Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport : Population-level trends in hospital-treated injuries
- Finch, Caroline, Gray, Shannon, Akram, Muhammad, Donaldson, Alex, Lloyd, David, Cook, Jill
- Authors: Finch, Caroline , Gray, Shannon , Akram, Muhammad , Donaldson, Alex , Lloyd, David , Cook, Jill
- Date: 2019
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 53, no. 8 (2019), p. 487-492
- Full Text:
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- Description: Objective Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. Method A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16-50 years while participating in community-level Australian Football. FootyFirst was implemented with a € support' (FootyFirst+S) or a € without support' (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. Results After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006-2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. Conclusion Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.
- Authors: Finch, Caroline , Gray, Shannon , Akram, Muhammad , Donaldson, Alex , Lloyd, David , Cook, Jill
- Date: 2019
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 53, no. 8 (2019), p. 487-492
- Full Text:
- Reviewed:
- Description: Objective Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. Method A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16-50 years while participating in community-level Australian Football. FootyFirst was implemented with a € support' (FootyFirst+S) or a € without support' (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. Results After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006-2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. Conclusion Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.
Facilitators to support the implementation of injury prevention training in youth handball : A concept mapping approach
- Ageberg, Eva, Bunke, Sofia, Lucander, Karolina, Nilsen, Per, Donaldson, Alex
- Authors: Ageberg, Eva , Bunke, Sofia , Lucander, Karolina , Nilsen, Per , Donaldson, Alex
- Date: 2019
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 29, no. 2 (2019), p. 275-285
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- Description: There is a need for research to identify effective implementation strategies for injury prevention training within real-world community sports. The aim of this ecological participatory study was to identify facilitators, among stakeholders at multiple levels, that could help injury prevention training become part of regular training routines in youth team handball. Concept mapping, a mixed-method approach for qualitative data collection and quantitative data analysis, was used. Stakeholders (n = 196) of two community team handball clubs (29% players, 13% coaches, 38% caregivers, 11% club, district and national handball administrators, 9% unknown) participated in a brainstorming process. After the research team synthesized the 235 generated statements, 50 stakeholders (34% players, 22% coaches, 24% caregivers, 20% administrators) sorted 89 unique facilitator statements into clusters and rated them for importance and feasibility. Multidimensional scaling and hierarchical cluster analysis yielded five clusters (stress value 0.231): “Understanding and applying knowledge,” “Education, knowledge, and consistency,” “Set-up and exercises,” “Inspiration, motivation, and routines,” and “Club policy and expert collaboration.” The cluster “Understanding and applying knowledge” had the highest mean importance (3.17 out of 4) and feasibility (2.93) ratings. The 32 statements rated as both highly important and feasible (Go-zone) indicate action is required at the individual (end-users) and organizational (policymakers) levels to implement injury prevention training. Results suggest that developing evidence-based context-specific injury prevention training, incorporating physiological, biomechanical and psychological components, and an associated context-specific implementation plan in partnership with all stakeholders should be a high priority to facilitate the implementation of injury prevention training in youth team handball.
- Authors: Ageberg, Eva , Bunke, Sofia , Lucander, Karolina , Nilsen, Per , Donaldson, Alex
- Date: 2019
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 29, no. 2 (2019), p. 275-285
- Full Text:
- Reviewed:
- Description: There is a need for research to identify effective implementation strategies for injury prevention training within real-world community sports. The aim of this ecological participatory study was to identify facilitators, among stakeholders at multiple levels, that could help injury prevention training become part of regular training routines in youth team handball. Concept mapping, a mixed-method approach for qualitative data collection and quantitative data analysis, was used. Stakeholders (n = 196) of two community team handball clubs (29% players, 13% coaches, 38% caregivers, 11% club, district and national handball administrators, 9% unknown) participated in a brainstorming process. After the research team synthesized the 235 generated statements, 50 stakeholders (34% players, 22% coaches, 24% caregivers, 20% administrators) sorted 89 unique facilitator statements into clusters and rated them for importance and feasibility. Multidimensional scaling and hierarchical cluster analysis yielded five clusters (stress value 0.231): “Understanding and applying knowledge,” “Education, knowledge, and consistency,” “Set-up and exercises,” “Inspiration, motivation, and routines,” and “Club policy and expert collaboration.” The cluster “Understanding and applying knowledge” had the highest mean importance (3.17 out of 4) and feasibility (2.93) ratings. The 32 statements rated as both highly important and feasible (Go-zone) indicate action is required at the individual (end-users) and organizational (policymakers) levels to implement injury prevention training. Results suggest that developing evidence-based context-specific injury prevention training, incorporating physiological, biomechanical and psychological components, and an associated context-specific implementation plan in partnership with all stakeholders should be a high priority to facilitate the implementation of injury prevention training in youth team handball.
Scientific evidence is just the starting point : A generalizable process for developing sports injury prevention interventions
- Donaldson, Alex, Lloyd, David, Gabbe, Belinda, Cook, Jill, Young, Warren, White, Peta, Finch, Caroline
- Authors: Donaldson, Alex , Lloyd, David , Gabbe, Belinda , Cook, Jill , Young, Warren , White, Peta , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Sport and Health Science Vol. 5, no. 3 (2016), p. 334-341
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
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- 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.
- Authors: Donaldson, Alex , Lloyd, David , Gabbe, Belinda , Cook, Jill , Young, Warren , White, Peta , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Sport and Health Science Vol. 5, no. 3 (2016), p. 334-341
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- 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.
