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To (1) identify the education priorities that physical therapists have for people with knee osteoarthritis, including perceived importance and capability to provide, and (2) match priorities to education-specific content recommendations in knee osteoarthritis guidelines.Concept mapping methodology.Physical therapists generated, sorted (based on themes), and rated (5-point Likert scales: importance and capability) patient education priorities. Priorities were matched against education-specific content recommendations in knee osteoarthritis guidelines. Additional education-specific content recommendations were added from guidelines and expert opinion if necessary. Multidimensional scaling and hierarchical cluster analysis produced a cluster map with overarching domains.Physical therapists (brainstorming, n = 41; sorting, n = 20; rating, n = 22) generated 56 priorities, with 13 added (n = 2 from guidelines, n = 11 from expert opinion). Few priorities were clearly included as education-specific content recommendations in guidelines (ACR [2%, n = 1/56], EULAR [14%, 8/56], NICE [11%, 6/56], and OARSI [0%, 0/56]). An 8-cluster map emerged with 3 overarching domains: (i) first-line care (exercise therapy, lifestyle modification and general health, and weight management), (ii) knowledge formation and countering misconceptions (radiology misconceptions, understanding and managing pain and disability, and general beliefs and understanding about osteoarthritis), and (iii) decision making for medical management (surgery and medications). The exercise therapy cluster was rated the highest for both importance (3.84/5) and capability (4.00). The medications and weight management clusters were rated the lowest for importance (2.54) and capability (2.82), respectively.Physical therapists prioritize a range of education topics for people with knee osteoarthritis, focusing on exercise therapy. Physical therapists feel least capable of providing weight management education.

SummaryA recent literature review indicated that the settings-based approach, as it is applied to sports clubs, is poorly understood and not well implemented. The current study builds on the health promoting sports clubs (HPSC) theoretical model as a basis for a settings-based approach in the sports setting and proposes a logic model to develop and evaluate HPSC in practice. The logic model was established through qualitative, iterative methods in the form of six meetings with eight experts in the field. Qualitative thematic coding was conducted on notes taken and contributions during and between meetings. The results describe a best-practice logic model of HPSC, including inputs, activities, outcomes and impacts at each HPSC level, while case studies illustrate the interactions between levels. Results indicate that a HPSC can have an impact at each level, from individual health to social and community capital. For a sports club, the logic model helps to define how the club’s board or management committee can set the conditions for club managers and coaches to support members’ health. External stakeholders to clubs are also recognized for their key responsibility in providing different types of resources to support sports clubs to be health promoting. Future research should focus on monitoring and evaluating at each level, including empirical testing system interactions as a whole and interactions across levels.

Objective The aim of this study was to explore expert opinion to identify the components of sprinting technique they believed to be risk factors for hamstring strain injuries (HSI). Design Mixed-method research design. Methods The Concept Systems groupwisdom™ web platform was used to analyse and collect data. Participants brainstormed, sorted and rated the components of sprinting technique to consider in a HSI prevention strategy. Results Twenty-three experts (academic/researcher, physiotherapist, strength and conditioning coaches and sprint coaches) brainstormed 66 statements that were synthesised and edited to 60 statements. Nineteen participants sorted the statements into clusters and rated them for relative importance and confidence they could be addressed in a hamstring injury prevention program. Multidimensional scaling and cluster analysis identified a 8-cluster solution modified to a 5-cluster solution by the research team: Training prescription (10 statements, mean importance: 3.79 out of 5 and mean confidence: 3.79); Neuromuscular and tendon properties (9, 3.09, 3.08); Kinematics parameters/Technical skills (27, 2.99, 2.98); Kinetics parameters (10, 2.85, 2.92); and Hip mechanics (4, 2.70, 2.63). The statement: “low exposure to maximal sprint running” located in the cluster “Training prescription” received the highest mean importance (4.55) and confidence ratings (4.42) of all statements. Conclusion The five clusters of components of sprinting technique believed to be risk factors for HSIs in order of most to least important were: training prescription, neuromuscular and tendon properties, kinematics parameters/technical drills, kinetics parameters and hip mechanics.

