Effects of a two-school-year multi-factorial back education program in elementary schoolchildren. E. Geldhof, G. Cardon, I. De Bourdeaudhuij, D. De Clercq Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium bstract t of improved postural behavior at young age on ack pain prevalence later in life is of interest for future research. eywords: children, back education program, school environment, back pain, primary prevention 1. Introduction ts of school-based interventions are ess g environmental con A The present study evaluated the effects of a two-school-year multi-factorial back education program on back posture knowledge and postural behavior in elementary schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance beliefs were evaluated. The study sample included 193 intervention children and 172 controls (baseline 9-to-11 year olds). The intervention consisted of back education and the stimulation of postural dynamism in the class. Evaluation consisted of a questionnaire, an observation of postural behavior in the classroom and an observation of material handling. The intervention resulted in increased back posture knowledge (P<.001), improved postural behavior during material handling (P<.001) and decreased duration of trunk flexion (P<.05) and neck torsion (P<.05) during lesson time. Fear-avoidance beliefs were not increased and there was a trend for decreased pain reports in boys of the intervention group (P<.09). The long term effec b K Epidemiological studies over the last 20 years report mounting non-specific back pain prevalence among youngsters [1,2,3]. The multi-factorial nature of the risk for developing back pain in childhood is widely accepted [4] and complicates the determination of predisposing factors and preventive measures. In order to provide evidence on early prevention in low back pain, the determination of modifiable risk factors and the resul ential [5]. Recent studies have demonstrated that psychosocial factors play an important role in children‘s self- reported back pain [2,3]. Epidemiological evidence [1,2,3,4] and biomechanical argumentation related to the concepts of spinal loading [6] suggest that biomechanical factors might also be related to back pain occurrence at young age. The limited literature supports the presumption that the school environment exposes children to possible loading factors related to prolonged poor sitting [7], absence of appropriate furniture [8] and backpack use [9]. In consequence, the school is an ideal setting for back pain prevention since it has the potential of optimizin ditions and giving prolonged feedback reaching a large percentage of the population. Focusing on school-based interventions, a limited number of multi-factorial intervention studies could be located [5]. In the study of Cardon et al [10] the implementation of a six-week back education program had a significant impact on the use of back education