Enhancing integration of specialised exercise training into coach practice to prevent lower-limb injury : Using theory and exploring coaches' salient beliefs

Lower limb injuries (LLIs) are common in community-Australian football (CAF) and specialised exercise training (SET) programs can reduce their incidence. Despite the protection SET programs afford, the use of SET by coaches in CAF contexts, who play a key role in the preparation of players, is largely unknown. The overall purpose of this thesis research was to explore and describe: (1) the contextual and specific nature of CAF coaching practices, and, (2) the factors central to understanding whether or not coaches will make changes in their training practices in the future. Thereby, assisting to devise effective behaviour change and implementation strategies that maximise future integration (adoption and maintainence) of SET programs in CAF contexts to reduce the risk of LLIs for players. This mixed methods research was underpinned by a combination of behavioural and social science theories and models (BSSTM). Coaches’ were sampled from CAF clubs in Victoria and Western Australia. Eligible coaches completed cross-sectional questionnaires pre (n=31) and post (n=28) season in 2007/08. Three coaches engaged in semi-structured, in-depth interviews, 12-18 months later. At preseason, 58% of coaches used injury prevention strategies with their team. Only 69% of them had a formal training plan for the entire season, and most did not explicitly incorporate SET programs, despite their views being favourable towards the latter. Coaches believed their players had a high chance of sustaining a LLI and that LLI could have serious consequences. They believed it was important to have current knowledge of SET programs, but many lacked the behavioural capability and self-efficacy to implement SET programs. They also reported that player attendance at training could also impact on SET program outcomes. Postseason findings were similar with generally positive SET outcome expectancies; many coaches reported they intended to modify SET program implementation in future seasons. Suggested improvements related to collaboration, feedback/reinforcement approaches, education and other sociocultural themes. Coaches reported divergent views about their self-efficacy in relation to SET program implementation but were motivated by what their players thought. Qualitative analysis of the in-depth interviews identified four main themes (and associated coach salient beliefs) that supported and extended quantitative findings. These included: (1) the development of coach behavioural capability/self-efficacy (including informal and formal learning sources), (2) biopsychosocial risk perceptions regarding players’ injury susceptibility, (3) facilitators and hindrances to adopting/maintaining SET, and (4) cues to action/planning. The promotion of SET programs to reduce the susceptibility of LLIs and ensure safe and sustainable participation in AF is important. This thesis has captured a complexity of factors that can be used to enhance and facilitate CAF coaches’ adoption and maintenance of SET, alongside wider-prevention efforts. Future research should continue to use a range of BSSTM and methodological approaches, and devise and evaluate the efficacy of a comprehensive taxonomy of cognitive-behavioural strategies, to provide more insight into effective translation of SET programs into practice. Coaches and their players will be safer if such work continues.Doctor of Philosoph