High school health education: focus on the development of self-controlling

High school health education: focus on the development of self-controlling | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article High school health education: focus on the development of self-controlling Barbara Abonyi, József Bognár, István Simon This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7753463/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Apr, 2026 Read the published version in BMC Public Health → Version 1 posted 10 You are reading this latest preprint version Abstract Background The present study aimed to demonstrate the pedagogical value of developing self-assessment skills among high school students. In addition, the research investigated whether posture training could positively influence both self-assessment and health-related behaviors. The underlying assumption was that beyond merely providing theoretical knowledge and instructions regarding a healthy lifestyle, it is essential to support students in internalizing and adopting these behaviors as part of their daily routines. In fostering health-conscious behavior, self-regulation and self-control were considered particularly important alongside formal instruction. Methods A total of 169 high school students (69 boys and 100 girls) from three secondary schools in Budapest, Hungary, participated in the study (Mage = 16.02 ± 0.64). Participants were assigned to either a Habitual Posture Group (HPG) or a Control Group (CG), the intervention program lasted for 7 weeks. Data collection involved the use of questionnaires (including the Body Assessment Questionnaire – BAQ), locomotor function tests, and self-report surveys, administered both before and after the intervention. Data analysis was conducted using SPSS version 25. Results Following the intervention, both groups reported increased consumption of fruits, vegetables, and water, as well as decreased alcohol intake. The HPG showed greater improvement in strength exercises and stress management strategies. While both groups demonstrated significant gains in back muscle strength, only the HPG showed a significant increase in abdominal muscle strength in the posttest. Interestingly, the CG showed more marked improvements on the BAQ, likely due to their lower initial scores. Conclusion The findings support the effectiveness of self-assessment as a pedagogical method in promoting health behaviour among adolescents. In addition to factors such as age, socioeconomic background, and school environment, students' learning attitudes should be taken into account in future psychological and educational research. health behaviour healthy habits posture self-assessment Background Health education Advancements in medical science and socioeconomic development in industrialized nations have contributed to a steady rise in average life expectancy. As a result, there is an increasing societal demand for prolonged well-being, supported by a disciplined lifestyle that includes regular physical activity and the reduction of health-compromising behaviors [1; 2]. Encouraging health-conscious behavior among children and adolescents may yield dual benefits: not only does it enhance their current and future quality of life, but it also promotes healthier behavioral patterns in subsequent generations through intergenerational transmission. The Health Behavior in School-aged Children (HBSC) study, an internationally recognized initiative, aims to monitor and promote health-related behaviors among youth through a combination of psychological guidance and practical support mechanisms [ 3 ]. Hungary has participated in the HBSC program since 1985, allowing for the systematic collection and analysis of subjective health indicators that inform public health strategies. In 2019, the Hungarian National Center for Public Health launched a comprehensive initiative aimed at improving health behaviors among 7–18-year-old children. This project emphasized the design of age-appropriate educational materials and interventions tailored to the lifestyle and communication preferences of younger generations. Successful behavior change requires first identifying harmful habits, then raising awareness, and finally initiating corrective processes—such as eliminating risk factors or fostering the acquisition of health-supportive behaviors. Accordingly, it is critical not only to disseminate information about healthy lifestyles but also to facilitate the internalization of these behaviors through educational practice and experiential learning [ 4 ]. Sport habits established during early life often persist into adulthood. Despite potential obstacles, long-term adherence and professional guidance are essential for the maintenance of such health-promoting behaviors. A global study covering 67 countries by Martins et al. (2022) highlighted the benefits of regular participation in physical education (PE), which included improvements in dietary choices, stress resilience, and reduced engagement in harmful behaviors [ 5 ]. Nutrition Nutrition research consistently focuses on the daily intake of fruits and vegetables as key indicators of dietary health. An average consumption of 400 grams per day, when combined with a reduced intake of saturated fats and added sugars, and a higher intake of lean proteins and dietary fiber, has been shown to mitigate the risk of chronic diseases [ 6 ]. Among adolescents, dietary behavior is significantly shaped by sociocultural influences, including family practices, peer pressure, marketing strategies, and school food environments [7]. The roots of risk behaviors often lie in familial and social modeling [ 8 ]. Many adolescent smokers report perceived cognitive or emotional benefits from smoking, such as reduced stress and improved concentration [ 9 ]. Gender-based comparisons reveal that boys are more likely than girls to engage in smoking and alcohol consumption [10]. Although the prevalence of binge drinking among Hungarian youth aged 11–15 aligns with the national average, a marked decline has been observed since 2009. However, data suggest that girls are gradually closing the gap with boys, highlighting the need for targeted educational efforts alongside policy interventions [ 11 ]. Self-control and body awareness However, according to Clark et al. [ 12 ], current musculoskeletal rehabilitation practices may be inadequate for ensuring long-term joint health. Wilmore’s research [ 13 ] underscores that strength development relies not only on muscular adaptation but also on the plasticity of the central nervous system. Regarding the latter, promotion of health-conscious behavior among adolescents necessitates a focus on the development of self-control and body awareness. In this context, self-control is understood not simply as abstinence (e.g., avoiding sweets), but as a sustained attentiveness to one’s bodily states, responses, and needs. Several pedagogical strategies may be employed to cultivate this form of awareness, including reflective journaling and timed prompts or reminders, which serve both as behavioral regulators and as tools for enhancing self-awareness. Posture training also plays a valuable role by fostering kinesthetic intelligence and facilitating the development of self-assessment skills. Body awareness can be evaluated through various assessment tools. In some countries, the Postural Assessment Software (PAS/SAPO) is currently undergoing validation for use in clinical and educational settings [ 14 ]. Köteles (2014), drawing on the work of Shields et al., emphasized the importance of measurement instruments that assess general bodily awareness without focusing on physical symptoms or health complaints. For the present study, the Body Awareness Questionnaire (BAQ) was selected due to its clarity and appropriateness for adolescent populations. Higher BAQ scores reflect more developed body awareness and self-perception abilities [ 15 ]. The objective of this study is to highlight the pedagogical significance of promoting self-assessment as a tool for fostering health-oriented behavior in adolescents. Additionally, it investigates whether posture training may enhance the effectiveness of this approach. Materials and methods Study Participants A total of 169 high school students (69 boys and 100 girls) from three secondary schools in Budapest, Hungary participated in the study. The study was conducted in accordance with the Declaration of Helsinki (2003). Written informed consent was obtained from all participants’ parents or legal guardians prior to the intervention. Ethical approval was granted by the Institutional Review Board of Eszterházy Károly Catholic University (Approval ID: RK/1243/2021). The average age of the participants was 16.02 ± 0.64 years. All students were enrolled in full-time secondary education. Regarding their prior engagement in posture-related activities, 3.4% reported participating in posture daily or two to three times per week, while 5.7% reported engaging in such activities weekly. In terms of general physical activity outside of school hours, 36.2% of students exercised three or more times per week, 45.6% once or twice per week, and 18.2% reported rarely or never being physically active. (Table 1 ) Table 1 Characteristics of the pupil’s sample Groups N Boys-Girls Age (M ± SD) Experimental Group: Habitual Posture Group (HPG) 94 34 / 60 16,11±,613 Control Group (CG) 75 35 / 40 15, 93 ±,475 Study design The intervention was conducted over a 7-week period, during which pre- and post-intervention measurements were taken. The program incorporated both theoretical and practical elements related to health and posture