Description:
After we developed FootyFirst and produced a draft program manual, we actively sought input from community football coaches, players, administrators and sports trainers. Two focus groups were conducted to seek feedback on how the program was presented (general impressions, text, images, etc), potential barriers to the program being widely used in community football, and strategies to reduce/overcome these. Feedback indicated that the type and level of the exercises within FootyFirst had been pitched at the right level and that the program was easy to follow and understand. The main concern was it would take too much time for community football players to complete the FootyFirst program, particularly given that most community football teams train only twice a week for about 90 minutes. Focus group participants suggested that the maximum time available in a typical training session for this type of program would be about 20 minutes. A range of questions and concerns were also raised including; Will the program work? Why should it be done? Are players likely to become fatigued and more prone to injury in their regular football training after completing FootyFirst? The focus group participants also indicated that endorsement of FootyFirst by a highly respected individual or organisation from within the elite AFL community would be a powerful influence on community coaches and players.
Description:
Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program (FootyFirst) for community Australian football. Methods: The intervention development process is underpinned by 2 complementary premises: (1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and (2) that research evidence alone is insufficient to develop implementable interventions. Results: The generalizable 6-step intervention development process involves (1) compiling research evidence, clinical experience, and knowledge of the implementation context; (2) consulting with experts; (3) engaging with end users; (4) testing the intervention; (5) using theory; and (6) obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For FootyFirst, this process involved establishing a multidisciplinary intervention development group, conducting 2 targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program. Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development.
Description:
Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program (FootyFirst) for community Australian football. Methods: The intervention development process is underpinned by 2 complementary premises: (1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and (2) that research evidence alone is insufficient to develop implementable interventions. Results: The generalizable 6-step intervention development process involves (1) compiling research evidence, clinical experience, and knowledge of the implementation context; (2) consulting with experts; (3) engaging with end users; (4) testing the intervention; (5) using theory; and (6) obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For FootyFirst, this process involved establishing a multidisciplinary intervention development group, conducting 2 targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program. Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development. (C) 2016 Production and hosting by Elsevier B.V. on behalf of Shanghai University of Sport.
Description:
Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program (FootyFirst) for community Australian football. Methods: The intervention development process is underpinned by 2 complementary premises: (1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and (2) that research evidence alone is insufficient to develop implementable interventions. Results: The generalizable 6-step intervention development process involves (1) compiling research evidence, clinical experience, and knowledge of the implementation context; (2) consulting with experts; (3) engaging with end users; (4) testing the intervention; (5) using theory; and (6) obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For FootyFirst, this process involved establishing a multidisciplinary intervention development group, conducting 2 targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program. Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development.
Description:
Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program (FootyFirst) for community Australian football. Methods: The intervention development process is underpinned by 2 complementary premises: (1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and (2) that research evidence alone is insufficient to develop implementable interventions. Results: The generalizable 6-step intervention development process involves (1) compiling research evidence, clinical experience, and knowledge of the implementation context; (2) consulting with experts; (3) engaging with end users; (4) testing the intervention; (5) using theory; and (6) obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For FootyFirst, this process involved establishing a multidisciplinary intervention development group, conducting 2 targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program. Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development. (C) 2016 Production and hosting by Elsevier B.V. on behalf of Shanghai University of Sport.
Description:
BACKGROUND AND AIM: The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. METHODS: An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. RESULTS: An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. CONCLUSIONS: A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context.
Description:
BACKGROUND AND AIM: The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. METHODS: An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. RESULTS: An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. CONCLUSIONS: A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context.
Description:
Translating research evidence into sustained improvements in population health outcomes is a current priority across many health research fields including sports medicine,1 injury prevention2 and physical activity promotion.3 Both the ‘traditional’ approach of publishing sports injury research findings in peer-reviewed journals and hoping for the best, and the more sophisticated approach of developing and disseminating consensus statements and related sport safety guidelines have been relatively unsuccessful to date.