Self-reported worst injuries in women's Australian football identify lower limb injuries as a prevention priority
- Fortington, Lauren, Donaldson, Alex, Finch, Caroline
- Authors: Fortington, Lauren , Donaldson, Alex , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 2, no. 1 (2016), p. e000112
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: BACKGROUND: Increasing participation by women in Australian football (AF) has made understanding their specific injury prevention needs a priority. In other sports, men and women have different injury profiles. This study aims to provide the first overview of self-reported injuries in women's AF. METHODS: Nationwide survey of women aged 17+ years who played in an AF competition was conducted following the 2014 playing season. The players' self-reported worst injury from the 2014 season is presented according to injury type, body part injured, treatment sought and games/training missed. RESULTS: Three-quarters of 553 respondents (n=431, 78%) reported at least 1 injury. Over half (n=235, 55%) of injuries were to the lower limb. Ankle ligament tears/sprains (n=50, 12% of all injuries) and knee ligament tears/sprains (n=45, 10%) were most frequent lower limb injuries reported. Two-thirds (65%) of all lower limb injuries led to at least 1 missed game. Of 111 (26% of all injuries) upper limb injuries reported, over half (n=57, 62%) were to the hand/fingers/thumb, including fractures (n=28, 6% of all injuries), ligament tears/sprains (n=18, 4%) and dislocations (n=11, 3%). Half of the upper limb injuries (51%) resulted in players missing matches/training. CONCLUSIONS: The most frequent self-reported worst injuries for women playing AF were joint damage to the ankle and knee. A prospective injury study is needed to confirm the causes and rate of these lower limb injuries to identify the most suitable prevention interventions.
- Authors: Fortington, Lauren , Donaldson, Alex , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 2, no. 1 (2016), p. e000112
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: BACKGROUND: Increasing participation by women in Australian football (AF) has made understanding their specific injury prevention needs a priority. In other sports, men and women have different injury profiles. This study aims to provide the first overview of self-reported injuries in women's AF. METHODS: Nationwide survey of women aged 17+ years who played in an AF competition was conducted following the 2014 playing season. The players' self-reported worst injury from the 2014 season is presented according to injury type, body part injured, treatment sought and games/training missed. RESULTS: Three-quarters of 553 respondents (n=431, 78%) reported at least 1 injury. Over half (n=235, 55%) of injuries were to the lower limb. Ankle ligament tears/sprains (n=50, 12% of all injuries) and knee ligament tears/sprains (n=45, 10%) were most frequent lower limb injuries reported. Two-thirds (65%) of all lower limb injuries led to at least 1 missed game. Of 111 (26% of all injuries) upper limb injuries reported, over half (n=57, 62%) were to the hand/fingers/thumb, including fractures (n=28, 6% of all injuries), ligament tears/sprains (n=18, 4%) and dislocations (n=11, 3%). Half of the upper limb injuries (51%) resulted in players missing matches/training. CONCLUSIONS: The most frequent self-reported worst injuries for women playing AF were joint damage to the ankle and knee. A prospective injury study is needed to confirm the causes and rate of these lower limb injuries to identify the most suitable prevention interventions.
The evolution of multiagency partnerships for safety over the course of research engagement : Experiences from the NoGAPS project
- Finch, Caroline, Donaldson, Alex, Gabbe, Belinda, Muhammad, Akram, Shee, Anna Wong, Lloyd, David, Cook, Jill
- Authors: Finch, Caroline , Donaldson, Alex , Gabbe, Belinda , Muhammad, Akram , Shee, Anna Wong , Lloyd, David , Cook, Jill
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 6 (2016), p. 386-391
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
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- Description: Objective Implementation of effective population-level injury prevention interventions requires broad multiagency partnerships. Different stakeholders address this from varying perspectives, and potential conflicts in priorities need to be addressed for such partnerships to be effective. The researcher-led National Guidance for Australian football Partnerships and Safety (NoGAPS) project involved the engagement and participation of seven non-academic partners, including government health promotion and safety agencies; peak sports professional and advocacy bodies and health insurance organisations. Design The partnership's ongoing development was assessed by each partner completing the Victorian Health Promotion Foundation Partnership Analysis Tool (VPAT) annually over 2011-2015. Changes in VPAT scores were compared through repeated measures analysis of variance. Results Overall, mean total VPAT scores increased significantly over the 5-year period (125.1-141.2; F-5,F-30=4.61, p=0.003), showing a significant improvement in how the partnership was functioning over time. This was largely driven by significant increases in several VPAT domains: determining the need for a partnership' (F-5,F-30=4.15, p=0.006), making sure the partnership works' (F-5,F-30=2.59, p=0.046), planning collaborative action' (F-5,F-30=5.13, p=0.002) and minimising the barriers to the partnership' (F-5,F-30=6.66, p<0.001). Conclusion This is the first study to assess the functioning of a multiagency partnership to address sport injury prevention implementation. For NoGAPS, the engagement of stakeholders from the outset facilitated the development of new and/or stronger links between non-academic partners. Partners shared the common goal of ensuring the real-world uptake of interventions and research evidence-informed recommendations. Effective multiagency partnerships have the potential to influence the implementation of policies and practices beyond the life of a research project.
- Authors: Finch, Caroline , Donaldson, Alex , Gabbe, Belinda , Muhammad, Akram , Shee, Anna Wong , Lloyd, David , Cook, Jill
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 6 (2016), p. 386-391
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Objective Implementation of effective population-level injury prevention interventions requires broad multiagency partnerships. Different stakeholders address this from varying perspectives, and potential conflicts in priorities need to be addressed for such partnerships to be effective. The researcher-led National Guidance for Australian football Partnerships and Safety (NoGAPS) project involved the engagement and participation of seven non-academic partners, including government health promotion and safety agencies; peak sports professional and advocacy bodies and health insurance organisations. Design The partnership's ongoing development was assessed by each partner completing the Victorian Health Promotion Foundation Partnership Analysis Tool (VPAT) annually over 2011-2015. Changes in VPAT scores were compared through repeated measures analysis of variance. Results Overall, mean total VPAT scores increased significantly over the 5-year period (125.1-141.2; F-5,F-30=4.61, p=0.003), showing a significant improvement in how the partnership was functioning over time. This was largely driven by significant increases in several VPAT domains: determining the need for a partnership' (F-5,F-30=4.15, p=0.006), making sure the partnership works' (F-5,F-30=2.59, p=0.046), planning collaborative action' (F-5,F-30=5.13, p=0.002) and minimising the barriers to the partnership' (F-5,F-30=6.66, p<0.001). Conclusion This is the first study to assess the functioning of a multiagency partnership to address sport injury prevention implementation. For NoGAPS, the engagement of stakeholders from the outset facilitated the development of new and/or stronger links between non-academic partners. Partners shared the common goal of ensuring the real-world uptake of interventions and research evidence-informed recommendations. Effective multiagency partnerships have the potential to influence the implementation of policies and practices beyond the life of a research project.
