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  • If we build it together, will they use it? A mixed-methods study evaluating the implementation of Prep-to-Play PRO: an injury prevention programme for women’s elite Australian Football

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Original research
If we build it together, will they use it? A mixed-methods study evaluating the implementation of Prep-to-Play PRO: an injury prevention programme for women’s elite Australian Football
  1. Andrea M Bruder1,2,3,
  2. Brooke E Patterson2,3,
  3. Kay M Crossley2,3,
  4. Andrea B Mosler2,3,
  5. Melissa J Haberfield2,3,
  6. Martin Hägglund4,
  7. Adam G Culvenor2,3,
  8. Sallie M Cowan2,3,
  9. Alex Donaldson5
  1. 1 School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
  2. 2 La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
  3. 3 Australian IOC Research Centre, Melbourne, Victoria, Australia
  4. 4 Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
  5. 5 Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Andrea M Bruder, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia; a.bruder{at}latrobe.edu.au

Abstract

Objectives We evaluated the implementation of Prep-to-Play PRO, an injury prevention programme for women’s elite Australian Football League (AFLW).

Methods The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of Prep-to-Play PRO were assessed based on the proportion of AFLW players and/or staff who: were aware of the programme (R), believed it may reduce anterior cruciate ligament injury (E), attempted to implement any/all programme components (A), implemented all intended components as practically as possible (I) and intended future programme implementation (M). Quantitative and qualitative data were triangulated to assess 58 RE-AIM items (evidence of yes/no/unsure/no evidence) and the 5 RE-AIM dimensions (fully achieved=evidence of yes on >50% dimension items, partially achieved=50% of items evidence of yes and 50% unsure or 50% mix of unsure and unanswered, or not met=evidence of yes on <50% dimension items).

Results Multiple sources including AFLW training observations (n=7 total), post-implementation surveys (141 players, 25 staff), semistructured interviews (19 players, 13 staff) and internal programme records (9 staff) contributed to the RE-AIM assessment. After the 2019 season, 8 of 10 (80%) AFLW clubs fully met all five RE-AIM dimensions. All 10 clubs participating in the AFLW fully achieved the reach (R) dimension. One club partially achieved the implementation (I) dimension, and one club partially achieved the effectiveness (E) and adoption (A) dimensions.

Conclusion The Prep-to-Play PRO injury prevention programme for the AFLW achieved high implementation, possibly due to the programme’s deliberately flexible approach coupled with our pragmatic definition of implementation. Engaging key stakeholders at multiple ecological levels (organisation, coaches, athletes) throughout programme development and implementation likely enhanced programme implementation.

  • Female
  • Sport
  • Rehabilitation
  • Knee injuries
  • Sports medicine

Data availability statement

Data are available upon reasonable request. The data are not publicly available due to privacy or ethical restrictions.

https://doi.org/10.1136/bjsports-2023-107518

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    Data availability statement

    Data are available upon reasonable request. The data are not publicly available due to privacy or ethical restrictions.

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    Footnotes

    • Twitter @AndreaBruder, @Knee_Howells, @kaymcrossley, @AndreaBMosler, @melhabphysio, @MHgglund, @agculvenor, @PhysioHill, @AlexDonaldson13

    • Contributors AMB, AD, KMC and BEP conceived and planned the study. AMB, ABM, KMC, BEP and AD designed the interview guide and survey with feedback from MH. AMB led the evaluation of Prep-to-Play PRO, with support from MJH and BEP to recruit players and staff. AMB, SMC, ABM and AGC conducted the interviews. MJH and AMB extracted evidence for analysis. BEP and AD rated the evidence against each RE-AIM dimension. AMB drafted the initial manuscript, analysed the data and is guarantor of the study. All authors contributed to early drafts of the manuscript and have read and approved the final version of the manuscript and agree with the order authors are presented.

    • Funding This work was supported by an Australian Football League Research Board Grant (2018) and La Trobe University Research Focus Area Grant (2018). ABM was supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (no. 1156674); and AGC is a recipient of an NHMRC of Australia Investigator Grant (GNT2008523). For the purposes of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

    • Disclaimer The funding bodies had no role in the study design or in data collection, analysis and interpretation.

    • Competing interests AGC and MH are associate editors of BJSM. ABM is a deputy editor and KMC a senior advisor of BJSM. AGC is an associate editor of Osteoarthritis and Cartilage. KMC, AMB, ABM, BEP, SMC and AD have received research grants from the Australian Football League (AFL). BEP is a past elite athlete and past assistant coach at an AFLW club. MJH is a current physiotherapist at an AFLW club. All other authors declare no competing interests.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.