A back education program for Belgian elementary school children was evaluated using self-reported questionnaires before intervention and at three follow-up points during one year. Most children found the program interesting, important, and amusing. Intervention children (n = 347) showed better back care knowledge than control children (n = 359), and knowledge gained was retained over a period of one year. Back education did not result in increased fear-avoidance beliefs about physical activity, and intervention children reported more checking of their book bag weight than controls at all test moments. Self-reported behavior in relation to posture-related and back care related self-efficacy were affected only minimally by the program, possibly due to poor self-judgment. Involvement, fear-avoidance beliefs, and back care knowledge of teachers and parents of the intervention children showed low correlation with the children's perceptions and knowledge. Sufficient promise exists to justify further development and evaluation of early back education.