Survey responses from a sample of nearly 15,000 Australian sports fans were used to study the determinants of: (i) gambling behaviour, including if a person does gamble and the type of gambling engaged with; (ii) the number of sports and non-sports bets made over a 12-month period; and (iii) attitudes towards betting on sports. The probability of betting on sports decreased with increasing age and was lower for women and people with a university education. This gender difference varied with age, with the greatest difference found among the young. Similar effects were observed for the number of sports bets made, which declined with age. The gender difference in the number of sports bets also varied with age with the greatest difference found among the young arising from the high propensity of young men to bet on sports. Attitudes to sports betting were also analysed, with a key finding that, within friendship circles, the views that sports betting is perceived as harmless, common and very much a part of enjoying sports were stronger among young men. These permissive attitudes were stronger among people who bet on sports and those who bet on sports more frequently. The analysis of sports fans provides insights into the characteristics of the target market most likely to bet on sports, which can be used to inform public health initiatives and harm reduction campaigns. Supplementary Information The online version contains supplementary material available at 10.1007/s10899-021-10101-7.

ObjectiveExercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness.MethodA controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16–50 years while participating in community-level Australian Football. FootyFirst was implemented with ‘support’ (FootyFirst+S) or ‘without support’ (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria.ResultsAfter 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006–2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase.ConclusionEcological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.

Background The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program (FootyFirst) for community Australian football. Methods The intervention development process is underpinned by 2 complementary premises: (1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and (2) that research evidence alone is insufficient to develop implementable interventions. Results The generalizable 6-step intervention development process involves (1) compiling research evidence, clinical experience, and knowledge of the implementation context; (2) consulting with experts; (3) engaging with end users; (4) testing the intervention; (5) using theory; and (6) obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For FootyFirst, this process involved establishing a multidisciplinary intervention development group, conducting 2 targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program. Conclusion This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development.

Objective: To identify the challenges adult community sport participants anticipate when returning to sport in Victoria, Australia, post a COVID‐19 shutdown. Methods: Using online concept mapping, participants brainstormed challenges to returning to community sport, sorted them into groups and rated them for impact and ability/capacity to overcome. Analysis included multidimensional scaling and hierarchical cluster analysis. Results: Forty‐five community sport participants representing 24 sports identified 69 unique challenges to returning to sport. Eight clusters/questions participants need answered emerged from the sorting data (mean cluster impact and ability/capacity rating out of 5): Will we have enough participants? (3.32, 2.89); How do we stay safe? (3.31, 3.35); How will our sport change? (3.17, 2.85); How can we stay together? (3.15, 3.01); Will I be physically ready? (3.15, 3.05); What about the money? (2.86, 2.53); What about me? (2.65, 3.13); and What about the facilities? (2.49, 2.45). Conclusions: Participants perceived paradoxical challenges to returning to sport after COVID‐19 shutdown, which revolved around staying safe, staying connected and accessing meaningful sport activities. Implications for public health: Sport organisations and public health practitioners should address the participant‐centred challenges identified in this study to maximise the public health benefits of participants returning to community sport.

Background Efficacious injury prevention programs exist, yet translation to practice in real-world settings is poor. Little is known about how women playing elite team ball-sports perceive and experience injury prevention programs in practice. Understanding the end-user's (athlete's) perspective is essential to improve program uptake and adherence. Objective To explore the perspectives and experiences of injury prevention practices in athletes from the elite Australian Football League for Women (AFLW). Methods Convenience sample of 13 athletes from three AFLW clubs. Semi-structured interviews were audio-recorded and transcribed verbatim, analysed with a thematic analysis approach, and classified within the Socio-Ecological Model (SEM). Results Women playing elite Australian Football: (1) believe injury prevention programs have multiple aims and benefits, (2) perceive varying injury prevention practices between and within AFLW clubs, (3) believe injury prevention program adoption and implementation is complex and multi-factorial, and (4) think implementing injury prevention programs in the AFLW could be enhanced through education and resources. Mapping our results onto the SEM highlighted that athletes perceive multiple ecological levels (i.e. individual, interpersonal, community, and organizational) are involved in sports injury prevention. Conclusions Multi-level engagement strategies are required to enhance injury prevention program adoption and implementation and to maximise athlete adherence.

Background: In high-performance sport, athlete performance health encompasses a state of optimal physical, mental, and social wellbeing related to an athlete’s sporting success. The aim of this study was to identify the priority areas for achieving athlete performance health in Australia’s high-performance sport system (HPSS). Methods: Participants across five socioecological levels of Australia’s HPSS were invited to contribute to this study. Concept mapping, a mixed-methods approach incorporating qualitative and quantitative data collection, was used. Participants brainstormed ideas for what athlete performance health requires, sorted the ideas into groups based on similar meaning and rated the importance, and ease of achieving each idea on a scale from 1 (not important/easiest to overcome) to 5 (extremely important/hardest to overcome). Results: Forty-nine participants generated 97 unique statements that were grouped into 12 clusters following multidimensional scaling and hierarchical cluster analysis. The three clusters with highest mean importance rating were (mean importance rating (1–5), mean ease of overcoming (1–5)): ‘Behavioral competency’ (4.37, 2.30); ‘Collaboration and teamwork’ (4.19, 2.65); ‘Valuing athlete wellbeing’ (4.17, 2.77). The 12 clusters were grouped into five overarching domains: Domain one—Performance health culture; Domain two—Integrated strategy; Domain three—Operational effectiveness; Domain four—Skilled people; Domain five—Leadership. Conclusion: A diverse sample of key stakeholders from Australia’s HPSS identified five overarching domains that contribute to athlete performance health. The themes that need to be addressed in a strategy to achieve athlete performance health in Australia’s HPSS are ‘Leadership’, ‘Skilled people’, ‘Performance health culture’, ‘Operational effectiveness’, and ‘Integrated strategy’.