education. The initial component of the intervention involved reviewing core health-related concepts taught in Physical Education classes, such as the importance of daily physical activity, recommended intake of fresh produce and water, and the impact of harmful habits on health. Additionally, the correct definition and awareness of proper posture were introduced, with supplementary materials (including presentations) made available to students via the Microsoft Teams platform. Standardized exercise protocols were developed and shared with all participating schools to ensure consistency across both groups. These included 14 structured posture-focused training sessions designed for use across the seven weeks. Each session lasted approximately 10 minutes and was incorporated into lessons following a warm-up routine. Both the HPG and CG participated in the weekly review of healthy lifestyle criteria. The Habitual Posture Group (HPG) received additional targeted content and support. This included private consultations, PowerPoint presentations, and in-class demonstrations emphasizing correct pelvic positioning—a fundamental element of proper posture and biomechanically sound movement patterns [ 16 ]. Students were shown ideal and faulty postures, along with guidance on correcting them through strengthening and stretching exercises. Visual materials such as images and real-life movement demonstrations were used to enhance kinesthetic awareness, encouraging students to actively engage their muscles during movement. To reinforce regular self-awareness of posture, students in the HPG were instructed to set auditory reminders (e.g., via mobile phones or classroom bells) at two-hour intervals. These reminders served as cues for students to self-check and correct their posture throughout the day, both during school hours and at home. In settings where mobile phones were restricted, the school bell was used as a substitute auditory prompt. (Table 2 – 3 ) Table 2 Summary of the program Pretest PPT: Healthy lifestyle Correct posture Healthy lifestyle recall weekly Posture exercises 2x weekly Habitual posture training weekly Posture control to an audible sign in every 2 hours Post-test HBG + + + + + + + CG + + + + - - + Table 3 Summary of exercises Time Target Habitual Posture Training (with tilted pelvis, closed scapulas with the shoulders down) Week 1 Static positions with correct posture • Standings (closed, normal, straddle, half squat) Week 2 • Sittings on different heights (chair, desk, floor), in different positions (crossed, on the heels, etc.) Week 3 Dynamical movements with correct posture • Walking of different speeds, jogging, running Week 4 • Arm liftings to different heights • Trunk bendings forward, to left/right, trunk rotations Week 5 Connections of different elements • Sitting down and up to different heights Week 6 • Lifting up and taking down objects Week 7 • Other, individual habitual actings Study Limitation Due to logistical constraints, entire classes were designated as study groups within each school. Students who chose not to participate were excluded from the study. As a result, group assignment was determined at the class level, not randomly. Two groups were formed: the Habitual Posture Group (HPG) (n = 94; 34 males, 60 females) and the Control Group (CG) (n = 75; 35 males, 40 females). Instruments and Data Collection Data were collected using a combination of survey instruments, locomotor performance tests, and Body Awareness Questionnaire (BAQ-H). Measurements were conducted both prior to (pretest) and following (posttest) the seven-week intervention. The survey instrument was employed to assess self-reported musculoskeletal issues, perceived postural control throughout the day, and various health-related behaviors. These included beneficial habits such as engagement in physical activity after school and daily consumption of raw fruits, vegetables, and water, as well as risk behaviors such as smoking and alcohol consumption. The survey included closed-ended items that yielded nominal (categorical) data. Locomotor tests were used to evaluate posture-related muscular endurance. Two static exercises were selected from a 12-item posture control protocol developed by the Hungarian Spine Society [ 17 ], which has been applied in prior research. The first test assessed abdominal muscle strength through a supine hold, and the second test evaluated back extensor strength via a prone position hold. For both exercises, the duration (in seconds) that participants could maintain the correct posture was recorded, resulting in interval level data. The BAQ-H (Body Awareness Questionnaire – Hungarian version) was used to assess participants’ awareness of internal bodily signals, cycles, and physiological responses. It is based on the premise of a stable internal representation of bodily states (Köteles, 2014). Participants rated each item on a 7-point Likert scale, where 1 indicated strong disagreement, 7 indicated strong agreement, and 4 represented a neutral stance. This instrument also generated interval level data. Data analysis All statistical analyses were performed using IBM SPSS Statistics version 25. The internal consistency of the questionnaire was assessed using Cronbach’s alpha, with the BAQ-H scores yielding a reliability coefficient of α = 0.855. Descriptive statistics were calculated to summarize the demographic and behavioral characteristics of the sample. Chi-square tests were applied to compare nominal variables between groups. Paired samples t-tests were used to compare pretest and posttest metric data within groups, and nonparametric tests (e.g., McNemar or Mann–Whitney U, as appropriate) were applied for nominal variables. A significance level of p < 0.05 was used to determine statistical significance for all analyses. Results Lifestyle Characteristics of the Groups Within the Habitualal Posture Group (HPG), 22.3% of students reported consuming fresh fruits and vegetables three to four times per day, while 48.9% consumed them once or twice daily, and 28.7% reported consuming them rarely or never. Regarding fluid intake, 12.8% of the HPG reported drinking 3–4 liters of fluids per day, 50.0% consumed 1–2 liters, and 37.2% consumed 1 liter or less. In terms of health risk behaviors, 88.3% of students in the HPG reported never having smoked. Alcohol consumption was also relatively low in this group: 48.9% reported never consuming alcohol, and 43.6% indicated occasional (rare) use. Concerning stress management, 40.4% of the HPG reported lacking any stress-coping strategy. When asked about changes in behavior during the program, 27.7% reported increased physical activity, while 32.0% reported negative behavioral changes, such as smoking or consuming more sweets. In the Control Group (CG), 14.7% of students consumed fresh fruits and vegetables three to four times daily, 58.7% once or twice daily, and 20.0% rarely or never. In terms of fluid consumption, 18.7% reported drinking 3–4 liters daily, 58.7% consumed 1–2 liters, and 22.7% consumed 1 liter or less. As for smoking habits, 93.3% of CG students reported never having smoked. Alcohol consumption was absent in 56.0% of the group, while 38.7% reported rare use. Half of the CG participants (50.0%) reported not using any stress-coping method. Regarding behavioral changes, 35.1% increased their physical activity, and 14.9% reported increases in smoking or sweet consumption. (Table 4 – 5 ) Table 4 Healthy habits Fruits and vegetables consuming daily Water/liquid consuming daily Before After Before After 3-4x 1-2x Rarely or never More Same amount Less 3–4 liter 1–2 liter Less, than 1 liter Optimal amount Same Less HPG 22,3% 48,9% 28,7% 20,2% 69,1% 9,6% 12,8% 50,0% 37,2% 34% 55,3% 9,6% CG 14,7% 58,7% 26,7% 20% 77,3% 2,7% 18,7% 58,7% 22,7% 46,7% 49,3% 4% Table 5 Health damaging habits Alcohol consuming Smoking consuming Before After Before After Never Rarely Frequently Rarerly Same More Never Frequently Daily Rarerly Same More HPG 48,9% 43,6% 7,4% 33% 16% 2,1% 88,3% 7,4% 4,3% 7,4% 2,1% 2,1% CG 56% 38,7% 5,3% 56% 28% 16% 93,3% 1,3% 5,4% 0% 5,3% 1,3% Impact of intervention Following the intervention, 52% of students in the Habitual Posture Group (HPG) reported that they found the program useful. Statistically significant improvements were observed in several lifestyle-related behaviors. Notably, participants in the HPG reported a significant increase in the consumption of fresh fruits and vegetables (Wilcoxon = − 2.185; p = 0.029), as well as a significant increase in water intake (Wilcoxon = − 5.047; p < 0.001). Additionally, alcohol consumption significantly decreased within the group (Wilcoxon = − 2.676; p = 0.007): 64.5% of participants reported drinking less alcohol than before the program, 31.2% reported no change, and 4.3% reported increased consumption. No statistically significant changes were detected in smoking habits or in the use of stress-coping strategies within the HPG. In the Control Group (CG), 48% of students indicated that they considered the cooperation useful. Post-intervention data showed a statistically significant increase in the daily consumption of raw fruits and vegetables (Wilcoxon = − 3.381; p = 0.001), as well as a significant improvement in water intake (Wilcoxon = − 4.714; p < 0.001). Alcohol consumption also decreased significantly (Wilcoxon = − 2.496; p = 0.013), with 63.6% of students reporting a reduction, 33.4% reporting no change, and 3% reporting an increase in alcohol use. However, stress-coping behaviors showed a statistically significant but unfavorable shift (Wilcoxon = − 2.900; p = 0.004); only a few students adopted physical activity as an