Zahra Akbari Chehrehbargh - Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares of University, Tehran, Iran.
Sedigheh Sadat Tavafian - Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares of University, Tehran, Iran.
Ali Montazeri - Health Metrics Research Center, Iranian Institutes for Health Sciences, ACECR, Tehran, Iran

Aims: Back pain is one of the most important public health problems. It is on rise among adolescent and pupils’ population. The aim of this study was to assess the relationshipbetween cognitive factors (skills, knowledge, self-efficacy, and expectation beliefs) and back care behavior among pupils. Method and Materials: A cross sectional study was conducted on a random sample of students attending public elementary schools in Tehran, Iran from October ۲۰۱۸ to March ۲۰۱۹. They completed a questionnaire containing items on cognitive abilities and a checklist to assess their skills on back care behaviors. Stepwise multiple regression analysis was performed to find out the contribution of cognitive factors on outcome. Findings: In all, ۲۰۴ students were entered into the study. The results revealed that ۹۵.۳% of the variance in the back behavior was explained by self-efficacy (β=۰.۵۸۶, t=۱۲.۰۸, P<۰.۰۰۱), expectation beliefs (β=۰.۲۳۲, t= ۵.۰۸, P<۰.۰۰۱), and skills (β=۰.۱۸۱, t=۴.۴۶, P<۰.۰۰۱). Conclusion: These results showed that the pupils who had more confident, skills, and expectation beliefs were more likely to do proper back behavior. In this regard, schoolbased back pain prevention interventions should be addressed using key cognitive factors that consider the potential change strategies.

Cognitive Factors, Spine-related Behavior, Pupils