A school-based posture education program to improve lung function, heart health, and psychological well-being in adolescents

This study implements a structured Posture Education Program (PEP) aimed at improving posture, cardiovascular health, and psychological well-being among high school students. The intervention is delivered over 14 weeks, with one face-to-face group session per week (each session lasting approximately 45–50 minutes). Content of the Intervention: The sessions are interactive and based on evidence-informed practices from physiotherapy, health psychology, and ergonomic guidelines. They include: Posture awareness and ergonomics education (aligned with ICF framework and informed by the American Physical Therapy Association and WHO school health frameworks) Stretching and strengthening exercises for postural muscles Breathing techniques to support lung function Mindfulness and stress-reduction strategies to support psychological well-being Program materials were developed by the research team, validated through the Delphi method, and aligned with clinical guidelines and evidence from studies such as Alves et al. (2020), Macialczyk-Paprocka et al. (2017), and Inagaki et al. (2018). Delivery Mode: Face-to-face in group settings, conducted within secondary school classrooms. Provider Expertise: Delivered by certified physiotherapists and trained PE teachers/health educators experienced in youth health promotion and posture correction strategies. Materials Used: Includes posters, ergonomic toolkits, posture grids, and educational leaflets. Materials are specifically developed for this study based on posture and health education best practices. Where adapted from existing resources. Co-Interventions: Students will continue attending their regular Physical Education (PE) classes as per the school curriculum. The posture program acts as an adjunct intervention and does not replace routine PE. Fidelity Monitoring: Attendance will be tracked using session logs. Students will complete weekly reflection logs summarizing key learnings and behavior changes. Facilitators will use session checklists to ensure consistency in content delivery.