alternative to unhealthy coping strategies such as snacking, smoking, or alcohol use. Smoking habits in the CG remained unchanged. (Table 6 ) Table 6 The group’s differences in lifestyle HPG CG HPG CG HPG CG HPG CG HPG CG cons.of uncooked 2 – cons.of uncooked 1 water intake2 – water intake1 smoking2 - smoking1 alcohol2 - alcohol1 stresscoping2 - stresscoping1 Z -2,185 b -3,381 b -5,047 b -4,714 b -,447 c ,000 c -2,676 c -2,496 d -,767 b -2,900 b A.Sig. (2-tailed) ,029 ,001 ,000 ,000 ,655 1,000 ,007 ,013 ,443 ,004 Following the intervention, 26.9% of students in the Habitual Posture Group (HPG) reported that they regularly paid attention to their posture. This group demonstrated statistically significant improvements in both locomotor tests. Specifically, performance on the back muscle endurance test improved by an average of 18.25 seconds (t = − 5.180; df = 92; p < 0.001), while the abdominal muscle endurance test showed an average improvement of 105.55 seconds (t = − 3.092; df = 92; p = 0.003). In contrast, only 12% of the Control Group (CG) reported noticing any changes in their posture. While the CG also exhibited a statistically significant improvement in back muscle endurance—with an average gain of 25.68 seconds (t = − 5.734; df = 73; p < 0.001)—no significant improvement was observed in abdominal muscle endurance, despite an average increase of 22.47 seconds, which did not reach statistical significance. (Table 7 ) Table 7 Paired Samples Statistics HPG CG HPG CG HPG CG HPG CG back muscles 1 back muscles 2 abdominal 1 abdominal 2 Mean 96,3226 92,7973 114,5753 118,4730 261,8495 330,2267 367,3978 352,6933 Aver.distr. 41,22741 48,62746 51,03733 63,11508 196,60770 202,59369 381,23943 210,52630 df 4,27508 5,65283 5,29233 7,33698 20,38727 23,39350 39,53269 24,30948 Diff.s -11,25412 -16,75084 -37,75308 11,19433 t -5,734 -5,180 -1,330 -3,092 Sig. (2-tailed) ,000 ,000 ,003 ,188 In the Habitual Posture Group (HPG), the mean score on the Body Awareness Questionnaire (BAQ) increased from 74.34 ± 14.19 at pretest to 75.63 ± 13.94 at posttest, reflecting a modest improvement of 1.29 points. In comparison, the Control Group (CG) showed an increase from a pretest mean of 71.00 ± 15.49 to a posttest mean of 73.90 ± 15.15, indicating a 2.90-point improvement in self-assessment scores. (Table 8 ) Table 8 BAQ-H scores of pretest and posttest Type N Subset for alpha = 0.05 1 BAQ-H 1 BAQ-H 2 Habitual Posture Group 94 74,3404 75, 6344 Control Group 75 71,0000 73,9067 Discussion Numerous health behavior development programs have been designed for younger generations, with varying emphases on promoting water consumption, improving nutrition, or reducing health-damaging behaviors. The primary aim of the present study was to integrate body awareness and self-assessment into the development of health-related behavior [4;5]. The Control Group (CG) demonstrated positive changes in their lifestyle, including increased consumption of raw vegetables and fruits, greater water intake, and reduced alcohol consumption. However, their smoking habits remained unchanged, and their coping strategies for stress slightly deteriorated. The Habitual Posture Group (HPG) also showed improvements in healthy behaviors, particularly in fresh produce intake, optimal hydration, and moderation of alcohol use. Similar to the CG, no significant changes were observed in their smoking behavior or stress management strategies. Interestingly, a greater proportion of students in the CG reported subjective improvements in their overall lifestyle compared to those in the HPG. However, it is important to acknowledge that the HPG consisted of higher-performing students, many of whom were selected by supportive Physical Education teachers. Approximately two-thirds of the HPG were girls, and members of this group generally began the study with a more advanced health behavior profile. The lack of change in smoking behavior in both groups may be attributed to the already low frequency of reported smoking at baseline. It is also plausible that some students were not fully honest in their responses, possibly concealing their smoking behavior due to fear of repercussions from teachers or parents. This limitation is consistent with common challenges in self-reported data collection related to sensitive topics. Fewer students in the CG reported actively monitoring their posture during the program, which is not surprising. Although this group received information about correct posture and participated in posture-related physical exercises, they were not exposed to targeted self-awareness strategies. While the CG showed general improvement in locomotor tests, statistically significant gains were only observed in back muscle endurance. In contrast, members of the HPG were encouraged to repeatedly monitor and correct their posture throughout the day, particularly through engaging the abdominal and gluteal muscles to control pelvic alignment. Over one-quarter of the HPG reported regular posture monitoring, and this group showed significant improvements in both abdominal and back muscle endurance. Notably, their baseline results were lower, providing greater potential for measurable improvement. Self-assessment and kinesthetic intelligence are essential not only for athletes and artists, but for the general population as well. This study investigated the effects of a health behavior intervention on adolescents, with one key component being the development of self-assessment, as measured by the Body Awareness Questionnaire (BAQ-H). Both groups demonstrated improvement in their self-assessment scores. It is worth noting that the HPG had higher baseline scores than the CG’s posttest scores, limiting the magnitude of their observed progress. As previously discussed, the HPG consisted of more motivated and capable students, which may have masked the full impact of the intervention on self-assessment. Despite this, the overall performance of the HPG in terms of lifestyle improvement and posture development exceeded that of the CG. Taken together, these findings support the conclusion that, beyond providing information and instructions, the development of health behavior through pedagogical methods focused on self-assessment can be effective. Tools such as auditory or visual reminders (e.g., mobile phone alerts) can facilitate this process in practical settings. The results underscore the need for health behavior interventions among adolescents and highlight the importance of considering not only age, socioeconomic status, and school location, but also students’ learning attitudes when designing such programs. Declarations Ethics approval and consent to participate: This study was conducted in accordance with the principles of the Declaration of Helsinki. The study received approval from the Institutional Review Board of Eszterházy Károly Catholic University (Approval ID: RK/1243/2021). Prior to the intervention, written informed consent was obtained from all participants as well as from their parents or legal guardians during a teacher–parent conference held at the respective schools. The consent process included detailed information about the nature and scope of the intervention. Participants and their parents or guardians were fully informed about the purpose of the study, the voluntary nature of participation, the intended use of the data, and the measures taken to ensure anonymity and confidentiality. They were also made aware of any potential risks associated with participation. Consent for publication: All authors have approved the final version of the manuscript, take responsibility for the work, and agree with its submission to BMC Public Health. Availability of data and material: The data will be available and transparent. Competing interest: On behalf of all authors, the corresponding author states that there is no conflict of interest. Funding: The authors declare that they received no funding for this study. Authors' contributions: Abonyi, Barbara: research concept, design of the work, literature review, data collection, interpretation of data, drafting the work, final approval of the version to be published. Bognár, József: research concept, interpretation of data, reviewing the draft, final approval of the version to be published. Simon, István: literature review, interpretation of data, drafting the work, final approval of the version to be published. Acknowledgements: the authors thank for all the participants for being part in the study. References Feil, K.; Allion, S., Weyland, S., Jekauc, D. (2021): A Systematic Review Examining the Relationship Between Habit and Physical Activity Behavior in Longitudinal Studies. 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In: Musculoskeletal Science and Practice Volume 64, April 2023, 102725 https://www.sciencedirect.com/science/article/pii/S2468781223000103 Retrieved: 2023. 08. 08. Wilmore, J. H. (1996): Training for sport and activity. Human Kinetics, Champaign, p. 137 https://health.gov/sites/default/files/2019-09/2015-2020_Dietary_Guidelines.pdf pp. 14-19 Retrieved: 2023.07.31. Ferreira E. A. G., Duarte M., Maldonado E. P., Burke T. N., Marques A. P. (2010): Postural assessment software (PAS/SAPO): validation and reliabiliy. In:ClinicalSciences Clinics 65 (7) 2010 http://www.scielo.br/j/clin/a/pyLZn49HyjSXmJBtBrHqSYF/?lang=en Köteles F. (2014):Psychometric investigation of the Hungarian version of the Body Awareness Questionnaire (BAQ-H) among yoga practitioners and young adult controls. In: December 2014. Mentálhigiéné es Pszichoszomatika 15(4):373-391 DOI:10.1556/Mental.15.2014.4.4 https://www.researchgate.net/publication/277923795_Psychometric_investigation_of_the_Hungarian_version_of_the_Body_Awareness_Questionnaire_BAQ-H_among_yoga_practitioners_and_young_adult_controls Retrieved: 2025. 