We have the programme, what next? Planning the implementation of an injury prevention programme
- Donaldson, Alex, Lloyd, David, Gabbe, Belinda, Cook, Jill, Finch, Caroline
- Authors: Donaldson, Alex , Lloyd, David , Gabbe, Belinda , Cook, Jill , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 23, no. 4 (2016), p. 273-280
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- 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.
- Authors: Donaldson, Alex , Lloyd, David , Gabbe, Belinda , Cook, Jill , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 23, no. 4 (2016), p. 273-280
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- 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.
Ensuring implementation success: how should coach injury prevention education be improved if we want coaches to deliver safety programmes during training sessions?
- White, Peta, Otago, Leonie, Saunders, Natalie, Romiti, Maria, Donaldson, Alex, Ullah, Shahid, Finch, Caroline
- Authors: White, Peta , Otago, Leonie , Saunders, Natalie , Romiti, Maria , Donaldson, Alex , Ullah, Shahid , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 5 (2014), p. 402-403
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Coaches play a major role in encouraging and ensuring that participants of their teams adopt appropriate safety practices. However, the extent to which the coaches undertake this role will depend upon their attitudes about injury prevention, their perceptions of what the other coaches usually do and their own beliefs about how much control they have in delivering such programmes. Fifty-one junior netball coaches were surveyed about incorporating the teaching of correct (safe) landing technique during their delivery of training sessions to junior players. Overall, >94% of coaches had strongly positive attitudes towards teaching correct landing technique and >80% had strongly positive perceptions of their own control over delivering such programmes. Coaches’ ratings of social norms relating to what others think about teaching safe landing were more positive (>94%) than those relating to what others actually do (63–74%). In conclusion, the junior coaches were generally receptive towards delivering safe landing training programmes in the training sessions they led. Future coach education could include role modelling by prominent coaches so that more community-level coaches are aware that this is a behaviour that many coaches can, and do, engage in.
- Authors: White, Peta , Otago, Leonie , Saunders, Natalie , Romiti, Maria , Donaldson, Alex , Ullah, Shahid , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 5 (2014), p. 402-403
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Coaches play a major role in encouraging and ensuring that participants of their teams adopt appropriate safety practices. However, the extent to which the coaches undertake this role will depend upon their attitudes about injury prevention, their perceptions of what the other coaches usually do and their own beliefs about how much control they have in delivering such programmes. Fifty-one junior netball coaches were surveyed about incorporating the teaching of correct (safe) landing technique during their delivery of training sessions to junior players. Overall, >94% of coaches had strongly positive attitudes towards teaching correct landing technique and >80% had strongly positive perceptions of their own control over delivering such programmes. Coaches’ ratings of social norms relating to what others think about teaching safe landing were more positive (>94%) than those relating to what others actually do (63–74%). In conclusion, the junior coaches were generally receptive towards delivering safe landing training programmes in the training sessions they led. Future coach education could include role modelling by prominent coaches so that more community-level coaches are aware that this is a behaviour that many coaches can, and do, engage in.
Implementing injury surveillance systems alongside injury prevention programs: evaluation of an online surveillance system in a community setting
- Ekegren, Christina, Donaldson, Alex, Gabbe, Belinda, Finch, Caroline
- Authors: Ekegren, Christina , Donaldson, Alex , Gabbe, Belinda , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Injury Epidemiology Vol. 1, no. 1 (2014), p. 1-15
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: BACKGROUND:Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. METHODS:A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. RESULTS:Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). CONCLUSIONS:The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.
- Authors: Ekegren, Christina , Donaldson, Alex , Gabbe, Belinda , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Injury Epidemiology Vol. 1, no. 1 (2014), p. 1-15
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: BACKGROUND:Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. METHODS:A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. RESULTS:Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). CONCLUSIONS:The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.
Knowledge about sports-related concussion: is the message getting through to coaches and trainers?
- White, Peta, Newton, Joshua, Makdissi, Michael, Sullivan, John, Davis, Gavin, McCrory, Paul, Donaldson, Alex, Ewing, Michael, Finch, Caroline
- Authors: White, Peta , Newton, Joshua , Makdissi, Michael , Sullivan, John , Davis, Gavin , McCrory, Paul , Donaldson, Alex , Ewing, Michael , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 2 (2014), p. 119-124
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Aim: The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods: An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results: General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions: The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.
- Authors: White, Peta , Newton, Joshua , Makdissi, Michael , Sullivan, John , Davis, Gavin , McCrory, Paul , Donaldson, Alex , Ewing, Michael , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 2 (2014), p. 119-124
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Aim: The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods: An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results: General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions: The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.
