How do we know if they are doing what we want them to? Assessing exercise fidelity in an injury prevention exercise program

Abstract

Methods: Seventy-eight clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a larger injury prevention project (National Guidance for Australian Football Partnerships and Safety (NoGAPS)). System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively via semi-structured interviews with targeted-users (mainly sports trainers). Results: Across the 78 clubs, there was 69% reach (informed about/trained in use of injury surveillance system), 44% adoption (set up an online account with intention of recording injuries), 23% implementation (used system to record injuries throughout season) and 9% maintenance (used system over two consecutive seasons). Reach and adoption were highest in those leagues receiving concurrent support for the delivery of the NoGAPS injuryprevention trainingprogram(FootyFirst). Interviewees identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), sociocontextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online surveillance system). Discussion: The injury surveillance system was implemented andmaintained by only a small proportion of clubs. Outcomeswere best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with club personnel and organisations at all levels can enhance use of injury surveillance systems in community sport. Interview findings suggest that increased implementation could also be achievedby educating club personnel on the importance of recording injuries, asking leagues to create clearer injury surveillance guidelines, increasing club staffing, better remunerating those who conduct surveillance and offering flexible surveillance systems in a range of accessible formats. By increasing the use of surveillance systems, datawill better reflect the target population and increase our understanding of the injury problem in community sport.