{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T14:08:28Z","timestamp":1769263708017,"version":"3.49.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Workers in physically demanding industries, such as the marble sector, are highly susceptible to low back pain. This study was conducted to determine the effect of the training given to the workers in a marble factory using different methods on knowledge and behavior for protecting low back health and low back pain level of the workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This non-randomized experimental study with a pre-test, post-test, follow-up, and control group design was conducted with 135 workers. The data were collected with the Low Back Health Protection Information Form, Manual Handling Observation Form, Visual Analog Scale (VAS).\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05 was considered statistically significant in the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Knowledge scores increased significantly in both intervention groups, with the highest effect observed in the interactive training + printed materials group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      = 0.66). Manual handling behavior scores improved more than doubled in this group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      = 0.92). Low back pain (VAS) scores decreased significantly in both intervention groups, with a larger reduction in the interactive training group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      = 0.60).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Interactive education is more effective in protecting the back health of workers, increasing the level of knowledge and behavior, and reducing low back pain compared to the use of printed materials alone. However, the use of printed materials also had a significant effect. Proper manual handling training for workers who lift heavy loads can reduce low back pain and increase knowledge and behaviors related to low back health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1725015","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:46:50Z","timestamp":1769150810000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of training on knowledge, behaviors, and low back pain among marble workers: non-randomized experimental study"],"prefix":"10.3389","volume":"13","author":[{"given":"G\u00fclcihan Aybike","family":"Dilek Kart","sequence":"first","affiliation":[{"name":"Department of First Aid and Emergency, Vocational School of Health Services, Burdur Mehmet Akif Ersoy University","place":["Burdur, T\u00fcrkiye"]},{"name":"Health Sciences Institute, Akdeniz University","place":["Antalya, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayse","family":"Meydanlioglu","sequence":"additional","affiliation":[{"name":"Department of Public Health Nursing, Faculty of Nursing, Akdeniz University","place":["Antalya, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1559355","DOI":"10.3389\/fpubh.2025.1559355","article-title":"Global, regional, and national burden of low back pain in working-age population from 1990 to 2021 and projections for 2050","volume":"13","author":"Zhang","year":"2025","journal-title":"Front Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.3390\/safety10030081","article-title":"Prevalence of lower back pain and associated workplace and ergonomic factors among mineworkers in a nickel mine, Zimbabwe","volume":"10","author":"Zenda","year":"2024","journal-title":"Safety."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e34","DOI":"10.35371\/aoem.2021.33.e34","article-title":"A pilot study to assess a risk of a high-risk group of low back pain membership in workers who perform the manual material handling tasks","volume":"33","author":"Lee","year":"2021","journal-title":"Ann Occup Environ Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1573828","DOI":"10.3389\/fpubh.2025.1573828","article-title":"Global burden of occupational ergonomic factor-induced low back pain, 1990~2021: data analysis and projections of the global burden of disease","volume":"13","author":"Wu","year":"2025","journal-title":"Front Public Health."},{"key":"B5","doi-asserted-by":"publisher","first-page":"22","DOI":"10.31609\/jpmrs.2022-94349","article-title":"Determination of the relationship between low back pain and risk factors in T\u00fcrkiye using a population-based multilevel cross-sectional dataset","volume":"27","author":"Baygutalp","year":"2024","journal-title":"Turkiye Klinikleri J Phys Med Rehabil Sci."},{"key":"B6","volume-title":"Metal I\u015f\u00e7ilerinin Mesleki Saglik Riskleri ve Saglik Durumlari: Saha Ara\u015ftirmasi Sonu\u00e7lari.","author":"\u00d6ngel","year":"2022"},{"key":"B7","first-page":"173","article-title":"Relationship between physical fitness, low back pain disability and standing balance in underground coal miners","volume":"5","author":"Selici","year":"2018","journal-title":"J Exerc Ther Rehabil."},{"key":"B8","unstructured":"Resmi\n              Gazete TC\n            \n          \n          I\u015f Sagligi ve G\u00fcvenligine Ili\u015fkin I\u015fyeri Tehlike Siniflari Tebligi"},{"key":"B9","doi-asserted-by":"publisher","first-page":"370","DOI":"10.37989\/gumussagbil.1506341","article-title":"Mermer Fabrikasindaki Tehlike, Risklerin Degerlendirilmesi ve Kontrol\u00fc","volume":"14","author":"Demir Sahin","year":"2025","journal-title":"G\u00fcm\u00fc\u015fhane \u00dcniv Saglik Bilimleri Dergisi."},{"key":"B10","doi-asserted-by":"publisher","first-page":"47","DOI":"10.38213\/ohsacademy.664963","article-title":"Mermer fabrikalarinda \u00e7ali\u015fanlarin i\u015f sagligi ve g\u00fcvenligi a\u00e7isindan \u00e7ali\u015fma ko\u015fullarinin belirlenmesi: \u00c7orum il \u00f6rnegi","volume":"3","author":"G\u00fcr","year":"2020","journal-title":"OHS Acad."