Applying implementation science to sports injury prevention
- Authors: Donaldson, Alex , Finch, Caroline
- Date: 2013
- Type: Text , Editorial , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 8 (2013), p. 473-475
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: Recent commentary in the BJSM has argued that a key challenge for future sports injury prevention is to reduce the ‘research to practice’ gap. Unfortunately, very few examples of this type of research actually exist. In this issue, Myklebust et al describe their approach to anterior cruciate ligament (ACL) injury prevention in Norwegian Handball over the past 13 years. This is one of the first published papers on the long-term outcomes of a sports injury prevention intiative that has shown promising efficacy in controlled trials. While this paper describes an impressive intial research effort and outstanding example of long-term follow-up through an ACL Injury Surveillance Programme, it also highlights challenges associated with conducting sports injury prevention implementation research.
- Description: Editorial
- Description: 2003011041
Concussion guidelines need to move from only expert content to also include implementation and dissemination strategies
- Authors: Finch, Caroline , McCrory, Paul , Ewing, Michael , Sullivan, John
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 1 (2013), p. 12-14
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Sport-related head injuries place a significant burden on the health service delivery systems needed to treat and assess them; the sport delivery systems responsible for providing safe sporting opportunities; and personally on the individuals who sustain them. The number of head injury occurrences, the anecdotally high levels of public concern about the risk of head injury in sport and the fact that there is so much public misinformation about their assessment, management and prevention make the prevention of sport-related head injury a health priority. The most recent international consensus statement on the management of concussion in sport stated that there is a need to develop guidelines, education resources and other health promotion approaches for the prevention of head injury and its adverse outcomes across all sports with a risk of serious head injury.4 However, while there is evidence that some educational resources and guidelines have been developed, these have had varying success because they have not incorporated social marketing approaches.
Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11+) impact team adherence and injury risk in Canadian female youth football players : A cluster-randomised trial
- Authors: Steffen, Kathrin , Meeuwisse, Willem , Romiti, Maria , Kang, Jian , McKay, Carly , Bizzini, Mario , Dvorak, Jiri , Finch, Caroline , Myklebust, Grethe , Emery, Carolyn
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 8 (2013), p. 480-487
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Background Injury prevention programme delivery on adherence and injury risk, specifically involving regular supervisions with coaches and players on programme execution on field, has not been examined. Aim The objective of this cluster-randomised study was to evaluate different delivery methods of an effective injury prevention programme (FIFA 11+) on adherence and injury risk among female youth football teams. Method During the 4-month 2011 football season, coaches and 13-year-old to 18-year-old players from 31 tier 1-3 level teams were introduced to the 11+ through either an unsupervised website ('control') or a coachfocused workshop with ('comprehensive') and without ('regular') additional supervisions by a physiotherapist. Team and player adherence to the 11+, playing exposure, history and injuries were recorded. Results Teams in the comprehensive and regular intervention groups demonstrated adherence to the 11+ programme of 85.6% and 81.3% completion of total possible sessions, compared to 73.5% for teams in the control group. These differences were not statistically significant, after adjustment for cluster by team, age, level and injury history. Compared to players with low adherence, players with high adherence to the 11+ had a 57% lower injury risk (IRR 0.43, 95% CI 0.19 to 1.00). However, adjusting for covariates, this betweengroup difference was not statistically significant (IRR=0.44, 95% CI 0.18 to 1.06). Conclusion Following a coach workshop, coach-led delivery of the FIFA 11+ was equally successful with or without the additional field involvement of a physiotherapist. Proper education of coaches during an extensive preseason workshop was more effective in terms of team adherence than an unsupervised delivery of the 11+ programme to the team.
- Description: 2003011024
Changes in knee joint biomechanics following balance and technique training and a season of Australian football
- Authors: Donnelly, Cyril , Elliot, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 13 (October 2012 2012), p. 917-922
- Full Text: false
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- 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.
