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Tourism in the Spanish economy represents 11% of the GDP (INE, 2018). Its sun and beach tourism model has diversified into other products, such as cultural tourism, that has been increasing in recent years. The objective of this research is to develop a structural model that measures the behaviour of cultural tourists, to help better understand the main variables affecting their loyalty to a destination, travelling within Spain. After reviewing the scientific literature, a hypothetical-deductive method has been used that focussed on the importance of considering the customer’s experience, proposes a set of working hypotheses, contrasted by means of an analysis of the structural equations model (SEM), estimated taking the data from the Resident Tourism Survey/ FAMILITUR of the National Statistics Institute (INE). The model confirms the importance of socio-cultural variables and the experience of tourists in loyalty-building and the zero importance of the spend in this relationship. This paper analyses the new segments of tourist demand, with a view to the results obtained assisting in the design of differentiated marketing strategies to increase the repetition of the cultural tourisms visits to the same destination and, therefore customer loyalty.

Tourism in the Spanish economy represents 11% of the GDP (INE, 2018). Its sun and beach tourism model has diversified into other products, such as cultural tourism, that has been increasing in recent years. The objective of this research is to develop a structural model that measures the behaviour of cultural tourists, to help better understand the main variables affecting their loyalty to a destination, travelling within Spain. After reviewing the scientific literature, a hypothetical-deductive method has been used that focussed on the importance of considering the customer’s experience, proposes a set of working hypotheses, contrasted by means of an analysis of the structural equations model (SEM), estimated taking the data from the Resident Tourism Survey/ FAMILITUR of the National Statistics Institute (INE). The model confirms the importance of socio-cultural variables and the experience of tourists in loyalty-building and the zero importance of the spend in this relationship. This paper analyses the new segments of tourist demand, with a view to the results obtained assisting in the design of differentiated marketing strategies to increase the repetition of the cultural tourisms visits to the same destination and, therefore customer loyalty.

[EN] Introduction In spite of the relationship existing between exposure to physical workload and incidence of injuries, the aspects related with work activity has been sufficiently considered in studies on the effectiveness of back schools. This study has aimed to evaluate the effectiveness of a back school program oriented at workers, analyzing variables associated with exposure to physical workload. Material and methods A total of 319 subjects with low back pain or neck pain participating in the back school between November 2006 and November 2009 were included. The effectiveness of the back school was evaluated by means of a patient satisfaction questionnaire, and by assessment of pain and impairment with the Visual Analogue Scale (VAS) and Oswestry questionnaire, respectively. Results We have identified two workload factors related to pain and impairment at the beginning of the treatment. The comparison of VAS and Oswestry scores before and after the program shows significant improvement. However, this improvement is associated with the initial scores and with physical workload factors. Conclusions It is possible that the improvement with unspecific measures as training and exercises in a back school may not be equally effective for patients who are exposed to greater physical demands at work., [ES] Introducción A pesar de la relación existente entre la exposición a carga física en el trabajo y la incidencia de lesiones, los aspectos relacionados con la actividad laboral no han sido suficientemente considerados en los estudios sobre la eficacia de las escuelas de espalda (EE). El objetivo del presente trabajo es analizar el efecto de las variables asociadas a la exposición a carga física en el trabajo sobre la eficacia de un programa de EE orientado a trabajadores. Material y métodos Se incluyó a 319 sujetos con lumbalgia o cervicalgia que participaron en la Escuela de Espalda de Ibermutuamur durante un periodo de 3 años (2006-2009). La efectividad de la EE se ha evaluado mediante cuestionarios de satisfacción, así como a partir de la mejora funcional y el dolor. Resultados Se han identificado dos factores asociados a la carga física relacionados con la incapacidad y el dolor al iniciar el tratamiento. La comparación entre los valores iniciales y finales de las puntuaciones de la escala visual analógica (EVA) y del cuestionario de Oswestry muestra una mejora significativa tras el programa de EE. Sin embargo, dicha mejora está relacionada con la situación inicial y con la exposición a los factores de carga en el trabajo. Conclusiones Es posible que las mejoras asociadas a medidas generales, como la formación y los ejercicios propuestos en una escuela de espalda, no sean igualmente eficaces para trabajadores que parten de una situación funcional peor o que están expuestos a mayor carga física en el trabajo.

[EN] Introduction In spite of the relationship existing between exposure to physical workload and incidence of injuries, the aspects related with work activity has been sufficiently considered in studies on the effectiveness of back schools. This study has aimed to evaluate the effectiveness of a back school program oriented at workers, analyzing variables associated with exposure to physical workload. Material and methods A total of 319 subjects with low back pain or neck pain participating in the back school between November 2006 and November 2009 were included. The effectiveness of the back school was evaluated by means of a patient satisfaction questionnaire, and by assessment of pain and impairment with the Visual Analogue Scale (VAS) and Oswestry questionnaire, respectively. Results We have identified two workload factors related to pain and impairment at the beginning of the treatment. The comparison of VAS and Oswestry scores before and after the program shows significant improvement. However, this improvement is associated with the initial scores and with physical workload factors. Conclusions It is possible that the improvement with unspecific measures as training and exercises in a back school may not be equally effective for patients who are exposed to greater physical demands at work., [ES] Introducción A pesar de la relación existente entre la exposición a carga física en el trabajo y la incidencia de lesiones, los aspectos relacionados con la actividad laboral no han sido suficientemente considerados en los estudios sobre la eficacia de las escuelas de espalda (EE). El objetivo del presente trabajo es analizar el efecto de las variables asociadas a la exposición a carga física en el trabajo sobre la eficacia de un programa de EE orientado a trabajadores. Material y métodos Se incluyó a 319 sujetos con lumbalgia o cervicalgia que participaron en la Escuela de Espalda de Ibermutuamur durante un periodo de 3 años (2006-2009). La efectividad de la EE se ha evaluado mediante cuestionarios de satisfacción, así como a partir de la mejora funcional y el dolor. Resultados Se han identificado dos factores asociados a la carga física relacionados con la incapacidad y el dolor al iniciar el tratamiento. La comparación entre los valores iniciales y finales de las puntuaciones de la escala visual analógica (EVA) y del cuestionario de Oswestry muestra una mejora significativa tras el programa de EE. Sin embargo, dicha mejora está relacionada con la situación inicial y con la exposición a los factores de carga en el trabajo. Conclusiones Es posible que las mejoras asociadas a medidas generales, como la formación y los ejercicios propuestos en una escuela de espalda, no sean igualmente eficaces para trabajadores que parten de una situación funcional peor o que están expuestos a mayor carga física en el trabajo.