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1016\/j.matpr.2022.10.153","article-title":"Ergonomic risk assessment of tasks performed by workers in granite and marble units using ergonomics tool's REBA","volume":"72","author":"Kodle","year":"2023","journal-title":"Mater Today Proc."},{"key":"B12","unstructured":"Ticaret Bakanligi. Dogal Ta\u015flar Sekt\u00f6r Raporu 2021"},{"key":"B13","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1007\/s10926-024-10210-1","article-title":"Tensions of low-back pain and lifting; bridging clinical low-back pain and occupational lifting guidelines","volume":"34","author":"Reneman","year":"2024","journal-title":"J Occup Rehabil."},{"key":"B14","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1136\/oemed-2014-102346","article-title":"The effect of lifting during work on low back pain: a health impact assessment based on a meta-analysis","volume":"71","author":"Coenen","year":"2014","journal-title":"Occup Environ Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s00420-025-02148-5","article-title":"Effect of manual handling weight for lifting and carrying on the severity of acute occupational low back pain","volume":"98","author":"Iwakiri","year":"2025","journal-title":"Int Arch Occup Environ Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/00140139.2013.862307","article-title":"The effect of manual handling training on achieving training transfer, employee's behavior change and subsequent reduction of work-related musculoskeletal disorders: a systematic review","volume":"57","author":"Hogan","year":"2014","journal-title":"Ergonomics."},{"key":"B17","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1136\/oemed-2011-100214","article-title":"Manual material handling advice and assistive devices for preventing and treating back pain in workers: a Cochrane Systematic Review","volume":"69","author":"Verbeek","year":"2012","journal-title":"Occup Environ Med."},{"key":"B18","unstructured":"Risk Factors for Musculoskeletal Disorders in Manual Handling of Loads\n          \n          2020"},{"key":"B19","unstructured":"OSHA Technical Manual (OTM) Section VII: Chapter 1"},{"key":"B20","unstructured":"Cumhurba\u015fkanligi Mevzuat Bilgi Sistemi. I\u015f Sagligi ve G\u00fcvenligi Hizmetleri Y\u00f6netmeligi\n          \n          2012"},{"key":"B21","unstructured":"Alyafei\n              A\n            \n            \n              Easton-Carr\n              R\n            \n          \n          39163427\n          The Health Belief Model of Behavior Change"},{"key":"B22","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.ergon.2012.01.003","article-title":"Investigation of manual handling training practices in organisations and beliefs regarding effectiveness","volume":"42","author":"McDermott","year":"2012","journal-title":"Int J Ind Ergon."},{"key":"B23","unstructured":"Manual handling, manual handling operations regulations\n          \n          Guidance on Regulations\n          \n          2016"},{"key":"B24","unstructured":"\u00c7ali\u015fma\n              ve Sosyal G\u00fcvenlik Bakanligi\n            \n          \n          Elle Ta\u015fima I\u015fleri Y\u00f6netmeligi Uygulama Rehberi. I\u015f Sagligi ve G\u00fcvenligi Genel M\u00fcd\u00fcrl\u00fcg\u00fc\n          \n          2025"},{"key":"B25","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1136\/bjsports-2019-100780","article-title":"Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial","volume":"54","author":"O'Keeffe","year":"2020","journal-title":"Br J Sports Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1177\/216507991306100205","article-title":"Effectiveness of an education program to prevent nurses' low back pain: an interventional study in Turkey","volume":"61","author":"Karahan","year":"2013","journal-title":"Workplace Health Saf."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e12973","DOI":"10.1111\/ijn.12973","article-title":"The effect of health education on prevention of low back pain for health caregivers and cleaning workers","volume":"28","author":"G\u00fcne\u015f","year":"2022","journal-title":"Int J Nurs Pract."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e0274527","DOI":"10.1371\/journal.pone.0274527","article-title":"Patient education materials for non-specific low back pain and sciatica: a systematic review and meta-analysis","volume":"17","author":"Furlong","year":"2022","journal-title":"PLoS ONE."},{"key":"B29","unstructured":"Viz\u00fcel Analog Skala\n          \n          T\u00fcrk N\u00f6ro\u015fir\u00fcrji Dernegi - Spinal ve Periferik Sinir Cerrahisi Grubu"},{"key":"B30","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/j.1744-6570.1975.tb01393.x","article-title":"Quantitative approach to content validity","volume":"28","author":"Lawshe","year":"1975","journal-title":"Pers Psychol."},{"key":"B31","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1177\/0748175613513808","article-title":"Scally AJ. Critical values for Lawshe's content validity ratio: revisiting the original methods of calculation","volume":"47","author":"Ayre","year":"2014","journal-title":"Meas Eval Couns Dev."},{"key":"B32","doi-asserted-by":"publisher","first-page":"100478","DOI":"10.1016\/j.bjpt.2022.100478","article-title":"Person-centred education and advice for people with low back pain: making the best of what we know","volume":"27","author":"O'Hagan","year":"2023","journal-title":"Braz J Phys Ther."