The efficacy of back education in elementary school children was shown using a practical test. Similar results in a candid camera evaluation were questioned. The purposes of this study were (i) to explore the relationship between the results of a practical test and the results of a candid camera procedure when evaluating back education principles, and (ii) to investigate whether in a candid camera procedure scores are still better in pupils who followed a back education programme than in controls. A candid camera evaluation followed by a practical test was performed in 71 pupils who had participated in a back education programme and 60 controls. Correlations between the two evaluation methods were significant but weak for 5 of the 9 test items in the intervention group (Rs 0.26-0.46) and for 7 test items in the control group (Rs 0.38-0.58). The difference in sum scores between the evaluation methods was significantly higher in the intervention group than in the control group (p < 0.001). The intervention group scored higher than the control group for 8 practical test items and 7 candid evaluation items.
Conclusion: The study results question the use of a practical test for the individual evaluation of back education principles but show the usefulness of a practical test to study programme efficacy. As some principles seem to have become a habit, while for the implementation of others the pupils need external stimuli, the effects of more specific guidelines for parents and teachers to generalize back education principles require further study.