Description:
Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
Description:
Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
Description:
Anterior cruciate ligament (ACL) injury rates have increased by ∼50% over the last 10 years. These figures suggest that ACL focused research has not been effective in reducing injury rates among community level athletes. Training protocols designed to reduce ACL injury rates have been both effective (n = 3) and ineffective (n = 7). Although a rationale for the use of exercise to reduce ACL injuries is established, the mechanisms by which they act are relatively unknown. This article provides an injury prevention framework specific to noncontact ACL injuries and the design of prophylactic training protocols. It is also apparent that feedback within this framework is needed to determine how biomechanically relevant risk factors like peak joint loading and muscular support are influenced following training. It is by identifying these links that more effective ACL injury prevention training programs can be developed, and, in turn, lead to reduced ACL injury rates in the future.
Description:
Purpose: Determine if balance and technique training (BTT) implemented adjunct to normal Australian football (AF) training reduces external knee loading during sidestepping. Additionally, the authors determined if an athlete's knee joint kinematics and kinetics change over a season of AF. Methodology: Eight amateur-level AF clubs (n=1,001 males) volunteered to participate in either 28 weeks of BTT or a ‘sham’ training (ST) adjunct to their normal preseason and regular training. A subset of 34 athletes (BTT, n=20; ST, n=14) were recruited for biomechanical testing in weeks 1–7 and 18–25 of the 28-week training intervention. During biomechanical testing, participants completed a series running, preplanned (PpSS) and unplanned sidestepping (UnSS) tasks. A linear mixed model (a=0.05) was used to determine if knee kinematics and peak moments during PpSS and UnSS were influenced by BTT and/or a season of AF Results: Both training groups significantly (p=0.025) decreased their peak internal-rotation knee moments during PpSS, and significantly (p=0.022) increased their peak valgus knee moments during UnSS following their respective training interventions. Conclusions: BTT was not effective in changing an athlete's knee joint biomechanics during sidestepping when conducted in ‘real-world’ training environments. Following normal AF training, the players had different changes to their knee joint biomechanics during both preplanned and unplanned sidestepping. When performing an unplanned sidestepping task in the latter half of a playing season, athletes are at an increased risk of ACL injury. The authors therefore recommend both sidestepping tasks are performed during biomechanical testing when assessing the effectiveness of prophylactic training protocols.
Description:
Objective: Over recent years, there has been increasing attention given to preventing falls and falls injury in older people through policy and other initiatives. This paper presents a baseline set of fall injury outcome indicators against which these preventive efforts can be assessed in terms of monitoring the rate of fall-related deaths and hospitalisations. Methods: ICD-10-AM coded hospital separations, Australian Bureau of Statistics (ABS) mortality and ABS population data were used to determine the rate of fall-related injury mortality and hospitalisations occurring in people aged 65+ years in New South Wales (NSW), Australia, over the six-year period from 1998/99 to 2003/04, inclusive. Results: Baseline trends for one fatality and five separations-based metrics are presented. Overall, fall mortality rates increased over the six years, with higher rates in males. Falls hospitalisation rates also increased slightly, with higher rates in females. The rates of hip fracture and pelvic fracture hospital separations generally declined over the six years and were highest in females. The level of unspecified and missing information about the place where falls occur increased by 1.5%. Conclusion: Baseline trends in fall injury outcome metrics highlight the severity and frequency of fall injuries before wide scale implementation of the Management Policy to Reduce Fall Injury Among Older People in NSW. Implications: Future use of these metrics will help to evaluate and monitor the progress of falls prevention in older people in NSW. They could also be adopted in other jurisdictions.
Description:
Objective: Over recent years, there has been increasing attention given to preventing falls and falls injury in older people through policy and other initiatives. This paper presents a baseline set of fall injury outcome indicators against which these preventive efforts can be assessed in terms of monitoring the rate of fall-related deaths and hospitalisations. Methods: ICD-10-AM coded hospital separations, Australian Bureau of Statistics (ABS) mortality and ABS population data were used to determine the rate of fall-related injury mortality and hospitalisations occurring in people aged 65+ years in New South Wales (NSW), Australia, over the six-year period from 1998/99 to 2003/04, inclusive. Results: Baseline trends for one fatality and five separations-based metrics are presented. Overall, fall mortality rates increased over the six years, with higher rates in males. Falls hospitalisation rates also increased slightly, with higher rates in females. The rates of hip fracture and pelvic fracture hospital separations generally declined over the six years and were highest in females. The level of unspecified and missing information about the place where falls occur increased by 1.5%. Conclusion: Baseline trends in fall injury outcome metrics highlight the severity and frequency of fall injuries before wide scale implementation of the Management Policy to Reduce Fall Injury Among Older People in NSW. Implications: Future use of these metrics will help to evaluate and monitor the progress of falls prevention in older people in NSW. They could also be adopted in other jurisdictions.
