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A concept mapping approach to identifying the barriers to implementing an evidence-based sports injury prevention programme
  1. Alex Donaldson1,2,3,
  2. Aisling Callaghan4,
  3. Mario Bizzini5,
  4. Andrew Jowett4,
  5. Patrick Keyzer2,
  6. Matthew Nicholson1
  1. 1 Centre for Sport and Social Impact, La Trobe University, Melbourne, Australia
  2. 2 Law School, La Trobe University, Melbourne, Australia
  3. 3 Australian Collaboration for Research into Injuries in Sport and their Prevention (ACRISP), Ballarat, Australia
  4. 4 Football Federation Victoria, Melbourne, Australia
  5. 5 Schulthess Clinic, Zurich, Switzerland
  1. Correspondence to Dr Alex Donaldson, Centre for Sport & Social Impact, La Trobe University, Bundoora 3086, Australia; a.donaldson{at}


Background and aim Understanding the barriers to programme use is important to facilitate implementation of injury prevention programmes in real-word settings. This study investigated the barriers to coaches of adolescent female soccer teams, in Victoria, Australia, implementing the evidence-based FIFA 11+ injury prevention programme.

Methods Concept mapping with data collected from 19 soccer coaches and administrators.

Results Brainstorming generated 65 statements as barriers to 11+ implementation. After the statements were synthesised and edited, participants sorted 59 statements into groups (mean, 6.2 groups; range, 3–10 groups). Multidimensional scaling and hierarchical cluster analysis identified a six-cluster solution: Lack of 11+ knowledge among coaches (15 statements), Lack of player enjoyment and engagement (14), Lack of link to football-related goals (11), Lack of facilities and resources (8), Lack of leadership (6) and Lack of time at training (5). Statements in the ‘Lack of 11+ knowledge among coaches’ cluster received the highest mean importance (3.67 out of 5) and feasibility for the Football Federation to address (3.20) rating. Statements in the ‘Lack of facilities and resources’ cluster received the lowest mean importance rating (2.23), while statements in the ‘Lack of time at training’ cluster received the lowest mean feasibility rating (2.19).

Conclusions A multistrategy, ecological approach to implementing the 11+—with specific attention paid to improving coach knowledge about the 11+ and how to implement it, linking the 11+ to the primary goal of soccer training, and organisational leadership—is required to improve the uptake of the 11+ among the targeted coaches.

  • barriers to programme implementation
  • sports injuries
  • adolescent female soccer players
  • sports coaches
  • concept mapping.

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  • Contributors All authors contributed to the writing and critical review of this manuscript. AD, MB and AJ developed the idea for the study. AD managed the concept mapping process. AD and AC analysed and interpreted the concept mapping data. Final approval of the contents of the manuscript was obtained from all authors. All authors take responsibility for the integrity of the work from conception to publication.

  • Funding This study was funded by grants from the Medibank Better Health Foundation and the La Trobe University Sport, Exercise and Rehabilitation Research Focus Area.

  • Competing interests None declared.

  • Ethics approval La Trobe University Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.