The structural relationship between spine-related behavior among pupils and the constructs of social cognitive theory: A structural equation modeling analysis

The structural relationship between spine-related behavior among pupils and the constructs of social cognitive theory: A structural equation modeling analysis Zahra Akbari-Chehrehbargh 1 , Sedigheh Sadat Tavafian 1 , Ali Montazeri 2 1. Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 2. Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran Payesh 2020; 19 (5): 581 – 589 Accepted for publication: 26 August 2020 [EPub a head of print 28 September 2020] Objective (s): Low back pain is a common disorder of spine. One of the most important concerns is the increasing rate of low back pain in schoolchildren that might predict adult disability. The purpose of this study was to explain the structural relationship between low back pain and spine-related behavior among pupils via structural equation modeling based on social cognitive theory (SCT). The hypothesized model included skills, knowledge of spine care principals, self-efficacy, and expectation beliefs as independent variables, and spine-related behavior as a dependent variable. Methods: We collected data from 204 students attending public elementary schools using a structured questionnaire in Tehran, Iran from October 2018 to March 2019. The hypothesized model was examined via a structural equation modeling (SEM) analysis using SPSS, version 24.0, and LISREL, version 8.80. Results: The effect of skills, knowledge, self-efficacy and beliefs on spine-related behavior was 0.73 (t-value=13.09), 0.42 (tvalue=6.71), 0.87 (t-value=16.67), and 0.55 (t-value=4.95) respectively. In addition, various indicators, such as Comparative Fit Index (CFI), Normed Fit Index (NFI), χ2/df, and Root Mean Squared Error of Approximation (RMSEA) showed the good fitness of the models. Conclusion: The results revealed that the pupils who had more confident, skills, expectation beliefs, and knowledge were more likely to perform proper spine-related behavior. In this regard, school-based low back pain prevention interventions should be addressed using key cognitive factors that consider the potential change strategies.