{
  "abstract": "Introduction Evaluate the effect of supported implementation on injury prevention program (Prep-to-Play) use and injury incidence and evaluate the dose response relationship between adherence and injury incidence.Materials and Methods 165 women’s/girls’ teams (2481 players) were randomly allocated to transition from unsupported to supported implementation at one-of-five sequences during 2021/2022. Supported implementation included in-person workshops and support-visits for coaches/team leaders. Unsupported implementation was access to online resources. Prep-to-Play includes warm-up, contact, and strength activities. Primary (Prep-to-Play use) and secondary outcomes (concussion, anterior cruciate ligament (ACL) injuries) were reported weekly. Weekly Prep-to-Play use was defined as using ≥75% of program elements, ≥two-thirds of sessions. Analyses compared outcomes between supported and unsupported, adjusted for clustering, period, age-group, competition-level, and region.Results Crude Prep-to-Play use was 13.1% (95%CI: 11.5 to 14.9%) in the unsupported and 29.7% (95%CI: 27.6 to 31.9%) in supported phase (OR 3.7 95%CI 2.4 to 5.7). Crude concussion and ACL injury incidence (per 1000 game hours) was 6.80 (95%CI 5.75 to 8.05) and 1.36 (95%CI 0.98 to 1.89) in unsupported, and 3.50 (95%CI 2.72 to 4.52) and 0.69 (95% CI 0.44 to 1.15) in supported, respectively, which was not statistically significant at this effect size (concussion: IRR 1.36; 95%CI 0.74 to 2.49; ACL: IRR 2.27 (0.56 to 9.12). Higher Prep-to-Play adherence was associated with fewer total injuries (IRR: 0.95 95%CI 0.92 to 0.99).Conclusion Supported implementation via in-person workshops and support was associated with greater Prep-to-Play use compared to unsupported implementation, and greater adherence was associated with fewer injuries.",
  "authors": [
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Brooke Patterson"
    },
    {
      "affiliations": [
        "Queensland University of Technology, Australia"
      ],
      "name": "Nicole White"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Sallie Cowan"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Matthew King"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Alex Donaldson"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Melissa Haberfield"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Andrea Bruder"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Christian Barton"
    },
    {
      "affiliations": [
        "Queensland University of Technology, Australia"
      ],
      "name": "Stephen McPhail"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Adam Culvenor"
    },
    {
      "affiliations": [
        "University of Birmingham, United Kingdom"
      ],
      "name": "Karla Hemming"
    },
    {
      "affiliations": [
        "Linköping University, Sweden"
      ],
      "name": "Martin Hägglund"
    },
    {
      "affiliations": [
        "Monash University, Australia"
      ],
      "name": "Natasha Lannin"
    },
    {
      "affiliations": [
        "Monash University, Australia"
      ],
      "name": "Ilana Ackerman"
    },
    {
      "affiliations": [
        "University of Melbourne, Australia"
      ],
      "name": "Michelle Dowsey"
    },
    {
      "affiliations": [
        "La Trobe University, Australia",
        "Australian Football League, Australia"
      ],
      "name": "Michael Makdissi"
    },
    {
      "affiliations": [
        "Medibank Better Health Foundation, Australia"
      ],
      "name": "Shona Sundaraj"
    },
    {
      "affiliations": [
        "Australian Football League, Australia"
      ],
      "name": "Nicole Livingstone"
    },
    {
      "affiliations": [
        "Australasian College of Sport and Exercise Physicians Research Committee, Australia"
      ],
      "name": "Jane Fitzpatrick"
    },
    {
      "affiliations": [
        "Sports Medicine Australia, Australia"
      ],
      "name": "Jamie Crain"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Sarah Lampard"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Eliza Roughead"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Karina Chilman"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Libby Gracias"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Elizabeth Birch"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Christian Bonello"
    },
    {
      "affiliations": [
        "La Trobe University, Australia"
      ],
      "name": "Kay Crossley"
    }
  ],
  "title": "6 Supported implementation enhances injury prevention program use in women’s Australian football: a type III hybrid implementation-effectiveness stepped-wedge cluster randomised trial",
  "uid": "08a29e62-89de-5c1f-84ad-0d1dc6a16bda"
}