When 'just doing it' is not enough: Assessing the fidelity of player performance of an injury prevention exercise program
- Fortington, Lauren, Donaldson, Alex, Lathlean, Tim, Young, Warren, Gabbe, Belinda, Lloyd, David, Finch, Caroline
- Authors: Fortington, Lauren , Donaldson, Alex , Lathlean, Tim , Young, Warren , Gabbe, Belinda , Lloyd, David , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (May 2014 2014), p.272-277
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: To obtain benefits from sports injury prevention programs, players are instructed to perform the exercises as prescribed. We developed an observational checklist to measure the quality of exercise performance by players participating in FootyFirst, a coach-led, exercise-based, lower-limb injury prevention program in community Australian Football (AF). Design: Observational. Methods: The essential performance criteria for each FootyFirst exercise were described in terms of the technique, volume and intensity required to perform each exercise. An observational checklist was developed to evaluate each criterion through direct visual observation of players at training. The checklist was trialled by two independent raters who observed the same 70 players completing the exercises at eight clubs. Agreement between observers was assessed by Kappa-statistics. Exercise fidelity was defined as the proportion of observed players who performed all aspects of their exercises correctly. Results: The raters agreed on 61/70 observations (87%) (Kappa = 0.72, 95% CI: 0.55; 0.89). Of the observations with agreed ratings, 41 (67%) players were judged as performing the exercises as prescribed. Conclusions: The observational checklist demonstrated high inter-rater reliability. Many players observed did not perform the exercises as prescribed, raising concern as to whether they would be receiving anticipated program benefits. Where quality of exercise performance is important, evaluation and reporting of program fidelity should include direct observations of participants.
- Authors: Fortington, Lauren , Donaldson, Alex , Lathlean, Tim , Young, Warren , Gabbe, Belinda , Lloyd, David , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (May 2014 2014), p.272-277
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: To obtain benefits from sports injury prevention programs, players are instructed to perform the exercises as prescribed. We developed an observational checklist to measure the quality of exercise performance by players participating in FootyFirst, a coach-led, exercise-based, lower-limb injury prevention program in community Australian Football (AF). Design: Observational. Methods: The essential performance criteria for each FootyFirst exercise were described in terms of the technique, volume and intensity required to perform each exercise. An observational checklist was developed to evaluate each criterion through direct visual observation of players at training. The checklist was trialled by two independent raters who observed the same 70 players completing the exercises at eight clubs. Agreement between observers was assessed by Kappa-statistics. Exercise fidelity was defined as the proportion of observed players who performed all aspects of their exercises correctly. Results: The raters agreed on 61/70 observations (87%) (Kappa = 0.72, 95% CI: 0.55; 0.89). Of the observations with agreed ratings, 41 (67%) players were judged as performing the exercises as prescribed. Conclusions: The observational checklist demonstrated high inter-rater reliability. Many players observed did not perform the exercises as prescribed, raising concern as to whether they would be receiving anticipated program benefits. Where quality of exercise performance is important, evaluation and reporting of program fidelity should include direct observations of participants.
Intention to use sport concussion guidelines among community-level coaches and sports trainers
- Newton, Joshua, White, Peta, Ewing, Michael, Makdissi, Michael, Davis, Gavin, Donaldson, Alex, Sullivan, John, Seward, Hugh, Finch, Caroline
- Authors: Newton, Joshua , White, Peta , Ewing, Michael , Makdissi, Michael , Davis, Gavin , Donaldson, Alex , Sullivan, John , Seward, Hugh , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.17, no.5 (2013), p.469-473
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Sporting bodies have developed guidelines for managing community-level players with suspected concussion in response to international consensus statements on concussion in sport. The purpose of this study was to examine the factors that influence the intended use of concussion guidelines among community-level coaches and sports trainers from two popular football codes in Australia: Australian football and rugby league. Design: Cross-sectional survey. Methods: The survey, based on an extended theory of planned behaviour model, was completed by 183 Australian football coaches, 121 Australian football sports trainers, 171 rugby league coaches, and 142 rugby league sports trainers. Results: Personal norms and self-efficacy were significant predictors of intention to use concussion guidelines, although the relationship between self-efficacy and intention was stronger among Australian football coaches than rugby league coaches. Analysis of the salient beliefs that underpin self-efficacy found that coaches, irrespective of football code, felt less familiar (2 = 25.70, p < 0.001) and less experienced (2 = 31.56, p < 0.001) than sports trainers in using the concussion guidelines. At the same time, Australian football personnel, irrespective oftheir team role, feltthatthey had insufficienttime (2 = 8.04, p < 0.01) and resources (2 = 12.31, p < 0.001) to implement the concussion guidelines relative to rugby league personnel. Conclusions: Programmes aimed at increasing the intended use of sport concussion guidelines should focus on enhancing self-efficacy and leveraging personal norms. Increasing coaches’ familiarity and experience in using the concussion guidelines would also be warranted, as would finding ways to overcome the perceived time and resource constraints identified among Australian football personnel.
- Authors: Newton, Joshua , White, Peta , Ewing, Michael , Makdissi, Michael , Davis, Gavin , Donaldson, Alex , Sullivan, John , Seward, Hugh , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.17, no.5 (2013), p.469-473
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Sporting bodies have developed guidelines for managing community-level players with suspected concussion in response to international consensus statements on concussion in sport. The purpose of this study was to examine the factors that influence the intended use of concussion guidelines among community-level coaches and sports trainers from two popular football codes in Australia: Australian football and rugby league. Design: Cross-sectional survey. Methods: The survey, based on an extended theory of planned behaviour model, was completed by 183 Australian football coaches, 121 Australian football sports trainers, 171 rugby league coaches, and 142 rugby league sports trainers. Results: Personal norms and self-efficacy were significant predictors of intention to use concussion guidelines, although the relationship between self-efficacy and intention was stronger among Australian football coaches than rugby league coaches. Analysis of the salient beliefs that underpin self-efficacy found that coaches, irrespective of football code, felt less familiar (2 = 25.70, p < 0.001) and less experienced (2 = 31.56, p < 0.001) than sports trainers in using the concussion guidelines. At the same time, Australian football personnel, irrespective oftheir team role, feltthatthey had insufficienttime (2 = 8.04, p < 0.01) and resources (2 = 12.31, p < 0.001) to implement the concussion guidelines relative to rugby league personnel. Conclusions: Programmes aimed at increasing the intended use of sport concussion guidelines should focus on enhancing self-efficacy and leveraging personal norms. Increasing coaches’ familiarity and experience in using the concussion guidelines would also be warranted, as would finding ways to overcome the perceived time and resource constraints identified among Australian football personnel.
