concept mapping approach to identifying the barriers to implementing an
evidence-based sports injury prevention programme
A, Callaghan A, Bizzini M, Jowett A, Keyzer P, & Nicholson M. Inj Prev. 2018; Online Ahead of Print January
20, 2018.  
Take Home Message: To improve
implementation of injury prevention programs, we need to adopt a
multi-factorial approach that focuses on coach education and linking program benefits to game-related outcomes.
Despite significant evidence that
injury prevention programs prevent injuries (see examples below), there is resistance
to implementing these programs.  It
remains unclear why there is a lack of implementation. Therefore, the authors performed
a mixed-methods study to identify perceived barriers by coaches to implementing
the FIFA 11+ injury prevention program among Australian female soccer teams.  The authors used concept mapping of
19 coaches’ brainstorming ideas, statement sorting, and importance/feasibility
ratings.  The authors reported 65
brainstorming ideas that were classified into 6 categorical barriers in order
of ranked importance to 11+ implementation: coaches’ 11+ knowledge, link to
sport related goals, leadership, time at training, player enjoyment/engagement,
and facilities/resources.  
This study emphasizes the importance
of a multi-tiered approach to successful injury prevention implementation
programming.  Education of coaches,
players, and possibly the medical staff is critical towards injury prevention
efforts.  Of significant interest is the
fact that the coaches are the gatekeepers towards implementation.  A previous post
identified the importance of coaches’ buy-in to influence player compliance and
there is also plenty of research to link compliance to injury prevention
programming effectiveness.  So, the
question remains how to best create coach buy-in.  Educating our coaches about the programs is
very important, in addition to educating or creating links between the injury
prevention programming and sport-specific tasks.  This may include minor modifications of
drills to include balls or more sport-specific drills to help bridge the gap
between the goal of the drill and the sport activities.  Furthermore, it would be beneficial to teach
coaches, players, and other stakeholders that these programs can also improve sport performance. The
FIFA 11+ exercises are soccer focused – yet soccer coaches feel that there is
little crossover to sport specific skills. 
It would be interesting to see the effectiveness of the programming if
coaches were able to provide input on the types of drills performed,
particularly in some sports other than soccer. These authors did a great job
identifying common barriers, and when implementing injury prevention
programming clinically it is important to address these barriers proactively to
increase buy in and adherence. 
Questions for Discussion:  What
strategies do you utilize during injury prevention introduction?  Are there any modifications that you make
based on coach or player feedback?
by: Nicole Cattano
by: Jeffrey Driban