Effect Nurse-Led PRECEDE-PROCEED Model Based Risk Management Program on Reducing Musculoskeletal Symptoms in Primary School Children

The Effect of Nurse-Led PRECEDE-PROCEED Model-Based Risk Management Program on Reducing Musculoskeletal Symptoms in Primary School Children

The Effect of a Nurse-Led Ergonomic Risk Management Program Based on the PRECEDE-PROCEED Model on Reducing Musculoskeletal Symptoms in Primary School Children

Study Overview

• Status: Completed
• Conditions: Primary School Children; Musculoskeletal Symptom
• Intervention / Treatment: Other: ergonomic risk management awareness training

Detailed Description

Primary school children spend a large portion of their school hours sitting at their desks (Chen 2021, Van Delden 2020). Students are associated with musculoskeletal pain and discomfort due to prolonged sitting (Guelfi 2019). Common causes of these musculoskeletal system (MSS) problems include carrying inappropriately heavy backpacks, sitting for extended periods in the classroom, long class hours, standardized desks and seats, excessive homework, and prolonged use of phones, tablets, and computers outside of homework. These factors contribute to MSS problems in children, particularly musculoskeletal pain and posture disorders. It is known that the prevalence of posture disorders in school children is increasing (Kinaci 2018). 55.5% of students reported having to lean over their desks while writing at school, and 58.1% reported discomfort due to the weight of their school bags (Yılmaz 2018). Because school-aged children are in the developmental stage of MSD and body posture is being shaped, if proper ergonomic adjustments and behavioral development interventions are not implemented during this period, significant health problems can occur in later years (Contardo 2016). Therefore, interest in school ergonomic intervention programs and their effects on MSD is increasing globally (Sellschop 2015). There is an urgent need for ergonomics-specific and behavior-based school programs (Ayed 2019). Research suggests that school nurses should be involved in these school health programs. To prevent MSD problems, they should collaborate with teachers to organize educational programs on posture training, weight-bearing methods, and the importance of exercise. They should also implement ergonomic adjustments in the classroom and regularly reiterate these recommendations with school administrators and guidance counselors (Yılmaz 2018). Therefore, this study aims to determine the effectiveness of a nurse-led ergonomic risk management education program based on the PRECEDE-PROCEED model on reducing MSD symptoms in primary school children.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Makbule Şenel

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being a student,
• Being in the 3rd or 4th grade,
• Volunteering to participate in the research,
• Volunteering with parental consent,
• No musculoskeletal problems,
• No physical disabilities that would prevent exercise,

Exclusion Criteria:

• Those diagnosed with a chronic disease
• Those with musculoskeletal problems
• Those with physical disabilities that may prevent them from exercising
• Those who volunteer but do not have parental permission
• Those who have parental permission but do not volunteer

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental group; The experimental group will be given training on ergonomic risk factors.	Other: ergonomic risk management awareness training; For 4 weeks, the experimental group will be trained on ergonomic risk factors (moving in appropriate posture, using ergonomic desks and chairs, carrying a backpack of appropriate weight according to body mass index (BMI), etc.).
No Intervention: control grup; No attempt was made to initiate the training process

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Upper Extremity Evaluation	It evaluates effort, repetition frequency, and duration of work at the upper arm, lower arm, wrist, neck, and trunk. Each site is assigned an Ergonomic Risk Score (ERP) from 1 to 4, with ERP 1 indicating acceptable risk, ERP 2 indicating risk requiring further investigation, ERP 3 indicating serious risk requiring immediate intervention and remediation, and ERP 4 indicating highest risk requiring immediate change.	The 4th week
Musculoskeletal Disorders Evaluation	The survey assesses frequency, severity, and work-relatedness, and calculates a total discomfort score. Frequency is scored as "Never" = 0; 1-2 times a week = 1.5; 3-4 times a week = 3.5; Once a day = 5; Several times a day = 10; severity is scored as "little" = 1, moderate = 2, and severe = 3; and work-relatedness is scored as "little" = 1, moderate = 2, and severe = 3. The total discomfort score frequency x severity x work relevance of discomfort).	The 4th week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Upper Extremity Evaluation	It evaluates effort, repetition frequency, and duration of work at the upper arm, lower arm, wrist, neck, and trunk. Each site is assigned an Ergonomic Risk Score (ERP) from 1 to 4, with ERP 1 indicating acceptable risk, ERP 2 indicating risk requiring further investigation, ERP 3 indicating serious risk requiring immediate intervention and remediation, and ERP 4 indicating highest risk requiring immediate change.	The 12th week
Musculoskeletal Disorders Evaluation	The survey assesses frequency, severity, and work-relatedness, and calculates a total discomfort score. Frequency is scored as "Never" = 0; 1-2 times a week = 1.5; 3-4 times a week = 3.5; Once a day = 5; Several times a day = 10; severity is scored as "little" = 1, moderate = 2, and severe = 3; and work-relatedness is scored as "little" = 1, moderate = 2, and severe = 3. The total discomfort score frequency x severity x work relevance of discomfort).	The 12th week

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa

Study record dates

Study Major Dates

• Study Start (Actual): November 20, 2022
• Primary Completion (Actual): January 20, 2024
• Study Completion (Actual): June 20, 2025

Study Registration Dates

• First Submitted: October 1, 2025
• First Submitted That Met QC Criteria: December 22, 2025
• First Posted (Actual): January 7, 2026

Study Record Updates

• Last Update Posted (Actual): January 7, 2026
• Last Update Submitted That Met QC Criteria: December 22, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: primary school children; musculoskeletal symptom
• Other Study ID Numbers: İUC-FNFN-MS-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Time Frame: 2022- 2025
• IPD Sharing Access Criteria: 2025
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No