Priorities for investment in injury prevention in community Australian football
- Finch, Caroline, Gabbe, Belinda, White, Peta, Lloyd, David, Twomey, Dara, Donaldson, Alex, Elliott, Bruce, Cook, Jill
- Authors: Finch, Caroline , Gabbe, Belinda , White, Peta , Lloyd, David , Twomey, Dara , Donaldson, Alex , Elliott, Bruce , Cook, Jill
- Date: 2013
- Type: Text , Journal article
- Relation: Clinical journal of sport medicine Vol. 23, no. 6 (November 2013 2013), p. 430-438
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Objective:High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes the type, nature, and mechanism of injuries in community Australian Football (community AF) players, as collected through field-based monitoring of injury in teams of players.Data Sources:Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism.Main Results:In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from overexertion. Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground.Conclusions:Lower limb injuries are common in community AF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
- Authors: Finch, Caroline , Gabbe, Belinda , White, Peta , Lloyd, David , Twomey, Dara , Donaldson, Alex , Elliott, Bruce , Cook, Jill
- Date: 2013
- Type: Text , Journal article
- Relation: Clinical journal of sport medicine Vol. 23, no. 6 (November 2013 2013), p. 430-438
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Objective:High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes the type, nature, and mechanism of injuries in community Australian Football (community AF) players, as collected through field-based monitoring of injury in teams of players.Data Sources:Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism.Main Results:In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from overexertion. Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground.Conclusions:Lower limb injuries are common in community AF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
Understanding safety management system applicability in community sport
- Donaldson, Alex, Borys, David, Finch, Caroline
- Authors: Donaldson, Alex , Borys, David , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Safety Science Vol. 60, no. (2013), p. 95-104
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Despite recent interest in understanding the implementation context for sports injury prevention interventions, little research attention has been paid to the management structures and processes of community sporting organisations. This study developed expert consensus about the importance of Occupational Health and Safety (OHS) setting-related safety management system (SMS) principles and performance indicators in the context of Australian community sporting organizations, and the feasibility of these organisations meeting the requirements for the SMS performance indicators. Twenty-nine sports injury prevention, community sports administration and OHS SMS experts participated in a three-round online Delphi study by rating the importance of 64 SMS performance indicators categorised under the five principles of Commitment and Policy; Planning; Implementation; Measurement and Evaluation; and Review and Improvement. Overall, consensus agreement - define as rated 'essential' or 'very important' on a five-point scale by ≥75% of the participants in Round 3 - was reached for 57 performance indicators. Ten (15%) performance indicators were rated as 'very difficult' or 'relatively difficult', and six (9%) were rated as 'very easy' or 'relatively easy' on a four-point scale, by ≥75% of participants. This research suggests that the guiding principles and associated performance indicators that underpin OHS safety management systems in the workplace are very relevant and applicable to community sporting organisations in Australia. However, considerable work is required to build organisational capacity to be able to develop and implement meaningfully and useful SMSs to prevent sports injuries in the most common setting in which they occur. © 2013 Elsevier Ltd. Funded by NHMRC.
- Description: 2003011206
- Authors: Donaldson, Alex , Borys, David , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Safety Science Vol. 60, no. (2013), p. 95-104
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Despite recent interest in understanding the implementation context for sports injury prevention interventions, little research attention has been paid to the management structures and processes of community sporting organisations. This study developed expert consensus about the importance of Occupational Health and Safety (OHS) setting-related safety management system (SMS) principles and performance indicators in the context of Australian community sporting organizations, and the feasibility of these organisations meeting the requirements for the SMS performance indicators. Twenty-nine sports injury prevention, community sports administration and OHS SMS experts participated in a three-round online Delphi study by rating the importance of 64 SMS performance indicators categorised under the five principles of Commitment and Policy; Planning; Implementation; Measurement and Evaluation; and Review and Improvement. Overall, consensus agreement - define as rated 'essential' or 'very important' on a five-point scale by ≥75% of the participants in Round 3 - was reached for 57 performance indicators. Ten (15%) performance indicators were rated as 'very difficult' or 'relatively difficult', and six (9%) were rated as 'very easy' or 'relatively easy' on a four-point scale, by ≥75% of participants. This research suggests that the guiding principles and associated performance indicators that underpin OHS safety management systems in the workplace are very relevant and applicable to community sporting organisations in Australia. However, considerable work is required to build organisational capacity to be able to develop and implement meaningfully and useful SMSs to prevent sports injuries in the most common setting in which they occur. © 2013 Elsevier Ltd. Funded by NHMRC.
- Description: 2003011206
Is sports safety policy being translated into practice: What can be learnt from the Australian Rugby Union Mayday procedure?
- Poulos, Roslyn, Donaldson, Alex
- Authors: Poulos, Roslyn , Donaldson, Alex
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 8 (2012), p. 585-590
- Full Text:
- Reviewed:
- Description: Description: Aim To investigate the level of translation of the Australian Rugby Union “Mayday” safety procedure into practice among community rugby union coaches in New South Wales (Australia). Methods All registered coaches of senior community rugby union teams in five zones/associations in the north eastern region of the state were invited to complete a short online questionnaire at the end of the 2010 rugby season. The questionnaire was designed around the five RE-AIM dimensions and assessed: Reach, perceived Effectiveness, Adoption, Implementation, and Maintenance of the Mayday procedure. Results Seventy (39%) coaches participated. There was a high level of awareness of the Mayday procedure, and most coaches believed it was effective in preventing injuries. The majority reported training their players in the procedure, although training was generally infrequent. Coaches were confident that their own players could implement the procedure appropriately if required to do so, but less confident that other teams or referees could do so. Barriers to providing training included: not enough players at training; players not taking training seriously; and technical difficulties (e.g. verbalisation of instructions for physical tasks). Conclusion The findings suggest that the translation of the Mayday ‘policy’ could be improved by building individual coach, and club or zone organisational capacity by: ensuring coaches have the resources and skills in ‘how’ to train their players to complement their existing knowledge on ‘what’ to train them; setting expectations that encourage coaches to provide regular training for players; and regular monitoring of player competency to perform the procedure appropriately.
