Factors influencing high school coaches’ adoption of injury prevention programs

This is an author's peer-reviewed final manuscript, as accepted by the publisher. The article is in press and will be published in the Journal of Science and Medicine in Sport.OBJECTIVES: Despite documented efficacy of injury prevention programs (IPPs) to reduce sport-related\ud lower extremity injury risk, there is evidence of a lack of widespread IPP adoption by high school\ud coaches. This study identified factors related to non-adoption of IPPs by assessing coaches’ knowledge,\ud attitudes, and behaviors related to prevention programs and comparing attitudes between adopter and non-adopter\ud coaches.\ud DESIGN: Cross-sectional\ud METHODS: Head soccer and basketball coaches (n=141) from 15 Oregon high schools were invited to\ud complete a web-based survey assessing their IPP-related knowledge, attitudes, and behaviors.\ud RESULTS: Of the 66 coach respondents, 52% reported being aware of IPPs; 21% reported using an IPP with\ud their team; and 9% reported having their student-athletes perform the IPP exactly as designed. No\ud apparent differences in the attitudes towards the importance of injury prevention or the effectiveness of\ud IPPs were identified between coaches that did and did not adopt an IPP. Perceptions that efficacious IPPs\ud do not offer a relative advantage over coaches’ existing practices, do not align with coaches’ needs\ud (compatibility), and are difficult to implement in their setting (complexity) emerged as key factors\ud underlying coaches’ decisions not to adopt a program. Of those that did report adopting an IPP, just 43%\ud (6/14) reported implementing the program as designed.\ud CONCLUSIONS: Improving preventative practices of high school coaches requires more than improved\ud dissemination to increase coach awareness. To improve the rate of IPP adoption and implementation\ud fidelity, coach education should directly address issues related to relative advantage, compatibility, and\ud complexity