06. 04. Boyle M. (2016): New functional training for sports . Human Kinetics pp.1-3 Somhegyi A . (2022):Posture correction as part of holistic health promotion in Hungarian schools. In: Ideggyógyászati Szemle 75(5-6):151-161 May 2022 DOI:10.18071/isz.75.0151 https://www.researchgate.net/publication/360865627_Posture_correction_as_part_of_holistic_health_promotion_in_Hungarian_schools Retrieved: 2025. 06. 04. Additional Declarations No competing interests reported. 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Abonyi","email":"data:image/png;base64,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","orcid":"","institution":"Eszterházy Károly Catholic University","correspondingAuthor":true,"prefix":"","firstName":"Barbara","middleName":"","lastName":"Abonyi","suffix":""},{"id":546040639,"identity":"aa2ce8b0-f8ee-4f11-85a9-6c2130d97c15","order_by":1,"name":"József Bognár","email":"","orcid":"","institution":"Eszterházy Károly Catholic 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04:57:10","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":98176,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7753463/v1/04b8cd88963469a586bf6a2f.html"},{"id":106809227,"identity":"84ec25cb-573c-405a-8023-7ba0d3cca884","added_by":"auto","created_at":"2026-04-13 16:08:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1351971,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7753463/v1/fd95cb0d-1f7f-4a54-83b9-742aabd63ae7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"High school health education: focus on the development of self-controlling","fulltext":[{"header":"Background","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003eHealth education\u003c/h2\u003e\u003cp\u003eAdvancements in medical science and socioeconomic development in industrialized nations have contributed to a steady rise in average life expectancy. As a result, there is an increasing societal demand for prolonged well-being, supported by a disciplined lifestyle that includes regular physical activity and the reduction of health-compromising behaviors [1; 2]. Encouraging health-conscious behavior among children and adolescents may yield dual benefits: not only does it enhance their current and future quality of life, but it also promotes healthier behavioral patterns in subsequent generations through intergenerational transmission. The Health Behavior in School-aged Children (HBSC) study, an internationally recognized initiative, aims to monitor and promote health-related behaviors among youth through a combination of psychological guidance and practical support mechanisms [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Hungary has participated in the HBSC program since 1985, allowing for the systematic collection and analysis of subjective health indicators that inform public health strategies. In 2019, the Hungarian National Center for Public Health launched a comprehensive initiative aimed at improving health behaviors among 7\u0026ndash;18-year-old children. This project emphasized the design of age-appropriate educational materials and interventions tailored to the lifestyle and communication preferences of younger generations. Successful behavior change requires first identifying harmful habits, then raising awareness, and finally initiating corrective processes\u0026mdash;such as eliminating risk factors or fostering the acquisition of health-supportive behaviors. Accordingly, it is critical not only to disseminate information about healthy lifestyles but also to facilitate the internalization of these behaviors through educational practice and experiential learning [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Sport habits established during early life often persist into adulthood. Despite potential obstacles, long-term adherence and professional guidance are essential for the maintenance of such health-promoting behaviors. A global study covering 67 countries by Martins et al. (2022) highlighted the benefits of regular participation in physical education (PE), which included improvements in dietary choices, stress resilience, and reduced engagement in harmful behaviors [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eNutrition\u003c/h2\u003e\u003cp\u003eNutrition research consistently focuses on the daily intake of fruits and vegetables as key indicators of dietary health. An average consumption of 400 grams per day, when combined with a reduced intake of saturated fats and added sugars, and a higher intake of lean proteins and dietary fiber, has been shown to mitigate the risk of chronic diseases [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Among adolescents, dietary behavior is significantly shaped by sociocultural influences, including family practices, peer pressure, marketing strategies, and school food environments [7]. The roots of risk behaviors often lie in familial and social modeling [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Many adolescent smokers report perceived cognitive or emotional benefits from smoking, such as reduced stress and improved concentration [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Gender-based comparisons reveal that boys are more likely than girls to engage in smoking and alcohol consumption [10]. Although the prevalence of binge drinking among Hungarian youth aged 11\u0026ndash;15 aligns with the national average, a marked decline has been observed since 2009. However, data suggest that girls are gradually closing the gap with boys, highlighting the need for targeted educational efforts alongside policy interventions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSelf-control and body awareness\u003c/h3\u003e\n\u003cp\u003eHowever, according to Clark et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e12\u003c/span\u003e], current musculoskeletal rehabilitation practices may be inadequate for ensuring long-term joint health. Wilmore\u0026rsquo;s research [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e13\u003c/span\u003e] underscores that strength development relies not only on muscular adaptation but also on the plasticity of the central nervous system. Regarding the latter, promotion of health-conscious behavior among adolescents necessitates a focus on the development of self-control and body awareness. In this context, self-control is understood not simply as abstinence (e.g., avoiding sweets), but as a sustained attentiveness to one\u0026rsquo;s bodily states, responses, and needs. Several pedagogical strategies may be employed to cultivate this form of awareness, including reflective journaling and timed prompts or reminders, which serve both as behavioral regulators and as tools for enhancing self-awareness. Posture training also plays a valuable role by fostering kinesthetic intelligence and facilitating the development of self-assessment skills.\u003c/p\u003e\u003cp\u003eBody awareness can be evaluated through various assessment tools. In some countries, the Postural Assessment Software (PAS/SAPO) is currently undergoing validation for use in clinical and educational settings [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. K\u0026ouml;teles (2014), drawing on the work of Shields et al., emphasized the importance of measurement instruments that assess general bodily awareness without focusing on physical symptoms or health complaints. For the present study, the Body Awareness Questionnaire (BAQ) was selected due to its clarity and appropriateness for adolescent populations. Higher BAQ scores reflect more developed body awareness and self-perception abilities [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe objective of this study is to highlight the pedagogical significance of promoting self-assessment as a tool for fostering health-oriented behavior in adolescents. Additionally, it investigates whether posture training may enhance the effectiveness of this approach.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eStudy Participants\u003c/h2\u003e\u003cp\u003eA total of 169 high school students (69 boys and 100 girls) from three secondary schools in Budapest, Hungary participated in the study. The study was conducted in accordance with the Declaration of Helsinki (2003). Written informed consent was obtained from all participants\u0026rsquo; parents or legal guardians prior to the intervention. Ethical approval was granted by the Institutional Review Board of Eszterh\u0026aacute;zy K\u0026aacute;roly Catholic University (Approval ID: RK/1243/2021).\u003c/p\u003e\u003cp\u003eThe average age of the participants was 16.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64 years. All students were enrolled in full-time secondary education. Regarding their prior engagement in posture-related activities, 3.4% reported participating in posture daily or two to three times per week, while 5.7% reported engaging in such activities weekly. In terms of general physical activity outside of school hours, 36.2% of students exercised three or more times per week, 45.6% once or twice per week, and 18.2% reported rarely or never being physically active. