Abstract
The Fédération Internationale de Football (FIFA) 11+ warm-up program is efficacious at preventing lower limb injury in youth soccer; however, there has been poor adoption of the program in the community. The purpose of this study was to determine the utility of the Health Action Process Approach (HAPA) behavior change model in predicting intention to use the FIFA 11+ in a sample of 12 youth soccer teams (coaches n = 10; 12–16 year old female players n = 200). A bespoke cross-sectional questionnaire measured pre-season risk perceptions, outcome expectancies, task self-efficacy, facilitators, barriers, and FIFA 11+ implementation intention. Most coaches (90.0%) and players (80.0%) expected the program to reduce injury risk but reported limited intention to use it. Player data demonstrated an acceptable fit to the hypothesized model (standardized root mean square residual (SRMR) = 0.08; root mean square of error of approximation (RMSEA) = 0.06 (0.047–0.080); comparative fit index (CFI) = 0.93; Tucker Lewis index (TLI) = 0.91) Task self-efficacy (β = 0.53, p ≤ 0.01) and outcome expectancies (β = 0.13 p ≤ 0.05) were positively associated with intention, but risk perceptions were not (β = −0.02). The findings suggest that the HAPA model is appropriate for use in this context, and highlight the need to target task self-efficacy and outcome expectancies in FIFA 11+ implementation strategies.
Highlights
The Fédération Internationale de Football (FIFA) estimates that there are over 22 million youth soccer players globally [1], and the frequency of injury in this population represents a significant public health burden
The findings suggest that the Health Action Process Approach (HAPA) model is appropriate for use in this context, and highlight the need to target task self-efficacy and outcome expectancies in FIFA 11+ implementation strategies
One team was excluded because the coach had experience with the FIFA 11+, 22 responded that they were not interested in engaging in research, and five were unable to schedule a data collection session prior to the start of the season and so declined participation
Summary
The Fédération Internationale de Football (FIFA) estimates that there are over 22 million youth soccer players globally [1], and the frequency of injury in this population represents a significant public health burden. Estimated injury rates in youth soccer range from 3.4–5.6 injuries/1000 participation hours, or 22.0–30.0 injuries/100 participants/year [2,3,4] These are characterized by a high proportion of lower extremity injuries, with the majority being to the ankle and knee joints [2,3,4,5,6,7,8,9]. Implementing successful injury prevention strategies in this population is, critical in reducing health care costs and decreasing risks for disability and inactivity through adulthood. Exercise-based prevention programs are efficacious at reducing sport injury risk [13,14,15,16]
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