Seyedeh-Somayeh Kazemi - Department of Health Education & Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Sedigheh-Sadat Tavafian - Department of Health Education & Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Claire E Hiller - Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney,New South Wales, Australia
Ali Montazeri - Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.. Faculty of Humanity Sciences, University of Sciences & Culture, ACECR, Tehran, Iranz
Alireza Hidarnia - Department of Health Education & Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Background: Nurses put at high risk of work-related low back pain (LBP) due to the nature of their work. The aim of this study was to develop and evaluate the educational intervention based on PRECEDE-PROCEED model on promoting behaviors of low back health via in-person and social media education among female nurses with LBP.Methods: The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior. The evaluation was undertaken in nurses (mean age 36.50 - 5.79 years) with LBP recruited to a community randomized controlled trial with two intervention arms: (1) in-person (n=60) and (2) social media (n=60). Data were collected with a self-designed questionnaire at baseline and at 3 and 6-months. Baseline comparisons between groups were made with Mann-Whitney U Test for non-normal data and T-Test for normal data. Comparison of change scores between groups and two intervention types across the three time periods used the mixed between-within subject analysis of variance.Results: A total of 120 nurses received the allocated intervention and completed the baseline and follow-up questionnaires. The results indicated there was no significant statistical difference between the two intervention groups in the variables at the baseline (p > .05). All components increased over the 3-months after intervention in both groups. But over the 6-month follow-up increased scores of enabling factor and behavior in the in-person group, while in the social media group in addition to them increased scores of knowledge, self-efficacy, and reinforcing factor. Based on Bonferroni Post hoc analysis there was the difference between the interventions types; social media was more effective in four components.Conclusion: The theory-based educational intervention proved effective at improving knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior. However, social media was more successful than in-person in the maintenance of behavior over the long-time.Message for policymakers: It is suggested policymakers assess resources, development, and allocation of budgets, organizational barriers, and coordination of the program with other departments and the community. So that health education programs implement into the mission statements, rules and regulations framework.

PRECEDE-PROCEED model, promoting behavior, nurse