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eCharacteristics of the pupil\u0026rsquo;s sample\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGroups\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBoys-Girls\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAge (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperimental Group:\u003c/p\u003e\u003cp\u003e\u003cb\u003eHabitual Posture Group (HPG)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34 / 60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e16,11\u0026plusmn;,613\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eControl Group (CG)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35 / 40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e15, 93 \u0026plusmn;,475\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eThe intervention was conducted over a 7-week period, during which pre- and post-intervention measurements were taken. The program incorporated both theoretical and practical elements related to health and posture education.\u003c/p\u003e\u003cp\u003eThe initial component of the intervention involved reviewing core health-related concepts taught in Physical Education classes, such as the importance of daily physical activity, recommended intake of fresh produce and water, and the impact of harmful habits on health. Additionally, the correct definition and awareness of proper posture were introduced, with supplementary materials (including presentations) made available to students via the Microsoft Teams platform.\u003c/p\u003e\u003cp\u003eStandardized exercise protocols were developed and shared with all participating schools to ensure consistency across both groups. These included 14 structured posture-focused training sessions designed for use across the seven weeks. Each session lasted approximately 10 minutes and was incorporated into lessons following a warm-up routine. Both the HPG and CG participated in the weekly review of healthy lifestyle criteria.\u003c/p\u003e\u003cp\u003eThe Habitual Posture Group (HPG) received additional targeted content and support. This included private consultations, PowerPoint presentations, and in-class demonstrations emphasizing correct pelvic positioning\u0026mdash;a fundamental element of proper posture and biomechanically sound movement patterns [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Students were shown ideal and faulty postures, along with guidance on correcting them through strengthening and stretching exercises. Visual materials such as images and real-life movement demonstrations were used to enhance kinesthetic awareness, encouraging students to actively engage their muscles during movement.\u003c/p\u003e\u003cp\u003eTo reinforce regular self-awareness of posture, students in the HPG were instructed to set auditory reminders (e.g., via mobile phones or classroom bells) at two-hour intervals. These reminders served as cues for students to self-check and correct their posture throughout the day, both during school hours and at home. In settings where mobile phones were restricted, the school bell was used as a substitute auditory prompt. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eSummary of the program\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePretest\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePPT: Healthy lifestyle Correct posture\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHealthy lifestyle recall weekly\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePosture exercises\u003c/p\u003e\u003cp\u003e2x weekly\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHabitual posture training weekly\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePosture control to an audible sign in every 2 hours\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePost-test\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHBG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eSummary of exercises\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTarget\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHabitual Posture Training\u003c/p\u003e\u003cp\u003e(with tilted pelvis, closed scapulas with the shoulders down)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 1\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eStatic positions with correct posture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Standings (closed, normal, straddle, half squat)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 2\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Sittings on different heights (chair, desk, floor), in different positions (crossed, on the heels, etc.)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 3\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDynamical movements with correct posture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Walking of different speeds, jogging, running\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 4\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Arm liftings to different heights\u003c/p\u003e\u003cp\u003e\u0026bull; Trunk bendings forward, to left/right, trunk rotations\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 5\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eConnections of different elements\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Sitting down and up to different heights\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 6\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Lifting up and taking down objects\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeek 7\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Other, individual habitual actings\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eStudy Limitation\u003c/h2\u003e\u003cp\u003eDue to logistical constraints, entire classes were designated as study groups within each school. Students who chose not to participate were excluded from the study. As a result, group assignment was determined at the class level, not randomly. Two groups were formed: the Habitual Posture Group (HPG) (n\u0026thinsp;=\u0026thinsp;94; 34 males, 60 females) and the Control Group (CG) (n\u0026thinsp;=\u0026thinsp;75; 35 males, 40 females).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eInstruments and Data Collection\u003c/h3\u003e\n\u003cp\u003eData were collected using a combination of survey instruments, locomotor performance tests, and Body Awareness Questionnaire (BAQ-H). Measurements were conducted both prior to (pretest) and following (posttest) the seven-week intervention.\u003c/p\u003e\u003cp\u003eThe survey instrument was employed to assess self-reported musculoskeletal issues, perceived postural control throughout the day, and various health-related behaviors. These included beneficial habits such as engagement in physical activity after school and daily consumption of raw fruits, vegetables, and water, as well as risk behaviors such as smoking and alcohol consumption. The survey included closed-ended items that yielded nominal (categorical) data.\u003c/p\u003e\u003cp\u003eLocomotor tests were used to evaluate posture-related muscular endurance. Two static exercises were selected from a 12-item posture control protocol developed by the Hungarian Spine Society [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e17\u003c/span\u003e], which has been applied in prior research. The first test assessed abdominal muscle strength through a supine hold, and the second test evaluated back extensor strength via a prone position hold. For both exercises, the duration (in seconds) that participants could maintain the correct posture was recorded, resulting in interval level data.\u003c/p\u003e\u003cp\u003eThe BAQ-H (Body Awareness Questionnaire \u0026ndash; Hungarian version) was used to assess participants\u0026rsquo; awareness of internal bodily signals, cycles, and physiological responses. It is based on the premise of a stable internal representation of bodily states (K\u0026ouml;teles, 2014). Participants rated each item on a 7-point Likert scale, where 1 indicated strong disagreement, 7 indicated strong agreement, and 4 represented a neutral stance. This instrument also generated interval level data.\u003c/p\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eAll statistical analyses were performed using IBM SPSS Statistics version 25. The internal consistency of the questionnaire was assessed using Cronbach\u0026rsquo;s alpha, with the BAQ-H scores yielding a reliability coefficient of α\u0026thinsp;=\u0026thinsp;0.855. Descriptive statistics were calculated to summarize the demographic and behavioral characteristics of the sample. Chi-square tests were applied to compare nominal variables between groups. Paired samples t-tests were used to compare pretest and posttest metric data within groups, and nonparametric tests (e.g., McNemar or Mann\u0026ndash;Whitney U, as appropriate) were applied for nominal variables. A significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was used to determine statistical significance for all analyses.