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Athlete Health and Prevention
18 The HAPPY hybrid effectiveness-implementation cluster-randomised trial: comparison of two strategies to implement an injury prevention exercise program in youth handball
  1. Merete Møller1,2,
  2. Lotte Nygaard Andersen3,
  3. Sören Möller4,5,
  4. Carsten Juhl1,6,
  5. Alice Kongsted7,
  6. Ewa Oos1
  1. 1Research Unit of Musculoskeletal Function and Physiotherapy, Department of Sports Science and clinical Biomechanics, The Faculty of Health Sciences, University of Southern Denmark, Denmark
  2. 2Oslo Sports Trauma Reseach Center (OSTRC), Department of Sports Medicine, Norwegian School of Sport Sciences, Norway
  3. 3Research Unit of Physical Activity and Health in Working life, Department of Sports Science and Clinical Biomechanics, The Faculty of Health Sciences, University of Southern Denmark, Denmark
  4. 4Open Patient data Explorative Network, Odense University Hospital, Denmark
  5. 5Research Unit Open, Department of Clinical Research, University of Southern Denmark, Denmark
  6. 6Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
  7. 7Research Unit of Clinical Biomechanics, Department of Sports Science and Clinical Biomechanics, The Faculty of Health Sciences, University of Southern Denmark, Denmark

Abstract

Introduction Injury prevention exercise programs (IPEPs) are insufficiently implemented in practice. We hypothesized that a combination of an online and onsite implementation strategy would be superior to an online-only strategy in enhancing adherence to an injury prevention exercise program (IPEP), and in reducing shoulder, knee and ankle injury risk in youth handball players over a handball season.

Materials and Methods In this 30-week hybrid effectiveness-implementation cluster-randomized study, 20 youth handball clubs were assigned to an online and onsite strategy (workshop utilizing the Health Action Process Approach [HAPA] behavior change model and health service provider [HSP] support) or an online-only strategy (control group). The primary implementation outcome was coach-reported adherence, measured as the average IPEP team usage over 30 weeks (weekly exercise usage range 0-33). The primary effectiveness outcome was player-reported handball time to any new handball-related shoulder, knee, and ankle injury, reported weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems.

Results We enrolled 945 players (mean age 14.5 years, 55% girls) and 63 coaches (27% woman). Intention-to-treat analyses showed no statistically significant difference between implementation strategies in mean weekly exercise utilization (between-group difference -1.4, 95% CI -3.4 to 0.6) or in cumulative injury risk (between-group difference -5.5, 95% CI -13.1 to 2.2).

Conclusion Our findings suggest that in youth handball, a combined online and onsite implementation strategy including a workshop and HSP support was not superior to an online-only strategy in improving adherence to an IPEP or in reducing shoulder, knee and ankle injury risk.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsem-2024-sportskongres2024.18

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