Background: Evidence-based preventive training programs (PTPs) used as a pre-participation warm-up for sport have been shown to reduce injury risk in youth athletes; however, injury risk improvements depend on PTP dosage and fidelity, where increased levels of PTP compliance facilitate and sustain greater reductions in injury risk. While coaches represent the best option to facilitate PTPs long term, it is unknown how to best train coaches to ensure effective PTP implementation behavior. In other areas of health behavior research, education strategies tailored specifically to an individual’s needs and interests increase the likelihood of adopting a given behavior. To encourage youth sport coaches to implement PTPs, it may be beneficial to tailor workshops. One way to gauge the impact of an education strategy is to look at end-user outcomes. Therefore, the purpose of this study was to evaluate changes in athlete injury risk, as measured by the Landing Error Scoring System (LESS), between adolescent basketball and soccer athletes whose coach attended a General pre-season education workshop on PTP implementation compared to a Tailored pre-season education workshop. Methods: A cluster randomized control trial was utilized. Youth soccer and basketball organizations were contacted to participate in a pre-season coaches’ education workshop on PTP implementation. Organizations were randomized into either a General or Tailored workshop. All participating coaches within a given organization attended the same workshop. General workshops contained standardized content including: youth sport injury epidemiology, injury rate and risk reduction benefits of PTPs, and hands-on instruction on how to implement a PTP. Coaches in Tailored workshops completed pre-workshop surveys. The pre-workshop survey contained Likert-style questions on knowledge of and experience with implementing PTPs. Researchers used the results to prioritize and inform content emphasis within the Tailored workshop. For example, if an organization had a high frequency of coaches who reported that they were particularly interested in the sport performance benefits of PTPs, the research team would devote increased time to discussing that particular component. Both the General and Tailored workshop were approximately 1-hour in length but varied in the amount of time spent on different topic areas. Athletes completed a PRE and POST season baseline assessment of injury risk. The injury risk assessment included three trials of a jump-landing task that was evaluated using the Landing Error Scoring System (LESS). The LESS is a valid and reliable clinical movement assessment used to identify high-risk movement patterns during a jump-landing task. LESS scores are based on observable errors, where a higher score indicates a greater number of movement errors and an increased risk of sustaining a lower extremity injury. To complete the task, participants jumped off a 30-cm high box to a distance half of their height and immediately rebounded straight in the air for maximum vertical height. A single, reliable rater graded all trials for PRE and POST. All three trials were averaged together for one composite LESS score at each time point. A mixed model analysis of variance (ANOVA) was used to evaluate differences in composite LESS score over time (PRE, POST) between educational workshops (General, Tailored). All data were analyzed using SPSS Version 21.0 with an a priori alpha level of p<0.05. Results: Seventy-seven athletes on 9 teams across 6 different organizations (Coaches’ Workshops: General=5 teams from 4 organizations; Tailored=4 teams from 2 organizations) completed both PRE and POST testing sessions. There were no significant differences between workshop (General, Tailored) and LESS scores at POST (P>0.05). Regardless of workshop LESS scores improved over time ((Mean±SD [95%CI]) Generalized PRE: 5.46±0.10 [4.84, 6.08], Generalized POST: 4.62±0.10 [4.00, 5.25], Tailored PRE: 5.99±0.09[5.40, 6.59], Tailored POST: 5.66±0.09[5.06, 6.25])(P=0.03). Conclusions: Regardless of coaches’ educational workshop strategy, athletes improved movement technique from PRE to POST across a single sport season. These findings suggest that any level of exposure to PTP-related content could have beneficial downstream effects for the end user, or in this case reduced injury risk for youth athletes. Future studies should look to evaluate the content of pre-season coach education workshops in conjunction with tracking fidelity of program delivery in order to optimize efforts to disseminate and implement PTPs for youth sport coaches. [Figure: see text]
Sport coaches’ experiences of athlete injury: the development and regulation of guilt