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eLifestyle Characteristics of the Groups\u003c/h2\u003e\u003cp\u003eWithin the Habitualal Posture Group (HPG), 22.3% of students reported consuming fresh fruits and vegetables three to four times per day, while 48.9% consumed them once or twice daily, and 28.7% reported consuming them rarely or never. Regarding fluid intake, 12.8% of the HPG reported drinking 3\u0026ndash;4 liters of fluids per day, 50.0% consumed 1\u0026ndash;2 liters, and 37.2% consumed 1 liter or less. In terms of health risk behaviors, 88.3% of students in the HPG reported never having smoked. Alcohol consumption was also relatively low in this group: 48.9% reported never consuming alcohol, and 43.6% indicated occasional (rare) use. Concerning stress management, 40.4% of the HPG reported lacking any stress-coping strategy. When asked about changes in behavior during the program, 27.7% reported increased physical activity, while 32.0% reported negative behavioral changes, such as smoking or consuming more sweets. In the Control Group (CG), 14.7% of students consumed fresh fruits and vegetables three to four times daily, 58.7% once or twice daily, and 20.0% rarely or never. In terms of fluid consumption, 18.7% reported drinking 3\u0026ndash;4 liters daily, 58.7% consumed 1\u0026ndash;2 liters, and 22.7% consumed 1 liter or less. As for smoking habits, 93.3% of CG students reported never having smoked. Alcohol consumption was absent in 56.0% of the group, while 38.7% reported rare use. Half of the CG participants (50.0%) reported not using any stress-coping method. Regarding behavioral changes, 35.1% increased their physical activity, and 14.9% reported increases in smoking or sweet consumption. (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eHealthy habits\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"13\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u003cp\u003eFruits and vegetables consuming daily\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u003cp\u003eWater/liquid consuming daily\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eBefore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eAfter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eBefore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e\u003cp\u003eAfter\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3-4x\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-2x\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003cp\u003eor\u003c/p\u003e\u003cp\u003enever\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSame amount\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eLess\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3\u0026ndash;4 liter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u0026ndash;2 liter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eLess, than 1 liter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eOptimal amount\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eSame\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eLess\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHPG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48,9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20,2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e69,1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9,6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12,8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e50,0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e37,2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e34%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e55,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e9,6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e77,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e18,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e58,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e22,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e46,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e49,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eHealth damaging habits\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"13\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u003cp\u003eAlcohol consuming\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u003cp\u003eSmoking consuming\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eBefore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eAfter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eBefore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e\u003cp\u003eAfter\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFrequently\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRarerly\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSame\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eFrequently\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eDaily\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eRarerly\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eSame\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eMore\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHPG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48,9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43,6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7,4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e33%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2,1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e88,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e7,4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e4,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e7,4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e2,1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e2,1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38,7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e56%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e16%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e93,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e5,4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e5,3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e1,3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eImpact of intervention\u003c/h2\u003e\u003cp\u003eFollowing the intervention, 52% of students in the Habitual Posture Group (HPG) reported that they found the program useful. Statistically significant improvements were observed in several lifestyle-related behaviors. Notably, participants in the HPG reported a significant increase in the consumption of fresh fruits and vegetables (Wilcoxon = \u0026minus;\u0026thinsp;2.185; p\u0026thinsp;=\u0026thinsp;0.029), as well as a significant increase in water intake (Wilcoxon = \u0026minus;\u0026thinsp;5.047; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Additionally, alcohol consumption significantly decreased within the group (Wilcoxon = \u0026minus;\u0026thinsp;2.676; p\u0026thinsp;=\u0026thinsp;0.007): 64.5% of participants reported drinking less alcohol than before the program, 31.2% reported no change, and 4.3% reported increased consumption. No statistically significant changes were detected in smoking habits or in the use of stress-coping strategies within the HPG.\u003c/p\u003e\u003cp\u003eIn the Control Group (CG), 48% of students indicated that they considered the cooperation useful. Post-intervention data showed a statistically significant increase in the daily consumption of raw fruits and vegetables (Wilcoxon = \u0026minus;\u0026thinsp;3.381; p\u0026thinsp;=\u0026thinsp;0.001), as well as a significant improvement in water intake (Wilcoxon = \u0026minus;\u0026thinsp;4.714; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Alcohol consumption also decreased significantly (Wilcoxon = \u0026minus;\u0026thinsp;2.496; p\u0026thinsp;=\u0026thinsp;0.013), with 63.6% of students reporting a reduction, 33.4% reporting no change, and 3% reporting an increase in alcohol use. However, stress-coping behaviors showed a statistically significant but unfavorable shift (Wilcoxon = \u0026minus;\u0026thinsp;2.900; p\u0026thinsp;=\u0026thinsp;0.004); only a few students adopted physical activity as an alternative to unhealthy coping strategies such as snacking, smoking, or alcohol use. Smoking habits in the CG remained unchanged. (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eThe group\u0026rsquo;s differences in lifestyle\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"11\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003econs.of uncooked 2 \u0026ndash; cons.of uncooked 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ewater intake2 \u0026ndash; water intake1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003esmoking2 - smoking1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003ealcohol2 - alcohol1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003estresscoping2 - stresscoping1\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eZ\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-2,185\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-3,381\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-5,047\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-4,714\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-,447\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e,000\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-2,676\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-2,496\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-,767\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-2,900\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA.Sig. (2-tailed)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e,029\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e,001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e,655\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e,007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e,013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e,443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e,004\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFollowing the intervention, 26.9% of students in the Habitual Posture Group (HPG) reported that they regularly paid attention to their posture. This group demonstrated statistically significant improvements in both locomotor tests. Specifically, performance on the back muscle endurance test improved by an average of 18.25 seconds (t = \u0026minus;\u0026thinsp;5.180; df\u0026thinsp;=\u0026thinsp;92; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while the abdominal muscle endurance test showed an average improvement of 105.55 seconds (t = \u0026minus;\u0026thinsp;3.092; df\u0026thinsp;=\u0026thinsp;92; p\u0026thinsp;=\u0026thinsp;0.003).