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Fortington LV, Badenhorst M, Bolling C, Derman W, Emery CA, Pasanen K, Schwellnus M, Verhagen E, Finch Ao CF. Are we levelling the playing field? A qualitative case study of the awareness, uptake and relevance of the IOC consensus statements in two countries. Br J Sports Med 2023; 57:1371-1381. [PMID: 36725283 PMCID: PMC10646857 DOI: 10.1136/bjsports-2022-105984] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Research evidence is commonly compiled into expert-informed consensus guidelines intended to consolidate and distribute sports medicine knowledge. Between 2003 and 2018, 27 International Olympic Committee (IOC) consensus statements were produced. This study explored the policy and practice impact of the IOC Statements on athlete health and medical team management in two economically and contextually diverse countries. METHODS A qualitative case study design was adopted. Fourteen face-to-face interviews were conducted with purposively selected interviewees, seven participants from Australia (higher economic equality) and seven from South Africa (lower economic equality), representing their national medical commissions (doctors and physiotherapists of Olympic, Paralympic and Youth teams). A framework method was used to analyse interview transcripts and identify key themes. RESULTS Differences across resource settings were found, particularly in the perceived usefulness of the IOC Statements and their accessibility. Both settings were unsure about the purpose of the IOC Statements and their intended audience. However, both valued the existence of evidence-informed guidelines. In the Australian setting, there was less reliance on the resources developed by the IOC, preferring to use locally contextualised documents that are readily available. CONCLUSION The IOC Statements are valuable evidence-informed resources that support translation of knowledge into clinical sports medicine practice. However, to be fully effective, they must be perceived as useful and relevant and should reach their target audiences with ready access. This study showed different contexts require different resources, levels of support and dissemination approaches. Future development and dissemination of IOC Statements should consider the perspectives and the diversity of contexts they are intended for.
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Affiliation(s)
- Lauren V Fortington
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Perth, Australia
| | - Marelise Badenhorst
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
- Institute of Sport and Exercise Medicine (ISEM) Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, IOC Research Centre, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| | - Caroline Bolling
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC, Amsterdam, Netherlands
| | - Wayne Derman
- Dept of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kati Pasanen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC, Amsterdam, Netherlands
| | - Caroline F Finch Ao
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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Assessing parents, youth athletes and coaches subjective health literacy: A cross-sectional study. J Sci Med Sport 2021; 24:627-634. [PMID: 33637410 DOI: 10.1016/j.jsams.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics. DESIGN Cross-sectional. METHODS Data on subjective HL were collected using the Swedish Communicative and Critical Health Literacy (S-CCHL) instrument for mentors and for youth the School-Aged Children (HLSAC) instrument. Questions assessing mentors' literacy on sports injury and return to play were also included. RESULTS The surveys were completed by 159 (91%) mentors and 143 youth athletes (87%). The level of S-CCHL was sufficient in 53% of the mentors. Of youth athletes, 28% reported a high level of HL and the item with least perceived high HL (21%) was critical thinking. Ninety-four percent of the mentors believed that it is quite possible to prevent injuries in athletics and 53% perceived having a very good knowledge about how to prevent injuries. Forty-six percent of the mentors perceived having a very good knowledge of return to sport criteria. CONCLUSIONS The level of health literacy was low with about half of the mentors and one out of three youth athletes having adequate HL levels. Only half of the mentors stated having a good knowledge of various injury prevention strategies. To reduce health consequences in youth sport and enable talent development more work is needed to understand the facilitators and barriers for the uptake of various health promotion and injury prevention strategies.
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Is It Time to Give Athletes a Voice in the Dissemination Strategies of Concussion-Related Information? Exploratory Examination of 2444 Adolescent Athletes. Clin J Sport Med 2020; 30:562-567. [PMID: 30119086 DOI: 10.1097/jsm.0000000000000653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of the research was to screen male and female adolescent athletes on their concussion educational histories and preferred future methods of education in terms of educational messenger, modality, and concussion-related areas of interest. DESIGN Cross-sectional survey. SETTING Examination setting within the classroom. PARTICIPANTS Adolescent male (n = 1854) and female (n = 590) athletes aged 12 to 18 years. MAIN OUTCOME MEASURES To explore the concussion educational histories and preferred future methods of education in Irish male and female adolescent athletes. RESULTS 19.7% (n = 482) of the sample received education in the past 12 months. Male athletes had a significantly higher rate of previous education than female athletes (41% vs 17%). The methods used in previous educational interventions are failing to match the interests of the athletes. Sex played a significant role in the preferred educational methods, as male and female athletes had significant differences in their choice of educational messenger, modality, and concussion-related areas of interest. CONCLUSIONS The current disparity in previous concussion education rates between male and female adolescent athletes should be addressed. Forthcoming research should explore the efficacy of tailoring knowledge translation strategies to match the specific needs of the recipient.
