Kirkpatrick Evaluation of Theory-Based Educational Program for Low Back Pain Management in Teachers

Background: Low back pain (LBP) is the primary cause of disability for individuals under 45 years of age, the second most common reason for physician visits, and the third most common diagnosis for surgery. Evidence supports the effectiveness of the Alexander technique (AT) for chronic LBP. Health promotion programs must be evaluated to determine their sustainability and validity. The purpose of this study was to evaluate the theory-based AT program for the management of LBP in teachers according to the Kirkpatrick evaluation model. Methods: This was a quasi-experimental study of female teachers with nonspecific LBP in southern Tehran in 2014. Group one AT training based on the integrative model (IM) of behavioral prediction contained 42 subjects and group 2 AT training alone contained 35 subjects. To evaluate the groups based on Kirkpatrick, a previously confirmed questionnaire was used for the reaction stage, and for the learning and behavior stage, a self-designed questionnaire was used that was confirmed for validity and reliability using content validity (CVR 0.94, CVI 0.90) and Cronbach’s α (0.83). Skill was assessed using a checklist objectively. The data from before the intervention, after, and 3 months later were assessed with an independent and one sample t-test, paired t-test, correlation, and univariate (GLM) assessment via SPSS 19. Results: Significant differences were not recorded between the two groups in terms of teaching methods (P = 0.36), class conditions (P = 0.49), and general assessment (P = 0.11). For teaching methods, the patients’ satisfaction as reported in all items in both groups was higher than 4 (P < 0.001). In both groups, significant differences were recorded in knowledge, skills, and behavior before and after the intervention, but the AT training based on IM group was higher than the AT training only group in behavior and skills (P < 0.001). Conclusions: Applying an educational framework such as IM to the design of AT lessons has positive effects on behavior and skills that can facilitate LBP management.