Original paper
Evaluation of RugbySmart: A rugby union community injury prevention programme

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Abstract

RugbySmart, a rugby union injury prevention programme, was launched in New Zealand in 2001. It was compulsory for all coaches and referees to complete RugbySmart requirements annually in order to continue coaching or refereeing. After 5 years of implementation the programme partners, Accident Compensation Corporation and New Zealand Rugby Union, evaluated RugbySmart to determine its effectiveness in reducing injuries. The purpose was to evaluate the effect of RugbySmart on reducing injury rates per 100,000 players and resulting injury prevention behaviours. The RugbySmart programme was associated with a decrease in injury claims per 100,000 players in most areas the programme targeted; the programme had negligible impact on non-targeted injury sites. The decrease in injury claims numbers was supported by results from the player behaviour surveys pre- and post-RugbySmart. There was an increase in safe behaviour in the contact situations of tackle, scrum and ruck technique.

Introduction

The RugbySmart programme, a joint project between the Accident Compensation Corporation (ACC) and the New Zealand Rugby Union (NZRU), was implemented at the start of the 2001 rugby season (March 2001). Both ACC and NZRU contribute to the annual implementation of RugbySmart, investing in the development and delivery of the RugbySmart resources and workshops for coaches and referees. As ACC provides for the cost of rehabilitation and replacement of income it predominantly desires a reduction in the number of injuries while the NZRU wants to make the game a competitive, safe and popular sport.

RugbySmart was designed to systematically reduce the number and severity of injuries in community rugby by providing evidence-based information about injury risks and injury prevention strategies to coaches and referees. Although the strength of evidence available regarding specific risks and the efficacy of recommended practices varied widely, efforts have been made throughout the programme to update information as better evidence became available. Information was delivered to coaches and referees via video presentations combined with active participation in workshops; these were supported initially by printed materials, and subsequently by Internet resources. The number of workshops for the approximately 10,000 coaches and 2000 referees varied from region to region, reflecting differences in coach and referee numbers between more and less heavily populated areas.

Coaches were chosen to be the primary group to which RugbySmart was delivered, with the expectation that they would influence player behaviour.1 The decision to target coaches was made on both pragmatic and evidence grounds. Firstly, delivering RugbySmart to approximately 10,000 coaches presented significantly less of a challenge than delivering it to over 130,000 players, which was considered unfeasible. Secondly, rugby coaches have been identified by both players and coaches in New Zealand as having an important role in the communication of injury prevention information and attitudes to player safety.2 In addition referees, who play a major role in preventing avoidable injuries during matches, were targeted by NZRU.2 To enforce the annual compulsory nature of RugbySmart for all levels of the game from under-6 grade to senior adults, rugby teams are audited and withdrawn from competition for non-compliance of their coach or a representative in attending annual workshops. Referees who did not complete RugbySmart were not assigned matches.

RugbySmart involves coaches and referees participating in a workshop setting with focus around the RugbySmart video. The video is produced to assist consistent delivery of the injury prevention messages throughout the country. The video and other resources can be taken home by coaches after the workshop. The emphasis given to different areas has varied from year to year, with the greatest attention given to physical conditioning, technique (specifically tackling and scrummaging) and injury management. Other areas covered have included warm-up/cool-down, protective equipment (specifically mouthguards in contact situations)3 and injury reporting.

While RugbySmart has helped to achieve a reduction in serious scrum-related spinal injuries4 the aim of the current review was to provide a more detailed evaluation of RugbySmart in terms of the effect of RugbySmart on reducing injury rates (ACC injury incidence data combined with NZRU participation data) and resulting behaviours (ACC survey data). Currently there is little information available as to what a worthwhile change in injury rate or injury prevention behaviour for sport may be for a population-based study as there are few large prospective population-based studies in the literature.5 This paper addresses the need for a prospective intervention study of sufficient size that can provide evidence of the effectiveness of a specific injury prevention programme.

Section snippets

Methods

Injury data were collected by ACC, a New Zealand government taxpayer-funded monopoly. The coverage by ACC provides compensation for injury costs including medical treatment, income replacement, social rehabilitation and vocational rehabilitation, and ancillary services such as transport and accommodation. A claim is made when a person seeks medical treatment from one of the 30,000 registered health professionals throughout New Zealand. When making a claim, information about the injury is

Results

Table 2 presents the injury rates per 100,000 players by rugby season. The season is concordant with the calendar year in the southern hemisphere. The injury rates in 2005 in general decreased compared to 2001 for targeted injuries and dental claims; however, non-targeted areas did not decrease by 2005. There was a worthwhile effect for targeted MSC but not for non-targeted MSC.

When rates for specific injury sites were analysed and grouped by similar sample sizes, some sites that were targeted,

Discussion

Educational strategies have been used in a number of public health areas, such as diabetes and cardiovascular disease, to reduce the risk of illness by changing participants’ knowledge and consequent behaviours. For example, Kirk et al.8 reported that exercise consultation was more effective in stimulating exercise behaviour change in the short term than a standard exercise leaflet in people with Type 2 diabetes. Within rugby there has been literature published on injury incidence at both

Practical implications

  • Workshops can be used to communicate injury prevention information on a nation-wide basis.

  • Community-focused injury prevention can be successful.

  • To increase acceptance of injury prevention information, the content needs to be suitable for the audience with plain language take home messages.

  • Plans for evaluation should be built into programme design.

References (8)

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