Sports Pre-Participation Evaluation in Healthy Adults-A Survey-Based Assessment of Guideline Acceptability and Feasibility Among Sports Physicians and Participants.

INTRODUCTION

Sports pre-participation evaluations (PPEs) aim to identify people at increased risk of acute adverse events during physical activity. Little is known about their acceptability and feasibility among physicians and participants ('interest holders'). During the development of a consensus-based PPE guideline in Germany targeted at healthy adults who plan to take up or resume intense physical activity, we used surveys to assess interest holder perceptions of the acceptability and feasibility of the PPE, and to obtain their feedback on draft guideline recommendations.

METHODS

Cross-sectional online surveys were conducted separately in two interest holder groups. Acceptability was evaluated among adults (≥ 18 years) in Germany ('consumers'), the target population of the PPE guideline. Feasibility was investigated among potential guideline users, which included sports medicine specialists and general practitioners practising in Germany ('sports physicians'). Agreement with nine acceptability and feasibility statements was analysed descriptively. Comments on draft recommendations were collected and grouped thematically.

RESULTS

A total of 144 consumers and 204 physicians (186 with certification in sports medicine) completed the survey. Among the consumers, 82% would consider making use of a PPE, 8% were neutral, and 10% would not. Only 1% had 'concerns or reservations'. The main barrier was a potential non-reimbursement of the PPE by their health insurance (61%). Of the 186 certified sports physicians, 83% would offer or already offer a PPE, 12% were neutral, and 5% would not offer a PPE. Potential barriers were non-reimbursement by health insurers (20%), the required time and effort (13%), and qualification issues (14%). About half of the draft recommendations (11/23, 48%) were modified based on interest holder feedback.

DISCUSSION: Conducting consumer and end-user surveys as part of the guideline development process increased awareness of the main acceptability and feasibility issues, provided relevant suggestions to the draft recommendations, and identified considerations for guideline implementation.