- Authors: Poulos, Roslyn , Donaldson, Alex
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 8 (2012), p. 585-590
- Full Text:
- Reviewed:
- Description: Description: Aim To investigate the level of translation of the Australian Rugby Union “Mayday” safety procedure into practice among community rugby union coaches in New South Wales (Australia). Methods All registered coaches of senior community rugby union teams in five zones/associations in the north eastern region of the state were invited to complete a short online questionnaire at the end of the 2010 rugby season. The questionnaire was designed around the five RE-AIM dimensions and assessed: Reach, perceived Effectiveness, Adoption, Implementation, and Maintenance of the Mayday procedure. Results Seventy (39%) coaches participated. There was a high level of awareness of the Mayday procedure, and most coaches believed it was effective in preventing injuries. The majority reported training their players in the procedure, although training was generally infrequent. Coaches were confident that their own players could implement the procedure appropriately if required to do so, but less confident that other teams or referees could do so. Barriers to providing training included: not enough players at training; players not taking training seriously; and technical difficulties (e.g. verbalisation of instructions for physical tasks). Conclusion The findings suggest that the translation of the Mayday ‘policy’ could be improved by building individual coach, and club or zone organisational capacity by: ensuring coaches have the resources and skills in ‘how’ to train their players to complement their existing knowledge on ‘what’ to train them; setting expectations that encourage coaches to provide regular training for players; and regular monitoring of player competency to perform the procedure appropriately.
Towards a national sports safety strategy: Addressing facilitators and barriers towards safety guideline uptake
- Finch, Caroline, Gabbe, Belinda, Lloyd, David, Cook, Jill, Young, Warren, Nicholson, Matthew, Seward, Hugh, Donaldson, Alex, Doyle, Tim
- Authors: Finch, Caroline , Gabbe, Belinda , Lloyd, David , Cook, Jill , Young, Warren , Nicholson, Matthew , Seward, Hugh , Donaldson, Alex , Doyle, Tim
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 3 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Limited information exists about how best to conduct intervention implementation studies in community sport settings. Research should be directed towards understanding the context within which evidence-based injury prevention interventions are to be implemented, while continuing to build the evidencebase for the effectiveness of sports injury interventions. Objectives: To identify factors that influence the translation of evidence-based injury prevention interventions into practice in community sport, and to provide specific evidence for the effectiveness of an evidence-based exercise training programme for lower limb injury prevention in community Australian football. Setting: Community-level Australian football clubs, teams and players. Methods: An exercise-based lower limb injury prevention programme will be developed and evaluated in terms of the implementation context, infrastructure and resources needed for its effective translation into community sport. Analysis of the community sports safety policy context will be undertaken to understand the barriers and facilitators to policy development and uptake. A randomised group-clustered ecological study will be conducted to compare the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of the intervention over 2 years. Outcome Measures: The primary outcome will be evidence-based prevention guidelines that are fully supported by a comprehensively evaluated dissemination plan. The plan will detail the support structures and add-ons necessary to ensure sustainability and subsequent national implementation. Research outcomes will include new knowledge about how sports safety policy is set, how consensus is reached among sports safety experts in the community setting and how evidence-based safety guidelines are best developed, packaged and disseminated to community sport.
- Authors: Finch, Caroline , Gabbe, Belinda , Lloyd, David , Cook, Jill , Young, Warren , Nicholson, Matthew , Seward, Hugh , Donaldson, Alex , Doyle, Tim
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 3 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Limited information exists about how best to conduct intervention implementation studies in community sport settings. Research should be directed towards understanding the context within which evidence-based injury prevention interventions are to be implemented, while continuing to build the evidencebase for the effectiveness of sports injury interventions. Objectives: To identify factors that influence the translation of evidence-based injury prevention interventions into practice in community sport, and to provide specific evidence for the effectiveness of an evidence-based exercise training programme for lower limb injury prevention in community Australian football. Setting: Community-level Australian football clubs, teams and players. Methods: An exercise-based lower limb injury prevention programme will be developed and evaluated in terms of the implementation context, infrastructure and resources needed for its effective translation into community sport. Analysis of the community sports safety policy context will be undertaken to understand the barriers and facilitators to policy development and uptake. A randomised group-clustered ecological study will be conducted to compare the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of the intervention over 2 years. Outcome Measures: The primary outcome will be evidence-based prevention guidelines that are fully supported by a comprehensively evaluated dissemination plan. The plan will detail the support structures and add-ons necessary to ensure sustainability and subsequent national implementation. Research outcomes will include new knowledge about how sports safety policy is set, how consensus is reached among sports safety experts in the community setting and how evidence-based safety guidelines are best developed, packaged and disseminated to community sport.
Coaches' perspectives on implementing an evidence-informed injury prevention programme in junior community netball
- Saunders, Natalie, Otago, Leonie, Romiti, Maria, Donaldson, Alex, White, Peta, Finch, Caroline
- Authors: Saunders, Natalie , Otago, Leonie , Romiti, Maria , Donaldson, Alex , White, Peta , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 44, no. 15 (2010), p. 1128-1132
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective For effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches' feedback on the implementation of an evidence-informed injury prevention programme in community junior netball using coaches' perceptions and the RE–AIM framework. Methods A lower-limb injury prevention programme (Down to Earth; D2E), for teaching safe-landing techniques, was delivered to 31 coaches from 31 junior community netball teams in a 1-h workshop. Coaches then delivered a 6-week programme at team training sessions starting in the week before the competition season commenced. 65% of coaches completed a feedback survey 17 weeks after they had delivered the programme. Results Most (88%) coaches believed that D2E improved their players' ability to perform correct landing techniques in games and that players had retained these improvements over the season. The majority (83%) indicated that an improvement in player athletic attributes was the greatest advantage of D2E, followed by a reduction in injury risk. Identified barriers to implementing D2E were running out of time and very young players finding the drills too difficult. Coaches reported that they needed more ideas for training drills that could be incorporated into their programmes and believed that their own coaching training did not adequately prepare them to implement an injury prevention programme. Conclusions Although coaches believed that D2E was effective in developing correct landing techniques, some modifications are needed to make it more suitable for younger players and coach education by accreditation courses could be improved to support the implementation of injury prevention programmes.
