The effectiveness of a model-based health education intervention to improve ergonomic posture in office computer workers: a randomized controlled trial

  • Hormoz Sanaeinasab
  • Mohsen SaffariEmail author
  • Firouz Valipour
  • Hassan Reza Alipour
  • Mojtaba Sepandi
  • Faten Al Zaben
  • Harold G. Koenig
Original Article



Lack of knowledge about computer ergonomics predisposes users to musculoskeletal and visual disorders. The present study examined the effect of a trans-theoretical model (TTM)-based educational program on work-related posture in office computer users.


This experimental study examined 102 hospital personnel whose primary job involved working at a computer. Participants were randomized to intervention and control groups. An educational intervention based on TTM was conducted over five sessions. A self-report questionnaire was used to collect data including stages of change, processes of change, pros and cons of change, and self-efficacy. A pen–paper-based observational method (i.e., Rapid Office Strain Assessment or ROSA) was used for assessing work posture. A visual analogue scale assessed pain intensity. Data were collected at baseline and 3-month follow-up.


Significant differences were found on TTM’s constructs and ROSA score between intervention and control groups at follow-up (p < 0.05). The mean ROSA score decreased from 5.65 (SD 1.03) to 3.95 (SD 0.83) in the intervention group, while no significant change was found in the control group. Pain intensity also decreased significantly among those in the intervention vs. control group (p < 0.001).


An educational intervention based on TTM was effective in improving ergonomic posture in computer workers. Further research is needed to determine if these results can be generalized to computer workers in other settings.


Ergonomics Computer workers The trans-theoretical model Education 



The authors would like to thank the authorities of research deputy in Baqiyatallah Hospital who granted us permission to conduct this study.



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Baqiyatallah University of Medical Sciences’ ethical committee approved this study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Health Research Center, Life Style InstituteBaqiyatallah University of Medical SciencesTehranIran
  2. 2.Health Education Department, Faculty of HealthBaqiyatallah University of Medical SciencesTehranIran
  3. 3.Occupational Health Department, Faculty of HealthBaqiyatallah University of Medical SciencesTehranIran
  4. 4.Department of Epidemiology and Biostatistics, Faculty of HealthBaqiyatallah University of Medical SciencesTehranIran
  5. 5.Department of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
  6. 6.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA
  7. 7.King Abdulaziz UniversityJeddahSaudi Arabia
  8. 8.Ningxia Medical UniversityYinchuanChina

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