Compliance with return-to-play regulations following concussion in Australian schoolboy and community rugby union players
- Authors: Hollis, Stephanie , Stevenson, Mark , McIntosh, Andrew , Shores, E Arthur , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 10 (2012), p. 735-740
- Full Text: false
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- Description: Background: There is a risk of concussion when playing rugby union. Appropriate management of concussion includes compliance with the return-to-play regulations of the sports body for reducing the likelihood of premature return-to-play by injured players. Purpose: To describe the proportion of rugby union players who comply with the sports body's regulations on returning to play postconcussion. Study design: Prospective cohort study. Methods: 1958 community rugby union players (aged 15–48 years) in Sydney (Australia) were recruited from schoolboy, grade and suburban competitions and followed over ≥1 playing seasons. Club doctors/physiotherapists/coaches or trained injury recorders who attended the game reported players who sustained a concussion. Concussed players were followed up over a 3-month period and the dates when they returned to play (including either a game or training session) were recorded, as well as any return-to-play advice they received. Results: 187 players sustained ≥1 concussion throughout the follow-up. The median number of days before players returned to play (competition game play or training) following concussion was 3 (range 1–84). Most players (78%) did not receive return-to-play advice postconcussion, and of those who received correct advice, all failed to comply with the 3-week stand-down regulation. Conclusions: The paucity of return-to-play advice received by community rugby union players postconcussion and the high level of non-compliance with return-to-play regulations highlight the need for better dissemination and implementation of the return-to-play regulations and improved understanding of the underlying causes of why players do not adhere to return-to-play practices.
Do parents' and children's concerns about sports safety and injury risk relate to how much physical activity children do?
- Authors: Telford, Amanda , Finch, Caroline , Barnett, Lisa , Abbott, Gavin , Salmon, Jo
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 15 (2012), p. 1084-1088
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objective: To see whether concerns about injury risk relate to children's physical activity (PA). Methods: Two cohorts were recruited from 19 Australian schools and assessed in 2001 (T1), 2004 (T2) and 2006 (T3). The younger (n=162) was assessed at 6, 9 and 11years old, and the older (n=259) at 11, 14 and 16 years old. At T1 and T2, parents of the younger cohort reported on fear of child being injured, and whether child would be at risk of injury if they played organised sport; the older cohort self-reported injury fear. Accelerometers assessed PA at each time point. Linear regression models examined cross-sectional associations, and also associations between T1 injury fear and risk and T2 PA, and T2 injury fear and risk and T3 PA. Results: In the younger cohort at T2 (9 years), fear and risk were both negatively associated with moderate to vigorous PA (MVPA) (β=−0.17, 95% CI −0.30 to −0.03 and β=−0.26, 95% CI −0.41 to −0.10) and also vigorous PA (VPA). Fear was also associated with moderate PA (MPA). For the older cohort at T1, injury fear was negatively associated with MVPA (β=−0.21, 95% CI −0.35 to −0.07) and also MPA and VPA. Parental perception of risk at T1 (6 years) was negatively associated with children’s MPA at T2 (9 years) (β= −0.17, 95% CI −0.32 to −0.02). Sex did not moderate any association. Conclusions Younger children and their parents need to know which sports have low injury risks. Some children may need increased confidence to participate.
- Description: Objective: To see whether concerns about injury risk relate to children's physical activity (PA). Methods: Two cohorts were recruited from 19 Australian schools and assessed in 2001 (T1), 2004 (T2) and 2006 (T3). The younger (n=162) was assessed at 6, 9 and 11years old, and the older (n=259) at 11, 14 and 16 years old. At T1 and T2, parents of the younger cohort reported on fear of child being injured, and whether child would be at risk of injury if they played organised sport; the older cohort self-reported injury fear. Accelerometers assessed PA at each time point. Linear regression models examined cross-sectional associations, and also associations between T1 injury fear and risk and T2 PA, and T2 injury fear and risk and T3 PA. Results: In the younger cohort at T2 (9 years), fear and risk were both negatively associated with moderate to vigorous PA (MVPA) (
Effect of comorbidity on relative survival following hospitalisation for fall-related hip fracture in older people
- Authors: Hindmarsh, Diane , Loh, Ming , Finch, Caroline , Hayen, Andrew , Close, Jacqueline
- Date: 2012
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 33, no. 3 (2012), p. E1-E7
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: To assess the effect of comorbidity on relative survival after hip fracture.
Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources
- Authors: Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 1 (January 2012 2012), p. 70-74
- Full Text: false
- Reviewed:
- Description: Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantifi cation of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.