- Authors: Saunders, Natalie , Otago, Leonie , Romiti, Maria , Donaldson, Alex , White, Peta , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 44, no. 15 (2010), p. 1128-1132
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective For effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches' feedback on the implementation of an evidence-informed injury prevention programme in community junior netball using coaches' perceptions and the RE–AIM framework. Methods A lower-limb injury prevention programme (Down to Earth; D2E), for teaching safe-landing techniques, was delivered to 31 coaches from 31 junior community netball teams in a 1-h workshop. Coaches then delivered a 6-week programme at team training sessions starting in the week before the competition season commenced. 65% of coaches completed a feedback survey 17 weeks after they had delivered the programme. Results Most (88%) coaches believed that D2E improved their players' ability to perform correct landing techniques in games and that players had retained these improvements over the season. The majority (83%) indicated that an improvement in player athletic attributes was the greatest advantage of D2E, followed by a reduction in injury risk. Identified barriers to implementing D2E were running out of time and very young players finding the drills too difficult. Coaches reported that they needed more ideas for training drills that could be incorporated into their programmes and believed that their own coaching training did not adequately prepare them to implement an injury prevention programme. Conclusions Although coaches believed that D2E was effective in developing correct landing techniques, some modifications are needed to make it more suitable for younger players and coach education by accreditation courses could be improved to support the implementation of injury prevention programmes.
Towards evidence-informed sports safety policy for New South Wales, Australia : Assessing the readiness of the sector
- Poulos, Roslyn, Donaldson, Alex, Finch, Caroline
- Authors: Poulos, Roslyn , Donaldson, Alex , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 16, no. 2 (2010), p. 127-131
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Authors: Poulos, Roslyn , Donaldson, Alex , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 16, no. 2 (2010), p. 127-131
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
Staying active, staying strong : Pilot evaluation of a once-weekly, community-based strength training program for older adults
- Bates, Amanda, Donaldson, Alex, Lloyd, Beverley, Castell, Sally, Krolik, Patricia, Coleman, Renee
- Authors: Bates, Amanda , Donaldson, Alex , Lloyd, Beverley , Castell, Sally , Krolik, Patricia , Coleman, Renee
- Date: 2009
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 20, no. 1 (2009), p. 42-47
- Full Text:
- Reviewed:
- Description: Issue addressed: Little is known about the effectiveness of once-weekly strength training programs for older adults based in community settings. This pilot study evaluated such a program to assess changes in the functional fitness of participants. Methods: A pre-test/post-test within subjects study design was used with new participants in the 10-week Staying Active, Staying Strong (SASS) program (all aged 50+ years). The Seniors Fitness Test (SFT) and SF-36 were used to assess functional fitness and health-related quality of life respectively. Perception of physical ability was assessed using a study-specific questionnaire. Pre- and post-test SFT and SF-36 scores were compared using paired t-tests. Frequency of responses was used to describe participant perceptions. Results: 110 evaluation participants (mean age 68.2 years; 85% female), 49% of those who completed the pre-test, also completed the post-test. Evaluation participants significantly improved their strength (assessed using arm curls and sit-to-stand); endurance (two-minute step test); flexibility (sit and reach, back scratch); and agility/dynamic balance (eight-foot up and go). SF-36 physical-functioning domain scores also significantly improved. Most participants reported improved strength, fitness, mobility, general well-being and confidence in performing daily activities. Conclusion: Weekly, community-based strength training programs show promise in improving the functional capacity, including the strength, of older adults. More thorough evaluation is now required to confirm these findings.
- Description: 2003008182
- Authors: Bates, Amanda , Donaldson, Alex , Lloyd, Beverley , Castell, Sally , Krolik, Patricia , Coleman, Renee
- Date: 2009
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 20, no. 1 (2009), p. 42-47
- Full Text:
- Reviewed:
- Description: Issue addressed: Little is known about the effectiveness of once-weekly strength training programs for older adults based in community settings. This pilot study evaluated such a program to assess changes in the functional fitness of participants. Methods: A pre-test/post-test within subjects study design was used with new participants in the 10-week Staying Active, Staying Strong (SASS) program (all aged 50+ years). The Seniors Fitness Test (SFT) and SF-36 were used to assess functional fitness and health-related quality of life respectively. Perception of physical ability was assessed using a study-specific questionnaire. Pre- and post-test SFT and SF-36 scores were compared using paired t-tests. Frequency of responses was used to describe participant perceptions. Results: 110 evaluation participants (mean age 68.2 years; 85% female), 49% of those who completed the pre-test, also completed the post-test. Evaluation participants significantly improved their strength (assessed using arm curls and sit-to-stand); endurance (two-minute step test); flexibility (sit and reach, back scratch); and agility/dynamic balance (eight-foot up and go). SF-36 physical-functioning domain scores also significantly improved. Most participants reported improved strength, fitness, mobility, general well-being and confidence in performing daily activities. Conclusion: Weekly, community-based strength training programs show promise in improving the functional capacity, including the strength, of older adults. More thorough evaluation is now required to confirm these findings.