\u003c/p\u003e\u003cp\u003eIn contrast, only 12% of the Control Group (CG) reported noticing any changes in their posture. While the CG also exhibited a statistically significant improvement in back muscle endurance\u0026mdash;with an average gain of 25.68 seconds (t = \u0026minus;\u0026thinsp;5.734; df\u0026thinsp;=\u0026thinsp;73; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u0026mdash;no significant improvement was observed in abdominal muscle endurance, despite an average increase of 22.47 seconds, which did not reach statistical significance. (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003ePaired Samples Statistics\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHPG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eback muscles 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eback muscles 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eabdominal 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eabdominal 2\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMean\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e96,3226\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e92,7973\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e114,5753\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e118,4730\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e261,8495\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e330,2267\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e367,3978\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e352,6933\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAver.distr.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41,22741\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48,62746\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51,03733\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e63,11508\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e196,60770\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e202,59369\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e381,23943\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e210,52630\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003edf\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4,27508\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5,65283\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5,29233\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7,33698\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20,38727\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e23,39350\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e39,53269\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e24,30948\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDiff.s\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c3\" namest=\"c2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-11,25412\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-16,75084\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c7\" namest=\"c6\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-37,75308\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e11,19433\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003et\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-5,734\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-5,180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-1,330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-3,092\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSig.\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(2-tailed)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e,003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e,188\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn the Habitual Posture Group (HPG), the mean score on the Body Awareness Questionnaire (BAQ) increased from 74.34\u0026thinsp;\u0026plusmn;\u0026thinsp;14.19 at pretest to 75.63\u0026thinsp;\u0026plusmn;\u0026thinsp;13.94 at posttest, reflecting a modest improvement of 1.29 points. In comparison, the Control Group (CG) showed an increase from a pretest mean of 71.00\u0026thinsp;\u0026plusmn;\u0026thinsp;15.49 to a posttest mean of 73.90\u0026thinsp;\u0026plusmn;\u0026thinsp;15.15, indicating a 2.90-point improvement in self-assessment scores. (Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eBAQ-H scores of pretest and posttest\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eType\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eSubset for alpha\u0026thinsp;=\u0026thinsp;0.05\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBAQ-H 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBAQ-H 2\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHabitual Posture Group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74,3404\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75, 6344\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eControl Group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e71,0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e73,9067\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eNumerous health behavior development programs have been designed for younger generations, with varying emphases on promoting water consumption, improving nutrition, or reducing health-damaging behaviors. The primary aim of the present study was to integrate body awareness and self-assessment into the development of health-related behavior [4;5].\u003c/p\u003e\u003cp\u003eThe Control Group (CG) demonstrated positive changes in their lifestyle, including increased consumption of raw vegetables and fruits, greater water intake, and reduced alcohol consumption. However, their smoking habits remained unchanged, and their coping strategies for stress slightly deteriorated. The Habitual Posture Group (HPG) also showed improvements in healthy behaviors, particularly in fresh produce intake, optimal hydration, and moderation of alcohol use. Similar to the CG, no significant changes were observed in their smoking behavior or stress management strategies.\u003c/p\u003e\u003cp\u003eInterestingly, a greater proportion of students in the CG reported subjective improvements in their overall lifestyle compared to those in the HPG. However, it is important to acknowledge that the HPG consisted of higher-performing students, many of whom were selected by supportive Physical Education teachers. Approximately two-thirds of the HPG were girls, and members of this group generally began the study with a more advanced health behavior profile.\u003c/p\u003e\u003cp\u003eThe lack of change in smoking behavior in both groups may be attributed to the already low frequency of reported smoking at baseline. It is also plausible that some students were not fully honest in their responses, possibly concealing their smoking behavior due to fear of repercussions from teachers or parents. This limitation is consistent with common challenges in self-reported data collection related to sensitive topics.\u003c/p\u003e\u003cp\u003eFewer students in the CG reported actively monitoring their posture during the program, which is not surprising. Although this group received information about correct posture and participated in posture-related physical exercises, they were not exposed to targeted self-awareness strategies. While the CG showed general improvement in locomotor tests, statistically significant gains were only observed in back muscle endurance. In contrast, members of the HPG were encouraged to repeatedly monitor and correct their posture throughout the day, particularly through engaging the abdominal and gluteal muscles to control pelvic alignment. Over one-quarter of the HPG reported regular posture monitoring, and this group showed significant improvements in both abdominal and back muscle endurance. Notably, their baseline results were lower, providing greater potential for measurable improvement.\u003c/p\u003e\u003cp\u003eSelf-assessment and kinesthetic intelligence are essential not only for athletes and artists, but for the general population as well. This study investigated the effects of a health behavior intervention on adolescents, with one key component being the development of self-assessment, as measured by the Body Awareness Questionnaire (BAQ-H). Both groups demonstrated improvement in their self-assessment scores. It is worth noting that the HPG had higher baseline scores than the CG\u0026rsquo;s posttest scores, limiting the magnitude of their observed progress. As previously discussed, the HPG consisted of more motivated and capable students, which may have masked the full impact of the intervention on self-assessment.\u003c/p\u003e\u003cp\u003eDespite this, the overall performance of the HPG in terms of lifestyle improvement and posture development exceeded that of the CG. Taken together, these findings support the conclusion that, beyond providing information and instructions, the development of health behavior through pedagogical methods focused on self-assessment can be effective. Tools such as auditory or visual reminders (e.g., mobile phone alerts) can facilitate this process in practical settings. The results underscore the need for health behavior interventions among adolescents and highlight the importance of considering not only age, socioeconomic status, and school location, but also students\u0026rsquo; learning attitudes when designing such programs.