the parents of school-children with recurrent non-specific low back pain are unaware of the low back pain status of their children. Although this does not dismiss the relevance of non-specific low back pain reported during adolescence, these findings create a need to involve parents in awareness or preventive initiatives against low back pain in schools.
authors.affiliation: Rehabilitation Department, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe. matthewchiwaridzo@yahoo.co.ukl.
authors.forename: Matthew
authors.initials: M
authors.lastname: Chiwaridzo
authors.affiliation: Division of Physiotherapy, Department of Health and Rehabilitation, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. niri.naidoo@uct.ac.za.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Naidoo
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D012008:Recurrence; D012574:Schools; D011795:Surveys and Questionnaires; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology