Which Factors Influence School Backpack Use Behaviours in Elementary School Students for Prevention Musculoskeletal...

Backpacks are the most popular means of carrying books and supplies for students. However, excessive weight of school bags can lead to musculoskeletal disorders (MSDs) in students. Parents play an important role in providing standard bags and supervising how students carry their school bags. The Health Belief Model (HBM) is one of the important models for examining the factors associated with these disorders. This study aimed to determine the factors associated with backpack use behaviours in elementary school students and the relationship between these factors and musculoskeletal disorders.

The present study was a cross-sectional study conducted in elementary schools of Hamadan city (west of Iran) from September to December 2023. The study population consisted of 500 pairs of elementary school students (grades 1 to 6) and their parents. Participants in the study were selected through multi-stage sampling. Data collection tools included a researcher-made questionnaire for parents and students based on HBM, the standard Cornell questionnaire, and an observation checklist, which were completed through interviews and observations. Data analysis was performed using SPSS and AMOS v.24 statistical software.

The results showed that only 6.5% of students had musculoskeletal disorders, with 13% of students experiencing pain and discomfort in the neck area 1-2 times in the past week. There was a statistically significant relationship between body mass index, school area and perceived susceptibility with the prevalence of musculoskeletal disorders in students (p < 0.05). There was a statistically significant difference between self-reported and observed behaviours in students (p = 0.001). Self-efficacy (β = 0.920, p = 0.008) and perceived benefits (β = 0.740, p = 0.001) had a significant and positive impact on the behaviours of using a school backpack, but the perceived severity (β = -0.150, p = 0.040) and cues to action (β = -0.390, p = 0.001) had negative significant relation with the behaviours of using a school backpack.

The study reveals that multiple factors influence the use of school backpacks and related behaviours among students. The findings underscore the need for teaching correct backpack usage to students and parents and suggest that educational strategies in schools should be improved to prevent musculoskeletal disorders.