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Valier ARS, Bacon CEW, Kucera KL, Williams RM. Implementation Science: Lessons Learned From Evaluating Practice Recommendations for the Care of Patients With Spine Injuries. J Athl Train 2019; 54:192-197. [PMID: 30951384 DOI: 10.4085/1062-6050-242-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health care providers are encouraged to provide care according to practice recommendations because these suggestions should improve patient care and promote optimal patient outcomes. The goals of these practice recommendations are to improve patient care and promote optimal patient outcomes. However, without integration into clinical practice, the value of practice recommendations in supporting patient care is lost. Unfortunately, little is known about the success of integrating practice recommendations into clinical practice, and targeted efforts to promote integration are likely needed. Implementation research is a broad area of study that focuses on how guidelines, programs, or interventions are put into practice and delivered. The Translating Research Into Injury Prevention Practice (TRIPP) framework consists of 6 stages that support implementation science, and the framework has been used to assist in integrating injury-prevention programs into patient care. The structure of the TRIPP framework makes it applicable to other programs that would benefit from implementation science, including practice recommendations. Stages 5 and 6 of the TRIPP framework emphasize the need to explore the implementation context and factors related to uptake of a program by end users. This commentary highlights our efforts to use methods for implementation research to evaluate stage 5 of the TRIPP framework as it relates to acute care for patients with suspected spine injuries and provides 6 lessons learned that may assist in future efforts to better implement practice recommendations in patient care. Targeted efforts to assist clinicians in implementing practice recommendations may promote their use and ultimately enhance the care provided for patients with a variety of health conditions. An essential component of any implementation effort is understanding end users via stages 5 and 6 of the TRIPP framework, and this understanding may maximize knowledge translation and encourage practice change and advancement.
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Affiliation(s)
- Alison R Snyder Valier
- Athletic Training Programs, A.T. Still University, Mesa.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa.,Research Support, A.T. Still University, Mesa
| | - Cailee E Welch Bacon
- Athletic Training Programs, A.T. Still University, Mesa.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa
| | - Kristen L Kucera
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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Niederer D, Engeroff T, Lange K, Vogt L, Banzer W. Return-to-play after concussion: state of knowledge, frequency of use and application barriers of guidelines among decision-makers in rugby. Brain Inj 2018; 32:1096-1102. [PMID: 29870281 DOI: 10.1080/02699052.2018.1483032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Validated strategies and guidelines for a safe and individualized diagnosis and return-to-play (RTP) after concussion in rugby are needed. Little is known about the state of knowledge, frequency of use and application barriers of state-of-the-art guidelines among decision-makers in professional or semi-professional rugby teams. Participants (n = 195) from the coaching team (head coach, assistance coach, athletic coach), the medical team (physiotherapist, physician, rehabilitation therapist, neuropsychologist), or from the officials of a professional or semi-professional rugby team (top three major leagues in Germany), filled in a questionnaire on their knowledge, frequency of use and application barriers of evidence-based guidelines (Graduated RTP protocol and The 5R). Depending on their function in the team and on the league of play, the state of knowledge and application of the diagnostic tools and the RTP guidelines differ. A considerable number are aware of one or both guidelines, but do not apply these guidelines (up to 27% of respondants). The main reasons for the non-usage were not my decision (59%), use of concurrent guidelines (54%), each player must decide by his own (36%), never experienced a concussion in my players (30%), other (19%), the guideline is useless (18%) and a player may play despite a concussion (14%). Raising awareness of the state-of-the-art guidelines is important to educate further the coaching, medical and official team members in identifying symptoms and executing the RTP-process in accordance with evidence-based strategies.
