title: Factors influencing high school coaches' adoption of injury prevention programs.
abstract: OBJECTIVE
  Despite documented efficacy of injury prevention programs (IPPs) to reduce sport-related lower extremity injury risk, there is evidence of a lack of widespread IPP adoption by high school coaches. This study identified factors related to non-adoption of IPPs by assessing coaches' knowledge, attitudes, and behaviors related to prevention programs and comparing attitudes between adopter and non-adopter coaches.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Head soccer and basketball coaches (n=141) from 15 Oregon high schools were invited to complete a web-based survey assessing their IPP-related knowledge, attitudes, and behaviors.
  
  
  RESULTS
  Of the 66 coach respondents, 52% reported being aware of IPPs; 21% reported using an IPP with their team; and 9% reported having their student-athletes perform the IPP exactly as designed. No apparent differences in the attitudes toward the importance of injury prevention or the effectiveness of IPPs were identified between coaches that did and did not adopt an IPP. Perceptions that efficacious IPPs do not offer a relative advantage over coaches' existing practices, do not align with coaches' needs (compatibility), and are difficult to implement in their setting (complexity) emerged as key factors underlying coaches' decisions not to adopt a program. Of those that did report adopting an IPP, just 43% (6/14) reported implementing the program as designed.
  
  
  CONCLUSIONS
  Improving preventative practices of high school coaches requires more than improved dissemination to increase coach awareness. To improve the rate of IPP adoption and implementation fidelity, coach education should directly address issues related to relative advantage, compatibility, and complexity.
authors: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, USA. Electronic address: marc.norcross@oregonstate.edu.
authors: Marc F
authors: MF
authors: Norcross
authors: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, USA.
authors: Samuel T
authors: ST
authors: Johnson
authors: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, USA.
authors: Viktor E
authors: VE
authors: Bovbjerg
authors: Slocum Center for Orthopedics and Sports Medicine, USA.
authors: Michael C
authors: MC
authors: Koester
authors: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, USA.
authors: Mark A
authors: MA
authors: Hoffman
mesh_terms: D056352:Athletes; D001265:Athletic Injuries / Q000517:prevention & control*; D001490:Basketball / Q000293:injuries*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007869:Leg Injuries / Q000517:prevention & control*; D008297:Male; D009922:Oregon; D000070777:School Teachers / Q000523:psychology*; D012574:Schools; D012916:Soccer / Q000293:injuries*
keywords: Athletic injuries; Attitudes; Knowledge; Lower extremity; Prevention