Awareness and use of the 11+ injury prevention program among coaches of adolescent female football teams

Abstract

Coaches are essential to participant safety, particularly by implementing injury prevention programs. The evidence-based injury prevention programs developed by sports scientists will not prevent injuries in real-world sports settings if they are not properly implemented. This study investigated the knowledge and use of the highly efficacious 11+ injury prevention program among coaches of adolescent, female football teams, in Victoria, Australia. A cross-sectional online survey based on the RE-AIM framework identified that nearly half (42%) of the 64 respondents (response rate = 36%) were not aware of the 11+, and only one-third (31%) reported using it. Three-quarters (74%) of the 19 respondents who reported on the 11+ components they used, did not use the entire program. Nearly half (44%) of the 18 respondents who reported the frequency with which they used the 11+, used it less than the recommended twice a week. Barriers to implementing the 11+ included: limited awareness of the 11+; lack of knowledge about how to implement it; not having time to implement it; and believing that the 11+ does not incorporate appropriate progression. This study suggests that it is unlikely that the 11+ prevents a significant number of injuries in real-world football settings due to the lack of awareness and use among coaches. Football-governing bodies should use evidence-based strategies to raise awareness of the 11+, build coach competency to implement it, and address time-related implementation barriers that coaches experience. Coaches should keep up-to-date with injury prevention research evidence and prioritize injury prevention at training, including allocating time to implement injury prevention programs properly.

Injury Prevention in Youth Football Players : Training Effects and Programme Implementation

“…Coaches for female high-school basketball and football players were more likely to be aware of IPEPs than coaches for male players, but just half of all coaches were aware of an effective IPEP 117 . In female youth football in Australia, nearly half of the studied coaches were not aware of the 11+ and among those who were, only half could describe it in a fully appropriate way, despite it being incorporated into the coaching curriculum 28 .…”

“…Ninety percent of the coaches who did not implement an IPEP still believed that an IPEP could reduce injury rates 117 . In female youth football, 79% of coaches believed the 11+ to be somewhat or very effective in preventing injuries, and 64% believed it somewhat or very effective in improving player performance 28 .…”

“…In one study, all the coaches agreed that injury prevention was important and that injuries may affect performance negatively, but despite this, few had adopted an IPEP 117 . In female youth football, 34% of all coaches used the 11+, and when only counting those aware of the IPEP, 59% had adopted it 28 . This was in line with the 11, which had been adopted by 57% of Swiss coaches 72 .…”

“…The facilitators for IPEP use that have been described in different team sports range from having easy access to programme materials, proper equipment, enough space for the training and support when adopting and using an IPEP, whereas the most widely reported barriers were not having enough time, poor player buy-in, lack of coaching resources and the IPEP being too difficult 28,105,123,150 . The study by O'Brien&Finch 123 also mentioned facilitators and barriers related to the head coach accepting the programme, attitude and motivation towards injury prevention, and staff-related issues in terms of cooperation, continuity and organisation.…”

“…To facilitate use of the IPEP, team staff also emphasized the need for adaptability so that they could tailor the IPEP towards the actual context (elite/amateur football) and circumstances (pre-season, in-season…) 124 . Within female youth football, most of the coaches (74%) who used the 11+ had implemented only parts of the programme, and additionally 44% used it less than the recommended dosage of twice per week 28 . The most frequently reported reason for modifying programme content was to add variation, progression, challenge and individualisation 125 .…”