This study investigates the challenges of returning to sport after a COVID-19 shutdown of sport from the perspective of community sport clubs (CSCs). We explore the relationship between the challen...

IntroductionDue to the increase in participation and risk of anterior cruciate ligament (ACL) injuries and concussion in women’s Australian Football, an injury prevention programme (Prep-to-Play) was codesigned with consumers (eg, coaches, players) and stakeholders (eg, the Australian Football League). The impact of supported and unsupported interventions on the use of Prep-to-Play (primary aim) and injury rates (secondary aim) will be evaluated in women and girls playing community Australian Football.Methods and analysisThis stepped-wedge, cluster randomised controlled trial will include ≥140 teams from U16, U18 or senior women’s competitions. All 10 geographically separated clusters (each containing ≥14 teams) will start in the control (unsupported) phase and be randomised to one of five dates (or ‘wedges’) during the 2021 or 2022 season to sequentially transition to the intervention (supported Prep-to-Play), until all teams receive the intervention. Prep-to-Play includes four elements: a neuromuscular training warm-up, contact-focussed football skills (eg, tackling), strength exercises and education (eg, technique cues). When transitioning to supported interventions, study physiotherapists will deliver a workshop to coaches and player leaders on how to use Prep-to-Play, attend team training at least two times and provide ongoing support. In the unsupported phase, team will continue usual routines and may freely access available Prep-to-Play resources online (eg, posters and videos about the four elements), but without additional face-to-face support. Outcomes will be evaluated throughout the 2021 and 2022 seasons (~14 weeks per season). Primary outcome: use of Prep-to-Play will be reported via a team designate (weekly) and an independent observer (five visits over the two seasons) and defined as the team completing 75% of the programme, two-thirds (67%) of the time. Secondary outcomes: injuries will be reported by the team sports trainer and/or players. Injury definition: any injury occurring during a football match or training that results in: (1) being unable to return to the field of play for that match or (2) missing ≥ one match. Outcomes in the supported and unsupported phases will be compared using a generalised linear mixed model adjusting for clustering and time. Due to the type III hybrid implementation-effectiveness design, the study is powered to detect a improvement in use of Prep-to-Play and a reduction in ACL injuries.Ethics and disseminationLa Trobe University Ethics Committee (HREC 20488) approved. Coaches provided informed consent to receive the supported intervention and players provided consent to be contacted if they sustained a head or knee injury. Results will be disseminated through partner organisations, peer-reviewed publications and scientific conferences.Trial registration numberNCT04856241.

To (1) identify the education priorities of people with knee osteoarthritis, including perceived importance and confidence that a health care professional can address each, and (2) match priorities to education-specific content recommendations in knee osteoarthritis management guidelines.Concept mapping methodology.Participants generated, sorted (based on themes), and rated (5-point Likert scales: importance and confidence) education priorities. Multidimensional scaling and hierarchical cluster analysis of sorting data produced a cluster map with overarching domains. Priorities were matched against education-specific content recommendations in knee osteoarthritis guidelines.Participants (brainstorming, n = 43; sorting and rating, n = 24) generated 76 priorities. A 4-domain, 11-cluster map was the most useful representation of sorting data: (i) understanding treatment options (relationship of education and exercise with surgery, adjunct options, treatment decision making); (ii) exercise therapy (how to exercise, why exercise); (iii) understanding and managing the condition (symptom management, understanding symptoms, understanding the condition); and (4) surgical, medical, and dietary management (surgery, medications, diet and supplements). The "relationship of education and exercise with surgery" (3.88/5), "surgery" (3.86/5), and "how to exercise" (3.78/5) clusters were rated highest for importance. Few priorities identified by participants were clearly recommended as education-specific content recommendations in the American College of Rheumatology (3%, n = 2/76), European Alliance of Associations for Rheumatology (12%, n = 9/76), National Institute for Health and Care Excellence (16%, n = 12/76), and Osteoarthritis Research Society International (1%, n = 1/76) guidelines.People with knee osteoarthritis presenting to physical therapists have broad education needs and prioritize information about surgery and exercise.