Identifying context-specific competencies required by community Australian Football sports trainers
- Authors: Donaldson, Alex , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 10 (August 2012 2012), p. 759-765
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: Background: First-aid is a recommended injury prevention and risk management strategy in community sport; however, little is known about the sport-specific competencies required by first-aid providers. Objective: To achieve expert consensus on the competencies required by community Australian Football (community-AF) sports trainers. Study design: A three-round online Delphi process. Setting: Community-AF. Participants: 16 Australian sports first-aid and community-AF experts. Outcome measures: Rating of competencies as either ‘essential’, ‘expected’, ‘ideal’ or ‘not required’. Results: After Round 3, 47 of the 77 (61%) competencies were endorsed as ‘essential’ or ‘expected’ for a sports trainer to effectively perform the activities required to the standards expected at a community-AF club by ≥75% of experts. These competencies covered: the role of the sports trainer; the responsibilities of the sports trainer; emergency management; injury and illness assessment and immediate management; taping; and injury prevention and risk management. Four competencies (5%) were endorsed as ‘ideal’ or ‘not required’ by ≥85% of experts and were excluded from further consideration. The 26 competencies where consensus was not reached were retained as second-tier, optional competencies. Conclusions: Sports trainers are important members of on-field first-aid teams, providing support to both injured players and other sports medicine professionals. The competencies identified in this study provide the basis of a proposed two-tiered community-AF–specific sports trainer education structure that can be implemented by the peak sports body. This includes six mandatory modules, relating to the ‘required’ competencies, and a further six optional modules covering competencies on which consensus was not reached.
Planning for implementation and translation : seek first to understand the end-users’ perspectives
- Authors: Donaldson, Alex , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 5 (April 2012), p. 306-307
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- 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.
Sport as a setting for promoting health
- Authors: Donaldson, Alex , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 1 (January 2012 2012), p. 4-5
- Full Text: false
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Attitude and behaviour of junior rugby union players towards tackling during training and match play
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Safety Science Vol. 50, no. 4 (April 2012), p. 1157
- Full Text: false
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Implementation and dissemination research: the time has come!
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 10 (August 2011), p. 763-764
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: In a provocative statement in a very recent issue of the American Journal of Preventive Medicine, Kessler and Glasgow have called for a 10-year moratorium on effi cacy randomised controlled trials (RCTs) in health and health services research. The authors argue that much intervention research has had minimal impact on both policy and practice because the very nature of effi cacy studies means that focus has had to be on a limited number of specifi c causal and preventive factors; this ignores both the complexity of real-world implementation and the multilevel ecological context in which interventions need to be conducted. I have also previously discussed those same limitations as they apply to sports injury prevention studies, most recently as part of my keynote address at the 2011 International Olympic Committee World Conference on The Prevention of Injury and Illness in Sport, to be published in a forthcoming issue of BJSM.
Lack of caregiver supervision : A contributing factor in Australian unintentional child drowning deaths, 2000-2009
- Authors: Petrass, Lauren , Blitvich, Jennifer , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 194, no. 5 (2011), p. 228-231
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565904
- Full Text: false
- Reviewed:
- Description: Objectives: To establish how frequently supervision was explicitly identified as a factor in coroner-certified unintentional drowning deaths of children in Australia, and to determine the percentage of cases where failure of supervision may have been a contributing factor; also, to identify the proportion of cases with coroners' recommendations relating to supervision and unintentional child drownings. Design and setting: Retrospective case-series analysis of unintentional drowning deaths of children (aged 0-14 years) in Australia from 1 July 2000 to 30 June 2009, based on data from the National Coroners Information System (NCIS). Main outcome measures: Number of unintentional child drownings and the extent to which supervisory factors were formally reported by coroners as a contributing factor; proportion of cases with coroners' findings that also had coroners' recommendations. Results: 339 relevant child drownings were identified within the 9-year period. Supervision (or lack thereof) was identified as a contributing factor in 71.7%. However, specific detail about the nature and extent of supervision varied across these cases. The availability of text documents describing the findings (police reports, coroners' findings, autopsy reports, toxicology reports), and the level of detail within these documents, also varied considerably across jurisdictions. Despite almost half (47.2%) of the closed cases having coroners' findings attached, only 15% of these also included specific coroners' recommendations. Conclusion: Lack of adequate supervision, or lack thereof, is a significant problem associated with fatal drownings of children in Australia. There is a need to improve the standard and consistency of information contained in text documents within the NCIS to provide more useful information for preventing child drowning deaths.
