Guest Blog by Prof Caroline Finch: Implementation study design and a protocol example

There was considerable discussion at the IOC World Conference on Prevention of Injury and Illness in Sport about the need for implementation studies – one could even say there was a certain buzz about this.  In my keynote address about the art and science of implementation research, I emphasised that to be most useful such studies would need to employ creative approaches and methodologies and that I expected this to be an area of research growth and development over the next few years.

It is not yet fully clear about what research approaches would best suit this new field, but some guidance is given in a chapter in the 2009 Sports Injury Research textbook, edited by Verhagen and van Mechelen. [1]

My research team is currently undertaking the first large scale implementation research study for sports injury prevention, with a focus on better understanding the uptake of exercise training programs in community football (in this case, Australian football).  Using the ecological version of RE-AIM for sports delivery [2] as the evaluation framework in a three- arm controlled study design, the study is comparing the real-world uptake and sustainability of two intervention delivery modes (fully-supported vs unsupported) compared to standard practice as the control.  The study protocol is available from the BJSM’s sister journal, Injury Prevention [3]. Whilst describing our NoGAPS study in detail, the protocol could also be used to provide additional guidance and information that may be helpful for others wanting to design similar studies.

1.                  Finch, C., Chapter 16: Implementing studies into real life, in Sports Injury Research, E. Verhagen and W. van Mechelen, Editors. 2009, Oxford University Press. p. 213-235.

2.                  Finch, C. and A. Donaldson, A sports setting matrix for understanding the implementation context for community sport. British Journal of Sports Medicine 2010. 44: p. 973-978.

3.                  Finch, C., et al., Towards a national sports safety strategy – addressing facilitators and barriers towards safety guideline uptake (the NoGAPS project). Injury Prevention, IP Online First, 2011. February 22, 2011: p. doi:10.1136/ip.2010.031385.

Professor Caroline Finch is a NHMRC Principal Research Fellow at the  Australian Centre for Research into Sports Injury and its Prevention (ACRISP), Melbourne, Australia.  You can follow her on Twitter @CarolineFinch

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  • everhage

    It is really good to see that such an important topic gets the attention it needs. I've heard many times, in relation to van Mechelen's sequence of prevention, that we need more intervention studies. This is whilst most studies focus on the first two steps of the four step prevention sequence; counting injuries and describing causal factors.

    However, positive intervention outcomes do not necessarily imply prevention of injuries. In fact, I hardly ever see positive study outcomes being implemented and adopted by associations, coaches or athletes. I have no idea whether it is practice that does not want to bow for the evidence, or whether it is evidence that does not fit practice. My opinion hangs to the latter. Nevertheless, fact remains that we are facing an important gap in our knowledge.

    Our research group has done a fair bit of implementation research, not only in the field of sports injury prevention, and we continuously face the difficulty in publishing the outcomes such studies. In relation to effectiveness studies, implementation research has no standard approaches, study designs and methodologies. In addition, the outcome measures are different and less objective.

    Yes, implementation research is a field in progress and we are still refining our methods. And yes, the outcomes seem a bit fuzzy and cloudy. But…implementation research is needed in order to move our knowledge to practice and really mean something for the athlete.

    I hope this short blog by Caroline Finch is a sign of things to come.

  • Barry Pless

    I certainly agree. I recently gave an after dinner (and after too much wine) talk about the evolution of injury research in Canada, and one of the main points I stressed was the need for better implementation. In turn, I suggested that there was a need for more studies of the 'science' of implementation, which I think is sorely lacking world wide. I would be interested in if others know of basic studies that examine this issue. I also said I think the field (injury prevention) tends to be 'parochial' so my comment for this blog is that the issue we are addressing is by no means confined to sports injuries Barry Pless