The development of an implementation guide for the FIFA 11+ injury prevention programme among female football players in South Africa
Date
2022
Authors
Bakare, Ummukulthoum
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Abstract
Injury prevention programmes are challenging to execute in real-life settings and low-resource areas due to limited recourse and infrastructure. Numerous factors account for injury prevention interventions or lack thereof in any team setting. Due to low income and human resources accessible and affordable in Sub Saharan Africa and increasing participation in women's football, it is essential to investigate how injury prevention uptake can be optimised. It is common knowledge that crucial factors for the larger ecological environment are critical when conducting any injury prevention programme implementation.
Aim
The study aimed to develop an implementation guide for the FIFA11+ injury prevention programme in women's football teams in South Africa.
Participants
All women teams (players and their support staff) participating in the USSA Women’s football League in the Gauteng Region were invited to participate in study
Methodology
The study was conducted in three phases using a mixture of research methods. The first phase was a cross sectional survey which included two studies aimed to determine the injury prevention knowledge, beliefs and practices in women's football teams and summarise the available evidence for implementation strategies and compliance to the FIFA11+ injury prevention programme in football teams. The second phase was a modified Delphi approach aimed at determining consensus for the content to develop the implementation guide, and the third phase was to assess the feasibility of the implementation guide developed.
Results
Study one (Phase1): One-third of the participants reported perceived knowledge of basic injury prevention practices in football. Only 24.9% of the respondents indicated that they had heard about the FIFA 11+ injury prevention programme (IPP), while the majority (83.2%) stated that they would be willing to adopt it if they were to gain access to detailed information.
Study two (Phase 1): A total of 22 articles were included in this scoping review, and most of the studies (91%) were randomised controlled trials (RCTs) whilst two were cohort studies. Our study showed that main implementation strategy for the FIFA11+ injury prevention programme is a preseason coach targeted education facilitated by an instructor. Details of the content and duration of workshops were not consistent. The procedure to ensure compliance was also narrated in most of the studies however there was no consistent assessment or documentation. Mode of measurement.
Study three (Phase 2): This was a modified Delphi approach with fifty-five panel members invited across the stakeholder's expert population spanning four continents. In round one, the consensus was achieved for 16/16 statements (100%), arising from adoption (3/3), implementation (9/9) and maintenance (4/4) domains. In round two, the consensus was 17/21 statements (81%) arising from domains on the role of the stakeholders (6/6), education on sports injury prevalence (3/4), surveillance and injury prevention (4/4), FIFA 11+ adoption and implementation (4/4), compliance and adherence (3/3) and motivation strategies (0/3). Our study showed that consensus was achieved amongst experts in areas identified as components of developing an implementation guide to provide support adaptable to the context and setting of low resources such as South Africa for the implementation of the FIFA11+.
Study four (Phase 3): This is a feasibility study which seven coaches from two consenting teams participated and 43% were females (n=3). All the coaches possess a coaching license certification from the South African Football Association (SAFA) with coaching experience ranging from two to ten years. Coaches provided their opinion about the implementation guide, adjustments they think should be considered as well as facilitators and barriers of implementation in their setting. Our study showed that the coaches who participated in the interviews welcomed the idea of the implementation guide positively suggesting that it is a guidance document which provided clarity and direction for the purpose it was intended for
Conclusion
The overall aim of this study was to develop an implementation guide for the FIFA 11+ comprehensive warm up injury prevention programme in women’s football teams in the USSA League in South Africa. Our studies showed that teams had perceived adequate knowledge of basic injury prevention practices. Less than a third of the respondents had heard about the FIFA11+ injury prevention programme, whilst the majority are willing to adopt it if they are more knowledgeable about the programme. This indicated gaps in education and implementation of a basis comprehensive injury prevention programme such as the FIFA 11+. It also showed that the key implementation strategy for the FIFA 11+ is coaches targeted education through preseason workshops with indicative supporting roles for team captains. The measure of compliance of the FIFA 11+ is however not consistently documented or standardized in available research within the time frame of our scoping review. The stakeholders and experts identified components and reached consensus to develop the implementation guide in the contextual setting of low resource. It was also showed that the coaches who participated in the structured interviews in the feasibility study welcomed the idea of the implementation guide positively suggesting that is a guidance document which provided clarity and is adaptable. The implementation guide is a useful tool to provide support to facilitate implementation of the FIFA11+ in the contextual setting of the women’s football teams in the USSA league in Gauteng
Description
A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2022