Mild traumatic brain injury among a cohort of rugby union players: predictors of time to injury
- Authors: Hollis, Stephanie , Stevenson, Mark , McIntosh, Andrew , Li, Ling , Heritier, Stephane , Shores, E Arthur , Collins, Michael , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 12 (2011), p. 997-999
- Full Text: false
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- Description: This study reports the time to sustain a mild traumatic brain injury (mTBI) among a cohort of community rugby union players. Demographic and player characteristics were collected and players followed up for between one and three playing seasons. 7% of the cohort sustained an mTBI within 10 h of game time, increasing twofold to 14% within 20 h. The mean time to first mTBI was 8 h with an SD of 6.2 (median 6.8 h; IQR: 2.9–11.7 h). Players reporting a recent history of concussion were 20% more likely to sustain an mTBI after 20 h of game time compared with those with no recent history of concussion. Players were likely to sustain an mTBI in shorter time if they trained for <3 h/week (HR=1.48, p=0.03) or had a body mass index <27 (HR=1.77, p=0.007). The findings highlight modifiable characteristics to reduce the likelihood of shortened time to mTBI.
No longer lost in translation : The art and science of sports injury prevention implementation research
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 16 (December 2011), p. 1253-1257
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: It is now understood that sports injury interventions will not have significant public health impact if they are not widely accepted and adopted by target sports participants. Although there has been increasing recognition of the need for intervention studies conducted within the real-world context of sports delivery, very few studies have been conducted in this important area. A major reason for this is that there are significant challenges in conducting implementation research; the more traditional sports medicine approaches may not be fully appropriate and new ways of thinking about how to design, conduct and report such research is needed. Moreover, real-world implementation of sports injury interventions and evaluation of their effectiveness needs to start to take into account the broad ecological context in which they are introduced, as well as considering the best way to translate this knowledge to reach the audiences who most need to benefit from such research. This overview paper provides perspectives and guidance on the design, conduct and evaluation of sports injury intervention implementation studies, including better understanding of the complexity of the ecological settings for intervention delivery. Some conceptual approaches that could be adopted in future implementation studies are discussed; particular emphasis is given to Intervention Mapping as a tool to assist intervention development, Diffusion of Innovations Theory to guide the planning of intervention strategies and the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework for programme evaluation and programme design. Finally, a broad agenda for this emerging important field of sports medicine research is outlined.
Reliability of equipment for measuring the ground hardness and traction
- Authors: Twomey, Dara , Otago, Leonie , Ullah, Shahid , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology Vol. 225, no. 3 (2011), p. 131-137
- Full Text: false
- Reviewed:
- Description: The aim of this paper is to report the inter-rater reliabilities and intra-rater reliabilities of the Clegg hammer, penetrometer, and studded-boot apparatus used for measuring the mechanical properties of natural turf, and to determine whether the level of experience influences the reliability. Three experienced and three novice testers measured the surface hardness and rotational traction at nine locations on a community-level Australian football oval. A repeated-measures analysis of variance tested for significant differences between the six testers for all equipment, and intra-class correlation coefficients (ICCs) were calculated to determine the inter-rater reliabilities and intra-rater reliabilities. The ICCs for the reliability between the six testers ranged between 0.77 and 0.87 for the Clegg hammer, ranged between 0.55 and 0.73 for the penetrometer, and equalled 0.51 for the studded-boot apparatus. The inter-rater reliabilities and intra-rater reliabilities were greater for the experienced testers than for the novice testers for the Clegg hammer and penetrometer but the novice testers produced greater inter-rater reliabilities for the studded-boot apparatus. This study highlights the potential variability that can exist between testers using the ground hardness and traction equipment, which has implications for future research involving multiple testers both in agronomic-based studies and in linking the surface properties to the injury risk across multiple venues. © Authors 2011.
Setting our minds to implementation
- Authors: Verhagen, Evert , Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 13 (2011), p.1015-1016
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: It is now well accepted that to prevent sports injuries we need more intervention studies. Therefore, it is somewhat alarming that most sports injury studies still only focus on the fi rst two steps of the four-step prevention sequence of van Mechelen et al: only counting injuries and describing causal factors. This has clearly been shown by Klügl et al, who reviewed approximately 5274 original sports injury publications, of which only 492 studies intended to establish the preventive value of a measure or programme. This review showed that although the number of efficacy/effectiveness studies has slowly increased over the years, this is still lagging behind the approximately 4000 descriptive and aetiological studies.
Research alone is not sufficient to prevent sports injury
- Authors: Hanson, Dale , Allegrante, John , Sleet, David , Finch, Caroline
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. p. 682-684
- Full Text: false
- Reviewed: