Back pain knowledge improvement through communitary health agents qualification in Amazon region

Introduction: Back-pain, symptom responsible for high levels of incapacity, reaching epidemic indexes in Brazilians, generating lots of day-work loss, especially in hand laborers. The Communitary Health Agents (CHA), as community members acting in their own neighborhood, may play an important role in prevention of back-pain using exercise and postural techniques. However, the CHA arise from general population and more often don’t have the essential cultural and technical background to deal with this problem.
The aim of this work was to evaluate the impact of a qualify program in back-pain to CHA approaching pathophysiology, ergonomics, and prevention.
Methods: A qualifying program was applied to 63 randomized selected CHA in Machadinho d’Oeste (Rondônia country-side, Brazil) based on a 16 hours program including theoretical and practical activities in 3 modules: (1) anatomy, biomechanics and pathophysiology of  spinal column; (2) practice of corporal consciousness exercises and back-pain prevention; (3) theatrical situations and classes performed by CHA under supervision, training how to multiply knowledge. The CHA knowledge acquisition was measured with the application of the same test before and after the program. The CHA satisfaction was also evaluated. The percentage of correct answers was compared using non parametric pared tests.
Results: The test grade from 0 to 14 was significantly higher in post-test (PO) compared to pre-test (PR) [PR5.8±4.2; PO9.93±2.2; p<0.001), representing 29,46% of improvement. The CHA evaluation of the qualify program showed 83.3% of excellent and 16,7% of good. Nobody classified the qualify program as regular or bad.
Conclusion: The qualify programs are effective to provide knowledge to CHA about how to deal and prevent hazardous problems in their communities.  As they are directly compromised with the community care and humanization, investments in qualify and educative programs are essential to supply them with technical background and consequently improve the public health in these communities.