},{"key":"B33","doi-asserted-by":"publisher","first-page":"5916","DOI":"10.3390\/ijerph17165916","article-title":"Interactive low back pain intervention module based on the back school program: a cluster-randomized experimental study evaluating its effectiveness among nurses in public hospitals","volume":"17","author":"Ibrahim","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"134","DOI":"10.12965\/jer.1836542.271","article-title":"Effectiveness of the back school program on the low back pain and functional disability of Iranian nurse","volume":"15","author":"Pakbaz","year":"2019","journal-title":"J Exerc Rehabil."},{"key":"B35","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1080\/10410236.2010.521906","article-title":"A meta-analysis of the effectiveness of health belief model variables in predicting behavior","volume":"25","author":"Carpenter","year":"2010","journal-title":"Health Commun."},{"key":"B36","doi-asserted-by":"publisher","first-page":"5","DOI":"10.5271\/sjweh.4070","article-title":"Interventions for preventing back pain among office workers \u2013 a systematic review and network meta-analysis","volume":"49","author":"Eisele-Metzger","year":"2023","journal-title":"Scand J Work Environ Health."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e35867","DOI":"10.2196\/35867","article-title":"Evaluation of the effect of patient education and strengthening exercise therapy using a mobile messaging app on work productivity in Japanese patients with chronic low back pain: open-label, randomized, parallel-group trial","volume":"10","author":"Itoh","year":"2022","journal-title":"JMIR Mhealth Uhealth."},{"key":"B38","doi-asserted-by":"publisher","first-page":"5367","DOI":"10.3390\/jcm10225367","article-title":"Prevention of low back pain in adults with a back school-based intervention","volume":"10","author":"Hernandez-Lucas","year":"2021","journal-title":"J Clin Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e27535","DOI":"10.2196\/27535","article-title":"Effects of an artificial intelligence\u2013assisted health program on workers with neck\/shoulder pain\/stiffness and low back pain: randomized controlled trial","volume":"9","author":"Anan","year":"2021","journal-title":"JMIR Mhealth Uhealth."},{"key":"B40","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.jom.2017.06.001","article-title":"Attention by design: using attention checks to detect inattentive respondents and improve data quality","volume":"53","author":"Abbey","year":"2017","journal-title":"J Oper Manage."},{"key":"B41","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.jclinepi.2013.08.015","article-title":"Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects","volume":"67","author":"McCambridge","year":"2014","journal-title":"J Clin Epidemiol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"503","DOI":"10.2486\/indhealth.2020-0130","article-title":"Effectiveness of workplace intervention strategies in lower back pain prevention: a review","volume":"58","author":"Roman-Liu","year":"2020","journal-title":"Ind Health."},{"key":"B43","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1186\/s12889-025-21798-1","article-title":"Ergonomic interventions to improve musculoskeletal disorders among vehicle assembly workers: a one-year longitudinal study","volume":"25","author":"Jin","year":"2025","journal-title":"BMC Public Health."},{"key":"B44","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1016\/j.pec.2019.11.031","article-title":"Effectiveness of communicative and educative strategies in chronic low back pain patients: a systematic review","volume":"103","author":"Barbari","year":"2019","journal-title":"Patient Educ Couns."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.3233\/WOR-205178","article-title":"Effect of a 6-month sedentary behavior reduction intervention on well-being and workplace health in desk workers with low back pain","volume":"71","author":"Hergenroeder","year":"2022","journal-title":"Work."},{"key":"B46","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1186\/s12875-021-01529-2","article-title":"Patient education booklet to support evidence-based low back pain care in primary care \u2013 a cluster randomized controlled trial","volume":"22","author":"Simula","year":"2021","journal-title":"BMC Fam Pract."},{"key":"B47","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jsr.2018.05.007","article-title":"Occupational interventions for the prevention of back pain: Overview of systematic reviews","volume":"66","author":"Sowah","year":"2018","journal-title":"J Safety Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1111\/jan.14614","article-title":"The effect of \u2018I am Protecting my Child from the Sun' programme on parental sun protection behaviors: randomized controlled trial","volume":"77","author":"S\u00fcmen","year":"2021","journal-title":"J Adv Nurs."},{"key":"B49","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1080\/03630242.2018.1478364","article-title":"Effect of telephone-supported ergonomic education on pregnancy-related low back pain","volume":"59","author":"Pek\u00e7etin","year":"2019","journal-title":"Women Health."},{"key":"B50","article-title":"The Health Belief Model","volume-title":"Health Behavior and Health Education: Theory, Research, and Practice","author":"Champion","year":"2008"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1725015\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:46:53Z","timestamp":1769150813000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1725015\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":50,"alternative-id":["10.3389\/fpubh.2025.1725015"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1725015","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]},"article-number":"1725015"}}