title: Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11+) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial.
abstract: BACKGROUND
  Injury prevention programme delivery on adherence and injury risk, specifically involving regular supervisions with coaches and players on programme execution on field, has not been examined.
  
  
  OBJECTIVE
  The objective of this cluster-randomised study was to evaluate different delivery methods of an effective injury prevention programme (FIFA 11+) on adherence and injury risk among female youth football teams.
  
  
  METHODS
  During the 4-month 2011 football season, coaches and 13-year-old to 18-year-old players from 31 tier 1-3 level teams were introduced to the 11+ through either an unsupervised website ('control') or a coach-focused workshop with ('comprehensive') and without ('regular') additional supervisions by a physiotherapist. Team and player adherence to the 11+, playing exposure, history and injuries were recorded.
  
  
  RESULTS
  Teams in the comprehensive and regular intervention groups demonstrated adherence to the 11+ programme of 85.6% and 81.3% completion of total possible sessions, compared to 73.5% for teams in the control group. These differences were not statistically significant, after adjustment for cluster by team, age, level and injury history. Compared to players with low adherence, players with high adherence to the 11+ had a 57% lower injury risk (IRR 0.43, 95% CI 0.19 to 1.00). However, adjusting for covariates, this between-group difference was not statistically significant (IRR=0.44, 95% CI 0.18 to 1.06).
  
  
  CONCLUSIONS
  Following a coach workshop, coach-led delivery of the FIFA 11+ was equally successful with or without the additional field involvement of a physiotherapist. Proper education of coaches during an extensive preseason workshop was more effective in terms of team adherence than an unsupervised delivery of the 11+ programme to the team.
  
  
  BACKGROUND
  ISRCTN67835569.
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada. kathrin.steffen@nih.no
authors.forename: Kathrin
authors.initials: K
authors.lastname: Steffen
authors.forename: Willem H
authors.initials: WH
authors.lastname: Meeuwisse
authors.forename: Maria
authors.initials: M
authors.lastname: Romiti
authors.forename: Jian
authors.initials: J
authors.lastname: Kang
authors.forename: Carly
authors.initials: C
authors.lastname: McKay
authors.forename: Mario
authors.initials: M
authors.lastname: Bizzini
authors.forename: Jiri
authors.initials: J
authors.lastname: Dvorak
authors.forename: Caroline
authors.initials: C
authors.lastname: Finch
authors.forename: Grethe
authors.initials: G
authors.lastname: Myklebust
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Emery
mesh_terms: D000293:Adolescent; D000416:Alberta; D001265:Athletic Injuries / Q000517:prevention & control; D004812:Epidemiologic Methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D010349:Patient Compliance; D012916:Soccer / Q000293:injuries*