Barriers and facilitators to the adoption and implementation of evidence-based injury prevention training programmes: a narrative review

Abstract

While there is a multitude of evidence supporting the efficacy of injury prevention training programmes, the literature investigating the implementation of these programmes is, in contrast, rather limited. This narrative review sought to describe the commonly reported barriers and facilitators of the implementation of injury prevention training programmes among athletes in organised sport. We also aimed to identify necessary steps to promote the uptake and sustainable use of these programmes in non-elite athletic communities. We identified 24 publications that discussed implementing evidence-based injury prevention training programmes. Frequently reported barriers to implementation include the perceived time and financial cost of the programme, coaches lacking confidence in their ability to implement it, and the programme including exercises that were difficult or confusing to follow. Frequently reported facilitators to implementation include the coach being aware of programme efficacy, shared motivation to complete the programme from both coaches and athletes, and the ability to easily integrate the programme into practice schedules. The current literature is focused on high-income, high-resource settings. We recommend that future studies focus on understanding the best practices of programme dissemination in culturally and economically diverse regions. Programmes ought to be of no financial burden to the user, be simply adaptable to different sports and individual athletes and be available for use in easily accessible forms, such as in a mobile smartphone application.

Best practices for the dissemination and implementation of neuromuscular training injury prevention warm-ups in youth team sport: a systematic review

“…Within the current review, lack of time, whether it be learning, instructing and/or practicing the programme, is a common barrier that plays a significant role in implementation. A recent narrative review focused solely on the barriers and facilitators associated with exercise-based warm-up programmes showed similar conclusions regarding time restrictions 115. Collective themes within this literature for players, coaches and organisations found that reduced buy-in and support at different levels impacted the adoption of NMT warm-up programmes.…”

“…Facilitators included comprehensive workshops from trained instructors (n=11),53 71 78–80 84 90 96 99 100 112 accessibility of supplementary resources (n=10)82 84 87 89 90 105 114 and uptake/support from multiple stakeholders (n=7) 56 67 84 101 103 105 112. Moreover, suggestions from multiple socioecological levels indicated that increasing programme education and support, increased sport-specific activities and improved awareness of preventive effects, influence NMT implementation success 36 88 89 115 116 Figure 2,. adapted from Basow et al 117 illustrates the contextual factors reported in the literature 117.…”

“…In our Adapted Socioecological Model (figure 2), we demonstrate that the utilisation of NMT programmes by individual players within youth team sport can depend on their coach adopting and implementing the warm-up, which may also be dependent on larger organisational systems. Barriers related to end-users’ success in wide-spread adoption and long-term maintenance can be moderated; however, researchers and implementers have to be intentional about tackling these recognised barriers and associated challenges25 87 104 115; integrating the facilitators of successful implementation intending to reduce and address these obstacles is essential. The barriers and facilitators identified in this systematic review provide insight into the combination of D&I strategies that should be formulated and tested by D&I researchers in the sports injury prevention field.…”

“…Organisations have expressed limited knowledge and education for implementation as a significant barrier to successful NMT programme use 90 99 101 105 112 115 122. Implementers should look to provide accessible resources and encourage further support from multiple stakeholders, including the governing bodies.…”

The Preventive Warm up to Reduce No-Contact Injury Risk in Amateur Male Soccer Players

“…The injuries are a limiting factor in performance, and appear frequently in the amateur soccer world (Minnig et al, 2022;Van de Hoef et al, 2017;Ekstrand et al, 2009;van der Horst et al, 2015): moreover, the amateur footballer often cannot have the presence of complete medical and technical staff in every training session.…”