363 Coach education as a strategy to improve adherence to ACL injury prevention programs: a cluster-randomized controlled trial

Abstract BackgroundCompared to urban children, children living in rural areas of most countries, including China, are at higher risk of suffering unintentional injuries. Most proven injury prevention interventions, however, are rarely implemented in rural China due to lack of resources. Mobile health interventions are low-cost and easy-to-implement, facilitating implementing injury prevention in resource-limited areas (e.g., rural areas). This study is designed to examine the effectiveness of an app-based intervention for unintentional injury prevention among rural preschoolers in China. MethodsA single-blind, 18-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be implemented in 2 rural areas of China (Yang County, Shaanxi Province, and Shicheng County, Jiangxi Province). In total, at least 3508 rural caregivers of preschoolers aged 3-6 years old who own a smartphone will be recruited from 24 preschools. Clusters will be randomized at the preschool level and allocated to the control group (receiving routine school-based education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (receiving routine school-based education plus app-based parenting education including unintentional injury prevention). External support strategies will be adopted by local partners to minimize user fatigue, non-compliance, and attrition. Data collection will be conducted at baseline and then every 3 months during the 18-month follow-up time period. Intention-to-treat (ITT) data analysis will be implemented. Missing values will be imputed by using the Expectation Maximization algorithm (EM). Generalized estimation equations (GEE) will test the overall effectiveness of the app-based intervention. A per-protocol (PP) sensitivity analysis will be conducted to test the robustness of results. Subgroup analyses will follow the strategies for primary analyses.ResultsThe primary outcome measure is the incidence rate of unintentional injury among preschoolers during the study period. Secondary outcome measures comprise longitudinal changes in caregiver’s attitudes, caregiver-reported supervision behaviors, and caregiver-assessed home environment safety surrounding child unintentional injury prevention in the last week using a standardized audit instrument.ConclusionThe app-based intervention is expected to be feasible and effective over the 18-month intervention period. If the app is demonstrated effective as hypothesized, we will initiate processes to generalize and popularize it broadly to rural child caregivers across China. Trial registrationChiCTR2000037606, registered on August 29, 2020.

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178 The effect of the fédération internationale de football association (FIFA) 11+ kids injury prevention program on reducing injury rates in children’s soccer: a cluster-randomized controlled trial

10.1136/bjsports-2021-ioc.164 ◽

2021 ◽

Author(s):

Wesam Saleh A Al Attar ◽

Saud Alarifi ◽

Hussain Saleh H Ghulam ◽

Hosam Alzahrani ◽

Msaad M Alzhrani ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Injury Prevention ◽

Prevention Program ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Injury Rates ◽

Randomized Controlled ◽

Injury Prevention Program ◽

Cluster Randomized

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COACH EDUCATION IMPROVES ADHERENCE TO ACL INJURY PREVENTION PROGRAMS: A CLUSTER-RANDOMIZED CONTROLLED TRIAL

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00070 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0007

Author(s):

Joseph Janosky

Keyword(s):