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Affiliation(s)
- Daniel Niederer
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Tobias Engeroff
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Kevin Lange
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Lutz Vogt
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Winfried Banzer
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
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White PE, Donaldson A, Sullivan SJ, Newton J, Finch CF. Australian Football League concussion guidelines: what do community players think? BMJ Open Sport Exerc Med 2017; 2:e000169. [PMID: 28890801 PMCID: PMC5566260 DOI: 10.1136/bmjsem-2016-000169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 12/19/2022] Open
Abstract
Background Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players’ views on following the Australian Football League's (AFL) concussion guidelines. Methods 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently. Results Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players’ rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players’ desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost. Conclusions Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport.
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Affiliation(s)
- Peta E White
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Alex Donaldson
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - S John Sullivan
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Joshua Newton
- Faculty of Business and Law, Deakin Business School, Deakin University Melbourne Burwood Campus, Melbourne, Victoria, Australia
| | - Caroline F Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
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Saw R, Finch CF, Samra D, Baquie P, Cardoso T, Hope D, Orchard JW. Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play. Sports Health 2017; 10:208-216. [PMID: 28825878 PMCID: PMC5958447 DOI: 10.1177/1941738117726070] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CONTEXT The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). OBJECTIVE To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. STUDY DESIGN A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. RESULTS The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. CLINICAL RELEVANCE An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.
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Affiliation(s)
- Richard Saw
- Olympic Park Sports Medicine Centre,
Melbourne, Victoria, Australia
| | - Caroline F. Finch
- Australian Collaboration for Research
into Injury in Sport and Its Prevention, Federation University Australia, Ballarat,
Victoria, Australia
| | - David Samra
- The Stadium Sports Medicine Clinic,
Sydney, New South Walesm Australia
| | - Peter Baquie
- Olympic Park Sports Medicine Centre,
Melbourne, Victoria, Australia
| | - Tanusha Cardoso
- Alphington Sports Medicine Clinic,
Melbourne, Victoria, Australia
| | - Danielle Hope
- Peak Sports Medicine Clinic, Melbourne,
Victoria, Australia
| | - John W. Orchard
- School of Public Health, University of
Sydney, Sydney, New South Wales, Australia
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White PE, Register-Mihalik J, Donaldson A, Sullivan SJ, Finch CF. Concussion guideline implementation perceptions and experiences among parents of community-level Australian Football junior players. BMJ Open Sport Exerc Med 2017; 3:e000215. [PMID: 28761707 PMCID: PMC5530102 DOI: 10.1136/bmjsem-2016-000215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND/AIM Concussion guidelines exist for multiple community sports. Parents are key stakeholders in guideline implementation and in appropriate responses following concussive injury. The purpose of this qualitative investigation was to understand how parents of community-level Australian Football (AF) players experience and perceive concussion guidelines in order to inform the design and implementation of concussion guidelines in community sport. METHODS A cross-sectional qualitative approach was adopted to allow for an open and detailed exploration of the views of parents of junior community AF players (ie, those aged <16 years) regarding concussion guidelines of the AF League (AFL)-the national governing body for AF. Participants were 15 parents of junior community AF players from two clubs affiliated with a large regional community AF League. RESULTS The key experiences and perceptions of the parents included appreciation that the guidelines outlined the postconcussion process that should be followed, desires for better understanding of the guidelines by general practitioners (ie, medical doctors) who care for children with concussion, having more readily available information for parents and receiving more formal policy guiding timing of return-to-participation following concussion. Difficulties with the guidelines not addressing delayed presentations of concussion were also frequently mentioned. CONCLUSIONS Parents are key stakeholders in concussion prevention and care in community sport. As such, their input should be considered when developing guidelines and resources for community sport. Furthermore, concussion information should be made available to parents in an easily accessible and community-friendly form.
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Affiliation(s)
- Peta E White
- Australian Collaboration for Research into Injury in Sport and Its Prevention, Federation University Australia, Ballarat, Victoria, Australia
| | | | - Alex Donaldson
- Australian Collaboration for Research into Injury in Sport and Its Prevention, Federation University Australia, Ballarat, Victoria, Australia
| | - S John Sullivan
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and Its Prevention, Federation University Australia, Ballarat, Victoria, Australia
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