Improving schoolchildren's knowledge of methods for the prevention and management of low back pain: a cluster randomized controlled trial

Spine (Phila Pa 1976). 2011 Apr 15;36(8):E505-12. doi: 10.1097/BRS.0b013e3181dccebc.


Study design: Cluster randomized controlled trial.

Objective: To evaluate the effect of a very simple education campaign among community-dwelling 8-year-old schoolchildren.

Summary of background data: Information has a positive effect on low back pain (LBP) prevention and management. There is sparse evidence on the feasibility and effectiveness of education campaigns focusing on LBP among young schoolchildren.

Methods: A stratified random sample of 12 schools was randomized to an intervention and a control group. Eight-year-old schoolchildren from these schools were given a questionnaire on LBP prevention and management at baseline, and 15 and 98 days later. On day 8, teachers in the intervention group gave the schoolchildren a Comic Book of the Back, while no intervention was carried out in the control group. After adjusting by possible confounders, generalized estimating equations (GEE) models were developed to calculate the probability of "success" (a score over 80% of the maximum possible one).

Results: Six schools (231 children, 46.5%) were assigned to the control group, and 6 (266 children, 53.5%) to the intervention one. At baseline, the percentage of correct answers was above 73% in both groups, with 8 as a median total score in the control group and 7 in the intervention group. GEE showed that the odds ratio for success in the intervention group, when compared with the control group, was 1.61 (95% CI: 1.03-2.52, P = 0.038).

Conclusion: The handing out of a Comic Book of the Back slightly improves children's knowledge of appropriate methods for the prevention and management of LBP, and the effect remains significant 3 months after intervention.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Female
  • Follow-Up Studies
  • Health Education / methods*
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / methods*
  • Humans
  • Low Back Pain / prevention & control*
  • Low Back Pain / therapy*
  • Male
  • Program Evaluation
  • School Health Services / standards
  • School Health Services / statistics & numerical data
  • Surveys and Questionnaires
  • Time Factors