Injury Prevention ◽

Controlled Trial ◽

Intervention Group ◽

Acl Injury ◽

Prevention Programs ◽

Control Group ◽

Warm Up ◽

Cluster Randomized ◽

Acl Injury Prevention ◽

Sports Coaches

Background: ACL injury prevention programs have demonstrated limited impact on population health, due in part to poor adherence to expert recommendations by sports coaches. Neuromuscular training (NMT) serves as a protective factor against ACL injury and serves as a key component of many ACL injury prevention programs. The objective of this study was to determine the effect of an educational workshop for sports coaches on adherence to neuromuscular training (NMT) implementation recommendations. Methods: In a cluster-randomized controlled trial, 22 teams in 8 high schools were randomized to either the intervention or control group. The intervention schools included 12 teams (5 female), and the control schools included 10 teams (4 female). The sports included basketball, volleyball, track and field, baseball, softball, and lacrosse. Coaches in the intervention group participated in a 60-minute educational workshop designed to teach coaches how to effectively implement a NMT program as a warm-up prior to team practice sessions and games. The schools in the control arm received print materials on recommended NMT exercises. Adherence to NMT implementation recommendation by sports coaches was the primary outcome. Eight data collectors, who were blinded to the teams’ assignment, were trained to observe each team’s practice or game 2-3 times a week. At each session, they completed a study questionnaire to identify the exercises completed by athletes during the team’s warm-up. They then recorded whether the coach 1) delivered exercise instructions, and 2) provided corrective cues. Generalized estimating equations (GEE) were used to account for potential correlations among teams at the same school. Results: A total of 399 practices or games were observed over 2 seasons. A greater proportion of coaches in the intervention group provided cues to correct improper technique compared to coaches in the control group [difference=0.04 (95% CI: 0.01, 0.07, p=0.006]. In addition, more coaches in the intervention group completed a full NMT program [OR=4.62 (1.22, 17.50), p=0.02]. There was a similar proportion of coaches in the intervention and control groups who provided exercise instructions [difference=0.01 (95% CI: -0.02, 0.04), p<0.44]. Conclusions: Coach education can improve adherence to NMT implementation recommendations and the delivery of corrective cues during NMT sessions, which are both critical to reducing the risk of ACL injury. All coaches should receive in-person training that highlights the salience of NMT and provides the knowledge and skills required to effectively implement NMT sessions with young athletes.

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Assessing the effectiveness of an app-based child unintentional injury prevention intervention for caregivers of rural Chinese preschoolers: protocol for a cluster randomized controlled trial

BMC Public Health ◽

10.1186/s12889-021-12156-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jieyi He ◽

Wanhui Wang ◽

Peishan Ning ◽

Peixia Cheng ◽

Jie Li ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Injury Prevention ◽

Rural Areas ◽

Controlled Trial ◽

Unintentional Injury ◽

Cluster Randomized Controlled Trial ◽

Parenting Education ◽

Randomized Controlled ◽

School Based ◽

Cluster Randomized

Abstract Background Compared to urban children, children living in rural areas of most countries, including China, are at higher risk of suffering unintentional injuries. Most proven injury prevention interventions, however, are rarely implemented in rural China due to lack of resources. Mobile health interventions are low-cost and easy-to-implement, facilitating implementing injury prevention in resource-limited areas (e.g., rural areas). This study is designed and implemented to examine the effectiveness of an app-based intervention for unintentional injury prevention among rural preschoolers in China. Methods A single-blind, 18-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be implemented in 2 rural areas of China (Yang County, Shaanxi Province, and Shicheng County, Jiangxi Province). In total, at least 3508 rural caregivers of preschoolers aged 3–6 years old who own a smartphone will be recruited from 24 preschools. Clusters will be randomized at the preschool level and allocated to the control group (receiving routine school-based education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (receiving routine school-based education plus app-based parenting education including unintentional injury prevention). External support strategies will be adopted by local partners to minimize user fatigue, non-compliance, and attrition. Data collection will be conducted at baseline and then every 3 months during the 18-month follow-up time period. Intention-to-treat data analysis will be implemented. Missing values will be imputed by using the Expectation Maximization algorithm. Generalized estimating equation will test the overall effectiveness of the app-based intervention. A per-protocol sensitivity analysis will be conducted to test the robustness of results. Subgroup analyses will follow the strategies for primary analyses. The primary outcome measure is the incidence rate of unintentional injury among preschoolers during the study period. Secondary outcome measures comprise longitudinal changes in caregiver’s attitudes, caregiver-reported supervision behaviors, and caregiver-assessed home environment safety surrounding child unintentional injury prevention in the last week using a standardized audit instrument. Discussion The app-based intervention is expected to be feasible and effective over the 18-month intervention period. If the app is demonstrated effective as hypothesized, we will initiate processes to generalize and popularize it broadly to rural child caregivers across China. Trial registration ChiCTR2000037606, registered on August 29, 2020.

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