Description:
Background Clinically it is understood that rapid increases in training loads expose an athlete to an increased risk of injury; however, there are no systematic reviews to qualify this statement. Objective The aim of this systematic review was to determine training and competition loads, and the relationship between injury, illness and soreness. Methods The MEDLINE, SPORTDiscus, CINAHL and EMBASE databases were searched using a predefined search strategy. Studies were included if they analysed the relationship between training or competition loads and injury or illness, and were published prior to October 2015. Participants were athletes of any age or level of competition. The quality of the studies included in the review was evaluated using the Newcastle-Ottawa Scale (NOS). The level of evidence was defined as strong, 'consistent findings among multiple high-quality randomised controlled trials (RCTs)'; moderate, 'consistent findings among multiple low-quality RCTs and/or non-randomised controlled trials (CCTs) and/or one high-quality RCT'; limited, 'one low-quality RCT and/or CCTs, conflicting evidence'; conflicting, 'inconsistent findings among multiple trials (RCTs and/or CCTs)'; or no evidence, 'no RCTs or CCTs'. Results A total of 799 studies were identified; 23 studies met the inclusion criteria, and a further 12 studies that were not identified in the search but met the inclusion criteria were subsequently added to the review. The largest number of studies evaluated the relationship between injuries and training load in rugby league players (n = 9) followed by cricket (n = 5), football (n = 3), Australian Football (n = 3), rugby union (n = 2), volleyball (n = 2), baseball (n = 2), water polo (n = 1), rowing (n = 1), basketball (n = 1), swimming (n = 1), middle-distance runners (n = 1) and various sports combined (n = 1). Moderate evidence for a significant relationship was observed between training loads and injury incidence in the majority of studies (n = 27, 93 %). In addition, moderate evidence exists for a significant relationship between training loads and illness incidence (n = 6, 75 %). Training loads were reported to have a protective effect against injury (n = 9, 31 %) and illness (n = 1, 13 %). The median (range) NOS score for injury and illness was 8 (5-9) and 6 (5-9), respectively. Limitations A limitation of this systematic review was the a priori search strategy. Twelve further studies were included that were not identified in the search strategy, thus potentially introducing bias. The quality assessment was completed by only one author. Conclusions The results of this systematic review highlight that there is emerging moderate evidence for the relationship between the training load applied to an athlete and the occurrence of injury and illness. Implications The training load applied to an athlete appears to be related to their risk of injury and/or illness. Sports science and medicine professionals working with athletes should monitor this load and avoid acute spikes in loads. It is recommended that internal load as the product of the rate of perceived exertion (10-point modified Borg) and duration be used when determining injury risk in team-based sports. External loads measured as throw counts should also be monitored and collected across a season to determine injury risk in throwing populations. Global positioning system-derived distances should be utilised in team sports, and injury monitoring should occur for at least 4 weeks after spikes in loads.
Description:
Training loads contribute to sports injury risk but their mitigation has rarely been considered in a sports injury prevention framework. A key concept behind monitoring training loads for injury prevention is to screen for those at increased risk of injury so that workloads can be adjusted to minimise these risks. This review describes how advances in management of workload can be applied as a preventive measure. Primary prevention involves screening for preparticipation load risk factors, such as low training loads, prior to a training period or competition. Secondary prevention involves screening for workloads that are known to precede an injury developing so that modification can be undertaken to mitigate this risk. Tertiary prevention involves rehabilitation practices that include a graded return to training programme to reduce the risk of sustaining a subsequent injury. The association of training loads with injury incidence is now established. Prevention measures such as rule changes that affect the workload of an athlete are universal whereas those that address risk factors of an asymptomatic subgroup are more selective. Prevention measures, when implemented for asymptomatic individuals exhibiting possible injury risk factors, are indicated for an athlete at risk of developing a sports injury. Seven key indicated risks and associated prevention measures are proposed.
