Title Development of the Young Spine Questionnaire Authors & Affiliations Henrik Hein Lauridsen1, Lise Hestbæk1,2 1. Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Clinical Locomotion Network, Campusvej 55, DK-5230 Odense M, Denmark 2. Nordic Institute of Chiropractic and Clinical Biomechanics, Clinical Locomotion Network, Forskerparken 10A, 5230 Odense M, Denmark Background Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood. Therefore preventive efforts must be targeted the young population but research relating to spinal problems in this age group is scarce. Focus has primarily been on the working age population, and therefore specific instruments to measure spinal pain and its consequences, specifically aimed at children and adolescents are absent. The purpose of this study was to develop an instrument for children aged 9-12 years which could fill this gap in the literature. Methods The Young Spine Questionnaire (YSQ) was developed in three phases – the conceptualisation, development and testing phase. We used the conceptual model of Wilson and Cleary (1995) and divided the YSQ into two parts: part one included spinal prevalence estimates (including pictures of spinal area) and part two questions regarding pain, activity restrictions, care seeking behaviour and influence of parental back trouble. During the developing phase we used an iterative process to carefully rephrase existing items used in prior questionnaires such as the Standardised Nordic Questionnaire. To measure pain the “Revised Faces Pain Scale” (rFPS) was included. The testing phase consisted of an iterative method assessing respondent understanding during two pilot tests. In the first pilot test 52 4th grade children filled in the draft version of the YSQ. This was followed by a semi-structured interview two days later designed to obtain the same information as contained in the YSQ, however, using different semantics and open-ended questions. The revised questionnaire was tested and reviewed a second time at the end of the first pilot test. The second pilot test included 23 children from the 4th grade. It followed similar procedures as the first pilot test but focused mainly on revised versions of the drawings demarcating the spinal areas. Results Agreement between the questionnaire prevalence estimates and the interviews ranged between 83.7% (cervical pain today) and 97.9% (thoracic pain today). Correlations between the rFPS and the interview NRS score ranged between 0.71 (cervical spine) and 0.84 (thoracic spine). Agreement between the questionnaire drawings and the interviews of the upper and lower boundaries of the spinal areas were 91.8% for the cervical spine and 67.4% (lumbar spine) and 63.3% (thoracic spine). This resulted in alterations to the drawings. Lastly, as some questions in the second part of the YSQ had a high prevalence of non-responses, it was decided to change question semantics and response options. Conclusion The Young Spine Questionnaire is a novel self-report measure of spinal pain and its consequences. The items have been tested for understanding of content among target respondents, and the results showed acceptable agreement between questionnaire scores and interview findings. On the basis of these preliminary results we conclude that the YSQ is a feasible and valid instrument to be used in cross-sectional cohort studies of children aged 9 to 12 years.