British journal of sports medicine · 2026
Supported implementation enhances injury prevention programme (Prep-to-Play) use in women and girls playing Australian Football: a pragmatic type III hybrid implementation-effectiveness stepped wedge cluster randomised trial.
СтатьяРандомизированное исследованиеPragmatic Clinical TrialНазвание и аннотация: Перевод в очереди
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Patterson Brooke E, White Nicole M, Cowan Sallie M, King Matthew G, Donaldson Alex, Haberfield Melissa J, Mosler Andrea B, Bruder Andrea M, Barton Christian J, McPhail Steven M, Culvenor Adam G, Hemming Karla, Hägglund Martin, Lannin Natasha A, Ackerman Ilana N, Dowsey Michelle M, Makdissi Michael, Sundaraj Shona, Livingstone Nicole, Fitzpatrick Jane, Crain Jamie, Lampard Sarah J, Roughead Eliza A, Chilman Karina L, Gracias Libby J, Birch Elizabeth, Bonello Christian, Crossley Kay M
Аннотация
OBJECTIVES: Evaluate the effect of supported implementation on a co-created injury prevention programme (Prep-to-Play) use and injury incidence and evaluate the dose response relationship between adherence and injury incidence.
METHODS: In this hybrid implementation-effectiveness stepped wedge cluster randomised trial, 165 women's/girls' Australian Football teams (2481 players) were randomly allocated to transition from unsupported to supported implementation at one of five time points during 2021/2022. Supported implementation included in-person workshops and support visits for coaches/team leaders. Unsupported implementation was access to online resources. Prep-to-Play includes warm-up, contact and strength activities. Primary (Prep-to-Play use) and secondary (concussion, anterior cruciate ligament (ACL)) outcomes were reported weekly. Weekly Prep-to-Play use (yes/no) was defined as using ≥75% of programme elements, ≥two-thirds of sessions each week. Analyses compared outcomes between supported and unsupported phases, adjusted for clustering, period, age group, competition level and region.
RESULTS: Average weekly Prep-to-Play use by teams was 13.1% (95% CI 11.5% to 14.9%) in the unsupported and 29.7% (95% CI 27.6% to 31.9%) in supported phase (OR 3.7 95% CI 2.4 to 5.7). The concussion and ACL injury incidence (per 1000 game hours) was 6.80 (95% CI 5.75 to 8.05) and 1.36 (95% CI 0.98 to 1.89) in unsupported, and 3.50 (95% CI 2.72 to 4.52) and 0.69 (95% CI 0.44 to 1.15) in supported, respectively, but the effect of supported implementation on injury incidence was unclear (concussion: incidence rate ratios (IRR) 1.36; 95% CI 0.74 to 2.49; ACL: IRR 2.27 (0.56 to 9.12). Higher Prep-to-Play adherence was associated with fewer total injuries (IRR: 0.95 95% CI 0.92 to 0.99).
CONCLUSIONS: Supported implementation via in-person workshops and support visits was associated with greater Prep-to-Play use compared with unsupported implementation, and greater adherence was associated with fewer injuries.
TRIAL REGISTRATION NUMBER: NCT04856241.
METHODS: In this hybrid implementation-effectiveness stepped wedge cluster randomised trial, 165 women's/girls' Australian Football teams (2481 players) were randomly allocated to transition from unsupported to supported implementation at one of five time points during 2021/2022. Supported implementation included in-person workshops and support visits for coaches/team leaders. Unsupported implementation was access to online resources. Prep-to-Play includes warm-up, contact and strength activities. Primary (Prep-to-Play use) and secondary (concussion, anterior cruciate ligament (ACL)) outcomes were reported weekly. Weekly Prep-to-Play use (yes/no) was defined as using ≥75% of programme elements, ≥two-thirds of sessions each week. Analyses compared outcomes between supported and unsupported phases, adjusted for clustering, period, age group, competition level and region.
RESULTS: Average weekly Prep-to-Play use by teams was 13.1% (95% CI 11.5% to 14.9%) in the unsupported and 29.7% (95% CI 27.6% to 31.9%) in supported phase (OR 3.7 95% CI 2.4 to 5.7). The concussion and ACL injury incidence (per 1000 game hours) was 6.80 (95% CI 5.75 to 8.05) and 1.36 (95% CI 0.98 to 1.89) in unsupported, and 3.50 (95% CI 2.72 to 4.52) and 0.69 (95% CI 0.44 to 1.15) in supported, respectively, but the effect of supported implementation on injury incidence was unclear (concussion: incidence rate ratios (IRR) 1.36; 95% CI 0.74 to 2.49; ACL: IRR 2.27 (0.56 to 9.12). Higher Prep-to-Play adherence was associated with fewer total injuries (IRR: 0.95 95% CI 0.92 to 0.99).
CONCLUSIONS: Supported implementation via in-person workshops and support visits was associated with greater Prep-to-Play use compared with unsupported implementation, and greater adherence was associated with fewer injuries.
TRIAL REGISTRATION NUMBER: NCT04856241.