Description:
Objective: To analyse changes in the incidence of injuries requiring hospitalisation for child passengers in motor vehicle crashes. Design, setting and participants: Population-based study of children (aged 0-15 years) residing in New South Wales and admitted to hospital for injuries resulting from a traffic crash in the period 1 July 1998 - 30 June 2005, identified from the NSW Inpatient Statistics Collection. Main outcome measures: Age-standardised rates of hospitalisation for injuries, and trends by inpatient demographics, severity of injuries, and injury sites and types. Results: 2297 children were hospitalised for injuries sustained in a motor vehicle crash over the study period. The overall hospitalisation rate for injuries was relatively constant, with a non-significant decline of -0.4% (95% Cl, -3.1% to 2.3%). The rate of hospitalisation for serious injuries also declined non-significantly (-5.5% [95% Cl, -11.8% to 1.1%]). Only hospitalisation rates for traumatic brain injuries declined significantly (-11.1% [95% Cl, -19.0% to -2.8%]) over the study period. Conclusion: The rate of hospitalisation for injuries to NSW-resident child motor vehicle passengers due to traffic crashes has not significantly decreased. High hospitalisation rates and the subsequent burden to the community and public health system make further injury prevention efforts for child motor vehicle passengers a priority.
Description:
Objective: To analyse changes in the incidence of injuries requiring hospitalisation for child passengers in motor vehicle crashes. Design, setting and participants: Population-based study of children (aged 0-15 years) residing in New South Wales and admitted to hospital for injuries resulting from a traffic crash in the period 1 July 1998 - 30 June 2005, identified from the NSW Inpatient Statistics Collection. Main outcome measures: Age-standardised rates of hospitalisation for injuries, and trends by inpatient demographics, severity of injuries, and injury sites and types. Results: 2297 children were hospitalised for injuries sustained in a motor vehicle crash over the study period. The overall hospitalisation rate for injuries was relatively constant, with a non-significant decline of -0.4% (95% Cl, -3.1% to 2.3%). The rate of hospitalisation for serious injuries also declined non-significantly (-5.5% [95% Cl, -11.8% to 1.1%]). Only hospitalisation rates for traumatic brain injuries declined significantly (-11.1% [95% Cl, -19.0% to -2.8%]) over the study period. Conclusion: The rate of hospitalisation for injuries to NSW-resident child motor vehicle passengers due to traffic crashes has not significantly decreased. High hospitalisation rates and the subsequent burden to the community and public health system make further injury prevention efforts for child motor vehicle passengers a priority.
Description:
Objective: To investigate the association between restraint use and death in rear-seated child passengers and to examine whether the estimated association varies by restraint type and age. Design: Matched cohort study. Setting: All reported crashed passenger vehicles with at least 2 rear-seated child passengers of whom at least 1 died from the US Fatality Analysis Reporting System for 1998 to 2006. Participants: Rear-seated child passengers aged 2 to 6 years. Interventions: Three models of restraint use: (1) no restraint use, any restraint use; (2) no restraint use, recorded improper restraint use (including improper use of seat belts or child restraints, use of shoulder-only seat belts, and use of an unknown type of restraint), any other restraint use; and (3) no restraint use, improper restraint use, seat belts, and child restraints. Main Outcome Measure: Death within 30 days of a crash. Results: Compared with no restraint use, being restrained reduced the risk of death in rear-seated child passengers (relative risk [RR], 0.33; 95% confidence interval [CI], 0.22-0.49). Compared with improper restraint use, any other restraint use reduced the risk of death (RR, 0.46; 95% CI, 0.20-0.63). The RR of death for using child restraints compared with seat belts was 0.91 (95% CI, 0.57-1.14). Child restraints performed slightly better in fatality risk reduction in children aged 2 to 3 years (RR, 0.24; 95% CI, 0.09-0.33) than in children aged 4 to 6 years (RR, 0.32; 95% CI, 0.11-0.44) compared with traveling unrestrained. Conclusions: This study demonstrates the protective effects of restraints for child passengers and highlights the importance of using restraints correctly.
