The purpose of this study was to investigate the effects of a back care edu
cation programme, consisting of six sessions of 1 h each, in fourth- and fi
fth-grade elementary schoolchildren. Testing consisted of a practical perfo
rmance and a back care knowledge test. Forty-two subjects and 36 controls p
erformed a pre-test and were tested within 1 wk after the programme. To mon
itor effects and follow-up effects on a larger sample, 82 different pupils
were tested within 1 wk after the programme and 116 other children 3 mo aft
er. Both larger samples were compared with one group of 129 controls. Inter
rater reliability for the test items of the practical assessment was high;
intraclass correlation coefficients varied from 0.785 to 0.980. In the pre/
post design study, interaction between time and condition was significant f
or the sum score of the practical assessment and for the knowledge test (p
< 0.001), with higher scores for the intervention group (15% improvement fo
r the knowledge test score, 31.6% for the practical sum score). Significant
ly higher sum scores for the knowledge test and for all practical assessmen
t items were found in the intervention groups, tested within 1 wk and 3 mo
after the programme, in comparison with the control group (p < 0.001).
Conclusion: The effectiveness of a primary educational prevention programme
back care principles was demonstrated in this study. Effectiveness, long-t
erm outcomes and behavioural changes need further evaluation to optimize ba
ck care prevention programmes for elementary schoolchildren.