Listen and learn from others to prevent injury

 

Cross Fertilising Injury Prevention (IP) and the British Journal of Sports Medicine (BJSM)

 

Preventing injuries needs more than just researchers to develop and evaluate interventions.  It also needs more than just professionals or practitioners to implement programs and safety measures.  It needs both.

The August 2012 46(10) issue of the British Journal of Sports Medicine contains several papers which demonstrate the importance and value of bringing together a wide breadth of expertise and experiences when designing and implementing injury prevention programs.

A commentary by Orchard describes experiences with using substitute and interchange rules as a means of reducing injury risk in (elite) team sports. Substitution strategies allow players who are injured or at particular risk of injury (e.g. through being fatigued) to be replaced by others for the remainder of the game.  Interchange rules, on the other hand, allow players to be removed from the game for a short period or their injuries (or injury risk) to be assessed, before then returning to play in the same session.  Both of these strategies are becoming increasingly popular in high-level sport. But they have had mixed success because of some unanticipated side effects, such as increased game speeds, which can actually exacerbate injury risk for other reasons. By drawing on different examples, Orchard clearly shows that sports injury researchers will need to work very closely with game administrators, coaches and the like to maximize ongoing safety benefits associated with introducing these sorts of game rules in the future.

Several of the papers discuss the qualitative research processes and research frameworks that they used to underpin discussions leading to consensus approaches.  An Editorial by Viljoen and Patricios describes how BokSmart has been implemented as a multifaceted program for rugby union safety in South Africa.  They mention that their implementation success was only achieved with cross-sector stakeholder engagement from the outset and advocate for use of the Intervention Mapping protocol to guide this process.

My colleague Alex Donaldson and I describe an application of the Delphi technique to guide consensus reaching on the range of competencies needed by people who provide on-field first aid sports treatment for sport injury. This work has since led to the Australian Football League mandating minimum competency standards for sports trainers at all Australian football games from 2013.

Consultative approaches are also necessary for sector wide buy-in into injury monitoring systems. Turner and colleagues present a consensus on epidemiological studies in the thoroughbred horse racing industry for monitoring of injuries to jockeys and non-riders.  This exercise also involved a Delphi consultation process and the result is a set of injury monitoring standards accepted by the  industry Europe-wide.

The injury prevention field has only recently appreciated how important it is to consider the input of the end–beneficiaries of prevention programs, as well as the practitioners who need to deliver them.   These examples from the sports injury prevention field show how this engagement does lead to better outcomes for that sector.

What examples are there from other injury prevention contexts?

 

 

Caroline Finch is an injury prevention researcher from the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) within the Monash Injury Research Centre, Monash University, Australia.  She specialises in implementation and dissemination science applications for sports injury prevention and sports injury surveillance.  She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.  Caroline can be followed on Twitter @CarolineFinch

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