Short summary

The effectiveness of injury prevention exercise programs (IPEPs) in a real-world setting is lacking in handball. Developing implementation strategies that focus on promoting coach self-efficacy has been a successful approach when implementing IPEPs in other youth sports. We have developed a multifaceted intervention featuring an IPEP and an implementation strategy. The primary aim is to evaluate the effectiveness of this multifaceted intervention on implementation and injury outcomes.

Rationale

Introduction

Handball is one of the most popular organised sports in Denmark, but also a sport with some of the highest injury rates. Injuries can lead to absence from sport with consequences for mental and physical health. Injury prevention exercise programs (IPEPs) can reduce the risk of injury by up to 68%. While these programs have been shown to 'work' under controlled conditions, the effectiveness of IPEPs in a real-world setting is lacking in handball.

Aims

1) To evaluate the effects of a coach workshop on coaches' self-efficacy and other implementation outcomes to deliver an IPEP (Paper 1).

2) To evaluate the effectiveness of an implementation strategy involving coach education, nudging, and management support on adherence of an IPEP among coaches, compared to usual practice (Paper 2).

3) To evaluate the effectiveness of a multifaceted intervention featuring an IPEP and an implementation strategy on reducing the risk of ankle, knee and shoulder injuries among youth handball players, compared to usual practice (Paper 3).

Description of the cohort

This injury prevention initiative's primary beneficiaries are young handball players aged 11-17 years. The study's target group also includes handball coaches as primary program deliverers. The desired teams are youth teams from the age groups under (u)13, u15, and u17. Handball clubs with at least four teams in the desired age groups, regardless of playing level, will be eligible for participation in the study. We aim to have clubs participating in all five regions of Denmark.

Data and biological material

Baseline data on handball players and coaches.

Weekly questionnaire for players on injury, illness and disease.

Weekly questionnaire for coaches on the use of the Happy program (warm up and strength training).

Questionnaire on determinants of behaviour for coaches (eg. self-efficacy, intention, action and coping plans, social influence).