Influencing Factors of the Back Care-related Behavior Among Female Schoolchildren: A Structural Equation Modeling

Background: Back pain is one of the most important public health problems that is on the rise among the schoolchildren’s population. The aim of this study was to determine cognitive factors related to back care-related behavior based on the social cognitive theory (SCT) among female schoolchildren. Methods: A cross-sectional study was directed among 5th-grade female students through a convenience method. Structured questionnaire data were collected from 610 students attending public elementary schools in Tehran, Iran from October 2018 to March 2019. The initial model was formulated based on the SCT. Based on these data, the hypothesized model was confirmed via a structural equation modeling analysis using SPSS (version 24.0) and LISREL (version 8.80). Results: The skills (r=0.73, t-value=13.42), self-efficacy (r=0.87, t-value=15.51), and expectation beliefs (r=0.61, t-value=6.68) were verified as key cognitive factors that cause a back behavior. Finally, various indicators such as comparative fit index, normed fit index, and root mean squared error of approximation demonstrated the fitness of the models (P<0.0001). Conclusion: The results showed that those schoolchildren having more self-efficacy, skills, and expectation beliefs are more likely to do proper back behavior. In this regard, school-based back pain prevention interventions should further focus on predefine key cognitive factors that consider the potential change strategies.