Planning injury prevention training for youth handball players: application of the generalisable six-step intervention development process

Abstract

BackgroundYouth handball players are vulnerable to injuries. Because there is no available injury prevention training specifically developed for youth handball players targeting both upper and lower limbs or incorporating psychological aspects of injury, we undertook the ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project. We used an ecological participatory design incorporating the perspectives of multiple stakeholders (health beneficiaries, programme deliverers and policy makers). The aim of this paper was to describe the process of developing the I-PROTECT model, featuring injury prevention training and an accompanying implementation strategy.DesignWe used the generalisable six-step intervention development process, outlined to guide researchers when developing implementable, evidence-based sports injury prevention interventions, to develop the I-PROTECT model. The six-step process involves establishing a research–stakeholder collaborative partnership to (1) identify and synthesise research evidence and clinical experience; (2) consult with relevant experts; (3) engage end users to ensure their needs, capacity and values are considered; (4) test the feasibility and acceptability of the intervention; (5) evaluate the intervention against theory; and (6) obtain feedback from early implementers. Two community handball clubs in southern Sweden, offering organised training for youth male and female players, and the district handball federation, participate in the intervention development. Drafts of the I-PROTECT model will be developed and revised with key stakeholder advice and input throughout all six steps.ConclusionThe I-PROTECT model described will be an end user-driven intervention, including evidence-based, theory-informed and context-specific injury prevention training for youth handball, and an associated implementation strategy.

“Yeah, I Mean, You’re Going to Handball, so You Want to Use Balls as Much as Possible at Training”: End-Users’ Perspectives of Injury Prevention Training for Youth Handball Players

“…A possible explanation for these different views is that not all coaches used the program as intended (i.e., to integrate some of the exercises into warm-up and some into handball skills training) but put the exercises in one block separate from other parts of practice, which could be experienced by the players as “it takes too long of a time from our practice” (statement of a female player). It emerged from earlier steps in developing the I-PROTECT GO pilot program [ 20 , 23 ] and was recently confirmed by Møller and colleagues [ 12 ] that injury prevention training needs to be integrated into regular practice. A take-away based on this result is that coaches need to be better educated about how to optimally integrate injury prevention training into their regular routine.…”

“…Although the importance of involving end-users in developing and evaluating injury prevention programs has been promoted [ 10 , 23 , 29 , 30 ], injury prevention training programs have frequently been developed by researchers with little [ 9 , 31 ] or no involvement of end-users [ 32 , 33 , 34 ]. One recent exception is Bruder et al [ 22 ], who involved experts and end-users when developing a context-specific program for female Australian Football players.…”

“…We initiated the ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project to address the challenge of the low utilization rate of injury prevention training, with the aim to achieve adoption, high-fidelity use, and maintenance of evidence-based and handball-specific injury prevention training in youth players. The project has an interdisciplinary and holistic approach, with a focus on end-user engagement throughout the project [ 20 , 23 ]. In a recent study [ 24 ], researchers/handball experts and end-users co-created a first pilot version of injury prevention exercises including physical principles and psychological aspects (i.e., motivation using principles from self-determination theory, task focus, and body awareness) to be integrated within handball practice.…”

“…The program development was based on the Health Action Process Approach (HAPA) [ 25 ] behavior change theory and self-determination theory (SDT) [ 26 ]. The integration of these theories into the program is described in more detail in Ageberg et al [ 23 ] for HAPA and in Ageberg et al [ 24 ] for SDT. The overall purpose of this study was to investigate how youth handball coaches and players experience this pilot version (the I-PROTECT GO pilot program) for injury prevention training, by focusing on barriers and facilitators.…”

Cocreating injury prevention training for youth team handball: bridging theory and practice

“…In this context, the ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project was initiated through dialogue between end-users and researchers in 2015 with the overall goal to make injury prevention training part of regular handball practice in youth handball through a series of studies. While available injury prevention training for handball players commonly has a researcher-perspective focusing on evidence-based content and poorly described end-user involvement,17–19 I-PROTECT has an ecological participatory design incorporating the perspectives of multiple stakeholders (health beneficiaries, programme deliverers, policymakers) throughout the project 7 22. The first I-PROTECT study identified the facilitators among stakeholders at multiple levels that could help embed injury prevention training in regular training routines 7.…”