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: This study was conducted in accordance with the principles of the Declaration of Helsinki. The study received approval from the Institutional Review Board of Eszterh\u0026aacute;zy K\u0026aacute;roly Catholic University (Approval ID: RK/1243/2021). Prior to the intervention, written informed consent was obtained from all participants as well as from their parents or legal guardians during a teacher\u0026ndash;parent conference held at the respective schools. The consent process included detailed information about the nature and scope of the intervention. Participants and their parents or guardians were fully informed about the purpose of the study, the voluntary nature of participation, the intended use of the data, and the measures taken to ensure anonymity and confidentiality. They were also made aware of any potential risks associated with participation.\u003c/p\u003e\n\u003cp\u003eConsent for publication: All authors have approved the final version of the manuscript, take responsibility for the work, and agree with its submission to BMC Public Health.\u003c/p\u003e\n\u003cp\u003eAvailability of data and material: The data will be available and transparent.\u003c/p\u003e\n\u003cp\u003eCompeting interest: On behalf of all authors, the corresponding author states that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003eFunding: The authors declare that they received no funding for this study.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbonyi, Barbara: research concept, design of the work, literature review, data collection, interpretation of data, drafting the work, final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003eBogn\u0026aacute;r, J\u0026oacute;zsef: research concept, interpretation of data, reviewing the draft, final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003eSimon, Istv\u0026aacute;n: literature review, interpretation of data, drafting the work, final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003eAcknowledgements: the authors thank for all the participants for being part in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cstrong\u003eFeil, K.; Allion, S., Weyland, S., Jekauc, D.\u0026nbsp;\u003c/strong\u003e(2021): A Systematic Review Examining the Relationship Between Habit and Physical Activity Behavior in Longitudinal Studies. 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N., Godeau, E., the International HBSC Network Coordinating Comittee\u003c/strong\u003e(2009):\u003cem\u003eThe Health Behaviour in School-aged Children: WHO Collaborative Cross-National (HBSC) Study: origins, concept, history and development 1982\u0026ndash;2008\u003c/em\u003e In: International Journal of Public Health \u0026middot; August 2009 DOI: 10.1007/s00038-009-5404- Source: PubMed pp.131-139. https://www.researchgate.net/publication/26702138_The_Health_Behaviour_in_School-aged_Children_WHO_Collaborative_Cross-National_HBSC_Study_Origins_concept_history_and_development_1982-2008\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eEuropean Commission 2025 https://national-policies.eacea.ec.europa.eu/youthwiki/chapters/hungary/7-health-and-well-being\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eMartins, J.; Marques, A.; Gouveia, \u0026Eacute;.R.; Carvalho, F.; Sarmento, H.; Valerio, M. 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In: Slovenian Journal of Public Health 2021 Oct 20;60 (4):244\u0026ndash;252. doi: 10.2478/sjph-2021-0033 https://pmc.ncbi.nlm.nih.gov/articles/PMC8643116/ Retrieved: 2025. 06. 04.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eClark N., Pethick J, Falla D.\u003c/strong\u003e (2023): Measuring complexity of muscle force control: Theoretical principles and clinical relevance in musculoskeletal research and practice. In: Musculoskeletal Science and Practice Volume 64, April 2023, 102725 https://www.sciencedirect.com/science/article/pii/S2468781223000103 Retrieved: 2023. 08. 08.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eWilmore, J. H.\u003c/strong\u003e (1996): Training for sport and activity. Human Kinetics, Champaign, p. 137 https://health.gov/sites/default/files/2019-09/2015-2020_Dietary_Guidelines.pdf pp. 14-19 Retrieved: 2023.07.31.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFerreira E. A. G., Duarte M., Maldonado E. P., Burke T. N., Marques A. P.\u0026nbsp;\u003c/strong\u003e(2010):\u003cem\u003e\u0026nbsp;Postural assessment software (PAS/SAPO): validation and reliabiliy.\u0026nbsp;\u003c/em\u003eIn:ClinicalSciences Clinics 65 (7) 2010 \u003cu\u003ehttp://www.scielo.br/j/clin/a/pyLZn49HyjSXmJBtBrHqSYF/?lang=en\u003c/u\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eK\u0026ouml;teles F.\u0026nbsp;\u003c/strong\u003e(2014):Psychometric investigation of the Hungarian version of the Body Awareness Questionnaire (BAQ-H) among yoga practitioners and young adult controls. In: December 2014. Ment\u0026aacute;lhigi\u0026eacute;n\u0026eacute; es Pszichoszomatika 15(4):373-391 DOI:10.1556/Mental.15.2014.4.4 https://www.researchgate.net/publication/277923795_Psychometric_investigation_of_the_Hungarian_version_of_the_Body_Awareness_Questionnaire_BAQ-H_among_yoga_practitioners_and_young_adult_controls Retrieved: 2025. 06. 04.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eBoyle M.\u003c/strong\u003e (2016): \u003cem\u003eNew functional training for sports\u003c/em\u003e. Human Kinetics pp.1-3\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSomhegyi A\u003c/strong\u003e. (2022):Posture correction as part of holistic health promotion in Hungarian schools. In: Ideggy\u0026oacute;gy\u0026aacute;szati Szemle 75(5-6):151-161 May 2022 DOI:10.18071/isz.75.0151 https://www.researchgate.net/publication/360865627_Posture_correction_as_part_of_holistic_health_promotion_in_Hungarian_schools Retrieved: 2025. 06. 04.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"health behaviour, healthy habits, posture, self-assessment","lastPublishedDoi":"10.21203/rs.3.rs-7753463/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7753463/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe present study aimed to demonstrate the pedagogical value of developing self-assessment skills among high school students. In addition, the research investigated whether posture training could positively influence both self-assessment and health-related behaviors. The underlying assumption was that beyond merely providing theoretical knowledge and instructions regarding a healthy lifestyle, it is essential to support students in internalizing and adopting these behaviors as part of their daily routines. In fostering health-conscious behavior, self-regulation and self-control were considered particularly important alongside formal instruction.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA total of 169 high school students (69 boys and 100 girls) from three secondary schools in Budapest, Hungary, participated in the study (Mage\u0026thinsp;=\u0026thinsp;16.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64). Participants were assigned to either a Habitual Posture Group (HPG) or a Control Group (CG), the intervention program lasted for 7 weeks. Data collection involved the use of questionnaires (including the Body Assessment Questionnaire \u0026ndash; BAQ), locomotor function tests, and self-report surveys, administered both before and after the intervention. Data analysis was conducted using SPSS version 25.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFollowing the intervention, both groups reported increased consumption of fruits, vegetables, and water, as well as decreased alcohol intake. The HPG showed greater improvement in strength exercises and stress management strategies. While both groups demonstrated significant gains in back muscle strength, only the HPG showed a significant increase in abdominal muscle strength in the posttest. Interestingly, the CG showed more marked improvements on the BAQ, likely due to their lower initial scores.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe findings support the effectiveness of self-assessment as a pedagogical method in promoting health behaviour among adolescents. In addition to factors such as age, socioeconomic background, and school environment, students' learning attitudes should be taken into account in future psychological and educational research.\u003c/p\u003e","manuscriptTitle":"High school health education: focus on the development of self-controlling","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-19 04:57:05","doi":"10.21203/rs.3.rs-7753463/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-16T17:21:47+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-01T17:12:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"163320022141565445163747775642150642316","date":"2025-11-21T16:06:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-21T15:48:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89806128296758667723267480856910498393","date":"2025-11-20T07:39:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-10T06:25:33+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-10T14:46:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-08T00:13:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-08T00:12:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-09-30T16:13:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d087a58a-02c2-49f3-81a7-bbdfd2b875a7","owner":[],"postedDate":"November 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-13T16:04:29+00:00","versionOfRecord":{"articleIdentity":"rs-7753463","link":"https://doi.org/10.1186/s12889-026-27180-z","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2026-04-09 15:59:03","publishedOnDateReadable":"April 9th, 2026"},"versionCreatedAt":"2025-11-19 04:57:05","video":"","vorDoi":"10.1186/s12889-026-27180-z","vorDoiUrl":"https://doi.org/10.1186/s12889-026-27180-z","workflowStages":[]},"version":"v1","identity":"rs-7753463","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7753463","identity":"rs-7753463","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}