- Description: 2003008182
Effect of a low-resource-intensive lifestyle modification program incorporating gymnasium-based and home-based resistance training on Type 2 Diabetes Risk in Australian adults
- Payne, Warren, Walsh, Kerry, Harvey, Jack, Livy, Michelle, McKenzie, Kylie, Donaldson, Alex, Atkinson, Meredith, Keogh, Jennifer, Moss, Robert, Dunstan, David, Hubbard, Wendy
- Authors: Payne, Warren , Walsh, Kerry , Harvey, Jack , Livy, Michelle , McKenzie, Kylie , Donaldson, Alex , Atkinson, Meredith , Keogh, Jennifer , Moss, Robert , Dunstan, David , Hubbard, Wendy
- Date: 2008
- Type: Text , Journal article
- Relation: Diabetes Care Vol. 31, no. 12 (Dec 2008), p. 2244-2250
- Full Text:
- Reviewed:
- Description: OBJECTIVE - The purpose of this study was to assess the effectiveness of a low-resource-intensive lifestyle modification program incorporating resistance training and to compare a gymnasium-based with a home-based resistance training program on diabetes diagnosis sa us and risk. RESEARCH DESIGN AND METHODS - A quasi-experimental two-group study was undertaken with 122 participants with diabetes risk factors; 36.9% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at baseline. The intervention included a 6-week group self-management education program, a gymnasium-based or home-based 12-week resistance training program, and a 34-week maintenance program. Fasting plasma glucose (FPG) and 2-h plasma glucose, blood lipids, blood pressure, body composition, physical activity, and diet were assessed at baseline and week 52. RESULTS - Mean 2-h plasma glucose and FPG fell by 0.34 mmol/l (95% CI -0.60 to -0.08) and 0.15 mmol/l (-0.23 to -0.07), respectively. The proportion of participants with IFG or IGT decreased from 36.9 to 23.0% (P = 0.006). Mean weight loss was 4.07 kg (-4.99 to -3.15). The only significant difference between resistance training groups was a greater reduction in systolic blood pressure for the gymnasium-based group (P = 0.008). CONCLUSIONS - This intervention significantly improved diabetes diagnostic status and reduced diabetes risk to a degree comparable to that of other low-resource-intensive lifestyle modification programs and more intensive interventions applied to individuals with IGT. The effects of home-based and gymnasium-based resistance training did not differ significantly.
- Description: C1
- Authors: Payne, Warren , Walsh, Kerry , Harvey, Jack , Livy, Michelle , McKenzie, Kylie , Donaldson, Alex , Atkinson, Meredith , Keogh, Jennifer , Moss, Robert , Dunstan, David , Hubbard, Wendy
- Date: 2008
- Type: Text , Journal article
- Relation: Diabetes Care Vol. 31, no. 12 (Dec 2008), p. 2244-2250
- Full Text:
- Reviewed:
- Description: OBJECTIVE - The purpose of this study was to assess the effectiveness of a low-resource-intensive lifestyle modification program incorporating resistance training and to compare a gymnasium-based with a home-based resistance training program on diabetes diagnosis sa us and risk. RESEARCH DESIGN AND METHODS - A quasi-experimental two-group study was undertaken with 122 participants with diabetes risk factors; 36.9% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at baseline. The intervention included a 6-week group self-management education program, a gymnasium-based or home-based 12-week resistance training program, and a 34-week maintenance program. Fasting plasma glucose (FPG) and 2-h plasma glucose, blood lipids, blood pressure, body composition, physical activity, and diet were assessed at baseline and week 52. RESULTS - Mean 2-h plasma glucose and FPG fell by 0.34 mmol/l (95% CI -0.60 to -0.08) and 0.15 mmol/l (-0.23 to -0.07), respectively. The proportion of participants with IFG or IGT decreased from 36.9 to 23.0% (P = 0.006). Mean weight loss was 4.07 kg (-4.99 to -3.15). The only significant difference between resistance training groups was a greater reduction in systolic blood pressure for the gymnasium-based group (P = 0.008). CONCLUSIONS - This intervention significantly improved diabetes diagnostic status and reduced diabetes risk to a degree comparable to that of other low-resource-intensive lifestyle modification programs and more intensive interventions applied to individuals with IGT. The effects of home-based and gymnasium-based resistance training did not differ significantly.
- Description: C1
Evaluating SafeClub : Can risk management training improve the safety activities of community soccer clubs?
- Abbott, Kristy, Klarenaar, Paul, Donaldson, Alex, Sherker, Shauna
- Authors: Abbott, Kristy , Klarenaar, Paul , Donaldson, Alex , Sherker, Shauna
- Date: 2008
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 42, no. 6 (Jun 2008), p. 460-465
- Full Text:
- Reviewed:
- Description: Objective: To evaluate a sports safety-focused risk-management training programme. Design: Controlled before and after test. Setting: Four community soccer associations in Sydney, Australia. Participants: 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. Intervention: SafeClub, a sports safety-focused risk-management training programme (362 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Main outcome measures: Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. Results: There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001) scores compared with control clubs at the post-season and 12-month follow-ups. There was also a significant linear interaction of time and group for all three scores: policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001). Conclusions: SafeClub effectively assisted community soccer clubs to improve their sports safety activities, particularly the foundations and processes for good risk-management practice, in a sustainable way.
- Description: C1
- Description: 2003005630
- Authors: Abbott, Kristy , Klarenaar, Paul , Donaldson, Alex , Sherker, Shauna
- Date: 2008
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 42, no. 6 (Jun 2008), p. 460-465
- Full Text:
- Reviewed:
- Description: Objective: To evaluate a sports safety-focused risk-management training programme. Design: Controlled before and after test. Setting: Four community soccer associations in Sydney, Australia. Participants: 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. Intervention: SafeClub, a sports safety-focused risk-management training programme (362 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Main outcome measures: Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. Results: There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001) scores compared with control clubs at the post-season and 12-month follow-ups. There was also a significant linear interaction of time and group for all three scores: policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001). Conclusions: SafeClub effectively assisted community soccer clubs to improve their sports safety activities, particularly the foundations and processes for good risk-management practice, in a sustainable way.
- Description: C1
- Description: 2003005630
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