Hespanhol L1,2,3, Vallio CS1, Oliveira GM1, Mota GAK1, Lopes AD1,4
1Universidade Cidade de São Paulo (UNICID), Masters and Doctoral Programs in Physical Therapy, São Paulo, Brazil, 2VU University Medical Center Amsterdam (VUmc), Department of Public and Occupational Health (DPOH) and the Amsterdam Public Health Research Institute (APH), Amsterdam, Netherlands, 3Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Academic Medical Center/VU University Medical Center IOC Research Center, Amsterdam, Netherlands, 4University of Massachusetts Lowell, Department of Physical Therapy, College of Health Sciences, Lowell, United States
Background: Despite running-related injury (RRI) is considered, in theory, a preventable side effect of running, there is limited evidence on the effectiveness of RRI prevention strategies.This may be partially explained by the fact that most prevention strategies were not developed following behavioural change theories. Developing injury prevention programmes based on behavioural and social science theories may increase the probability of effectiveness and implementation in 'real world'.
Purpose: To develop an RRI prevention programme based on perspectives of behavioural change and taking a participatory approach.
Methods: This was a mixed method study with a sequential implementation. Intervention Mapping (IM) was used as a framework for the development of the RRI prevention programme taking a participatory approach. A focus group composed of three face-to-face meetings was implemented. A semi-structure interview was conducted after the meetings in order to collect information on facilitators and barriers towards the development of the programme. Two researchers independently performed the audio transcriptions and coding. A third researcher performed the evaluation of transcriptions and coding accuracy. The data analysis was performed qualitatively by coding the transcriptions and interpreting the codes, and quantitatively by calculating the frequency and percentage of the codes emerged.
Results: Of the 15 individuals invited to participate, 10 were included in the study and five reported conflicting agendas. The participants were: one sports physician; two physiotherapists; two physical education professionals; two researchers; two runners; and one stakeholder. A needs assessment was performed in the first meeting. In subsequent meetings we discussed the matrices of chance objectives, application methods, programme production, implementation and an evaluation plan. An RRI prevention programme was developed based on the Integrated Behaviour Model. The main components of the programme are:
(1) to provide feedback on individual training characteristics and RRI risk;
(2) to increase knowledge on symptoms, foot strike patterns, running shoes and conditioning exercises;
(3) to facilitate self-efficacy on keeping a running training programme; and
(4) to increase skills on incorporating conditioning exercises.
The delivery strategy will be through automated tailored online feedback on running load and written/video information posted in a website. The evaluation of the effectiveness of the RRI prevention programme will be performed in a randomised controlled trial. Nine participants were interviewed regarding facilitators and barriers to the development of the prevention programme. 'Face-to-face group meetings' was identified as the most significant facilitator (24.1%, n=7/29 mentions), whilst 'absence of participants' and 'lack of consensus' were identified as the most significant barriers (15.6%, n=5/30 mentions).
Conclusion(s): An RRI prevention programme was successfully developed using the IM framework and a participatory approach. The programme is based on providing feedback on running load and RRI risk, and also on increasing knowledge, self-efficacy and skills related to RRI prevention.
Implications: This is the first RRI prevention programme developed based on a behavioural change approach. This might increase the probability of the effectiveness and implementation of the programme in 'real world'. In addition, facilitators and barriers were identified in order to optimise the development of future prevention programmes on sports injuries.
Keywords: athletic injuries, sports, behaviour
Funding acknowledgements: This study was funded by The São Paulo Research Foundation (FAPESP), process number 2016/09220-1.
Purpose: To develop an RRI prevention programme based on perspectives of behavioural change and taking a participatory approach.
Methods: This was a mixed method study with a sequential implementation. Intervention Mapping (IM) was used as a framework for the development of the RRI prevention programme taking a participatory approach. A focus group composed of three face-to-face meetings was implemented. A semi-structure interview was conducted after the meetings in order to collect information on facilitators and barriers towards the development of the programme. Two researchers independently performed the audio transcriptions and coding. A third researcher performed the evaluation of transcriptions and coding accuracy. The data analysis was performed qualitatively by coding the transcriptions and interpreting the codes, and quantitatively by calculating the frequency and percentage of the codes emerged.
Results: Of the 15 individuals invited to participate, 10 were included in the study and five reported conflicting agendas. The participants were: one sports physician; two physiotherapists; two physical education professionals; two researchers; two runners; and one stakeholder. A needs assessment was performed in the first meeting. In subsequent meetings we discussed the matrices of chance objectives, application methods, programme production, implementation and an evaluation plan. An RRI prevention programme was developed based on the Integrated Behaviour Model. The main components of the programme are:
(1) to provide feedback on individual training characteristics and RRI risk;
(2) to increase knowledge on symptoms, foot strike patterns, running shoes and conditioning exercises;
(3) to facilitate self-efficacy on keeping a running training programme; and
(4) to increase skills on incorporating conditioning exercises.
The delivery strategy will be through automated tailored online feedback on running load and written/video information posted in a website. The evaluation of the effectiveness of the RRI prevention programme will be performed in a randomised controlled trial. Nine participants were interviewed regarding facilitators and barriers to the development of the prevention programme. 'Face-to-face group meetings' was identified as the most significant facilitator (24.1%, n=7/29 mentions), whilst 'absence of participants' and 'lack of consensus' were identified as the most significant barriers (15.6%, n=5/30 mentions).
Conclusion(s): An RRI prevention programme was successfully developed using the IM framework and a participatory approach. The programme is based on providing feedback on running load and RRI risk, and also on increasing knowledge, self-efficacy and skills related to RRI prevention.
Implications: This is the first RRI prevention programme developed based on a behavioural change approach. This might increase the probability of the effectiveness and implementation of the programme in 'real world'. In addition, facilitators and barriers were identified in order to optimise the development of future prevention programmes on sports injuries.
Keywords: athletic injuries, sports, behaviour
Funding acknowledgements: This study was funded by The São Paulo Research Foundation (FAPESP), process number 2016/09220-1.
Topic: Sport & sports injuries
Ethics approval required: Yes
Institution: Universidade Cidade de São Paulo (UNICID)
Ethics committee: research ethics committee
Ethics number: CAAE 69503717.2.0000.0064
All authors, affiliations and abstracts have been published as submitted.