Comparison of methods to correct the miscounting of multiple episodes of care when estimating the incidence of hospitalised injury in child motor vehicle passengers
Description:
Objective: To evaluate the protective eyewear promotion (PEP) project, which was a comprehensive educational strategy to increase the use of appropriate protective eyewear by squash players. Methods: An ecological study design was used. Four squash venues in one playing association were randomly chosen to receive PEP and four in another association maintained usual practice and hence formed a control group. The primary evaluation measurements were surveys of cross sectional samples of players carried out before and after the intervention. The surveys investigated players’ knowledge, behaviours, and attitudes associated with the use of protective eyewear. The survey carried out after the intervention also determined players’ exposure to PEP. Univariate and multivariate analyses were undertaken to describe differences at PEP venues from pre- to post-intervention and to compare these with the control venues. Results: The PEP players had 2.4 times the odds (95% confidence interval, 1.3 to 4.2) of wearing appropriate eyewear compared with control group players post-intervention, relative to the groups’ preintervention baselines. Components of PEP, such as stickers and posters and the availability and prominent positioning of the project eyewear, were found to contribute to players adopting favourable eyewear behaviours. Conclusions: Components of the PEP intervention were shown to be effective. The true success will be the sustainability and dissemination of the project, favourable eyewear behaviours, and evidence of the prevention of eye injuries long into the future.
Description:
Objective: To evaluate the protective eyewear promotion (PEP) project, which was a comprehensive educational strategy to increase the use of appropriate protective eyewear by squash players. Methods: An ecological study design was used. Four squash venues in one playing association were randomly chosen to receive PEP and four in another association maintained usual practice and hence formed a control group. The primary evaluation measurements were surveys of cross sectional samples of players carried out before and after the intervention. The surveys investigated players’ knowledge, behaviours, and attitudes associated with the use of protective eyewear. The survey carried out after the intervention also determined players’ exposure to PEP. Univariate and multivariate analyses were undertaken to describe differences at PEP venues from pre- to post-intervention and to compare these with the control venues. Results: The PEP players had 2.4 times the odds (95% confidence interval, 1.3 to 4.2) of wearing appropriate eyewear compared with control group players post-intervention, relative to the groups’ preintervention baselines. Components of PEP, such as stickers and posters and the availability and prominent positioning of the project eyewear, were found to contribute to players adopting favourable eyewear behaviours. Conclusions: Components of the PEP intervention were shown to be effective. The true success will be the sustainability and dissemination of the project, favourable eyewear behaviours, and evidence of the prevention of eye injuries long into the future.
Description:
The use of appropriate eyewear in squash can protect the eyes against injury. However, few adult squash players adequately protect their eyes against potential severe injuries. We describe the characteristics of non-users of protective eyewear and examine predictors of appropriate eyewear use. Self-report surveys of adult players were conducted in metropolitan Melbourne, Australia. Information on players' knowledge, behaviours and attitudes associated with protective eyewear use was collected, in addition to player demographic data. Appropriate eyewear was defined as Standards-approved polycarbonate lens eyewear. The majority 92.2% of players did not adequately protect their eyes while playing squash. Significant predictors of reported eyewear use were: previous eye injury; playing squash on average more than 2 hr per wk; having played for more than 20 y; and having more favourable attitudes towards eye safety in squash. The significant predictors of appropriate eyewear use were: being female; previous eye injury; playing squash on average more than 2 hr per week; and having more favourable attitudes towards eye safety in squash. Understanding the characteristics of both users and non-users of appropriate eye protection in squash is essential for informing future prevention strategies.
Description:
Self-report surveys are a common method of collecting data on protective equipment use in sport. The aim of this study was to assess the validity of self-reported use of appropriate protective eyewear by squash players. Surveys of squash players' appropriate protective eyewear behaviours were conducted over two consecutive years (2002 and 2003) at randomly-selected squash venues in Melbourne, Australia. Over the two years, 1219 adult players were surveyed (response rate of 92%). Trained observers also recorded the actual oncourt appropriate protective eyewear behaviours of all players during the survey sessions. Eyewear use rates calculated from both data sources were compared. The self-reported appropriate protective eyewear use rate (9.4%; 95% CI 7.8, 11.0) was significantly higher (1.6 times more) than the observed rate (5.9%; 95%CI 4.6, 7.2). This suggests that players may over-report their use of appropriate protective equipment, though some may have incorrectly classified their eyewear as being appropriate or suitably protective. Studies that rely only on self-report data on protective equipment use need to take into account that this could lead to biased estimates.