Objective To identify challenges for implementing Netball Australia’s ‘Knee injury prevention for Netballers and Enhance performance and Extend play’ (KNEE) program for 17/U & 19/U State (i.e. regional/provincial representative) teams. Design Concept mapping, a mixed-methods approach incorporating qualitative and quantitative data collection and analyses. Setting Pre-elite netball. Participants Thirty-nine netball coaches, strength & conditioning coaches and physiotherapists working with State 17/U & 19/U teams. Methods Participants brainstormed challenges to implementing the KNEE program, sorted the challenges into groups based on similar meaning and rated the importance and difficulty of overcoming each challenge on a scale from 0 (least important/easiest to overcome) to 5 (most important/hardest to overcome). Results Forty-six statements (i.e. challenges) were identified and organised into the following eight clusters (mean importance rating out of 5, mean difficulty rating out of 5): ‘athlete engagement’ (3.31, 2.48); ‘supervision and correction of technique’ (3.03, 2.67); ‘time constraints’ (2.79, 2.59); ‘athlete technique’ (2.70, 2.64); ‘education’ (2.56, 2.16); ‘support staff resourcing’ (2.51, 2.67); ‘program flexibility and adaptability’ (2.02, 1.85); and ‘coach and support staff prioritisation’ (1.95, 1.81). Nineteen statements/challenges had above average ratings for importance (2.63) and difficulty (2.41). Conclusions This study identified ‘athlete engagement’, ‘supervision and correction of technique’, ‘time constraints’, ‘athlete technique’, ‘education’ and ‘support staff resourcing’ as the most important and difficult challenges to implementing the KNEE program in pre-elite netball. These multi-factorial challenges are the main barriers to implementing the KNEE program. They can be addressed using the implementation driver’s framework.

This study aimed to identify what male coaches of elite female team sport athletes want to know about the menstrual cycle and its influence on athlete health and performance. Using a mixed-methods concept mapping approach, 18 male coaches of Australian female elite football-codes brainstormed what they wanted to know about the menstrual cycle to work more effectively with female athletes. Ideas were sorted into groups of similar ideas and rated for importance and influence. Thirty-eight unique statements emerged from the brainstorming. These were organised into five clusters/topics following multidimensional scaling and hierarchical cluster analysis: 1) How does training need to be managed; 2) How is physical performance impacted; 3) What are the medical and dietary considerations; 4) When and how should we communicate with athletes; and 5) How are athletes affected psychologically and emotionally. These findings highlight the need for a comprehensive education framework to improve the knowledge of and practices related to the menstrual cycle. This education should 1) facilitate better recognition and referral of female athletes regarding menstrual cycle dysfunction and related health concerns; 2) encourage collaboration between athletes, coaches, and medical and dietary professionals; and 3) promote effective communication between athletes and coaches about the menstrual cycle.

Purpose: Violence against women is a global epidemic. Such violence occurs in sport, although previous research has focused on child/youth sexual abuse or elite sport. Despite sport being identified as having a role in preventing violence against women, little is known about how sport organizations respond to violence against adult women in community sport. Methods: Twenty-two individual participants from 12 sports organizations based in Victoria, Australia participated in this empirical and applied Concept Mapping study to explore the perceived challenges sports organizations face in responding to violence against women. Concept Mapping is a mixed-method participatory approach and we analyzed the results using a socio-ecological framework. Results: Sports administrators considered training-related challenges as the most important but most difficult to address. Challenges related to organizational capacity/social environment were perceived as easier but less important to address. Conclusions: Key initiatives can be developed to support sport organizations to respond to violence against women in sport, but they will need assistance to prioritize initiatives addressing the most important challenges given a perceived lack of capacity to do so.

International audience; Objectives: The potential of sports clubs to promote health beyond physical activity has been acknowledged by researchers and policy-makers. This study gathered stakeholder ideas on support sports clubs need to increase health promotion efforts and prioritize them based on importance and feasibility. Study design: The study design used in this study is a mixed-methods concept mapping approach. Methods: French sports and public health stakeholders (n ¼ 45) were invited to participate. Steps included are as follows: (1) formulating a focus prompt, (2) brainstorming statements in response to the focus prompt, (3) sorting statements into themed piles, and (4) rating statements based on indicators. Multidimensional scaling and hierarchical cluster analysis were used to produce visual cluster maps, and descriptive statistics generated Go-Zone graphs based on mean importance and feasible ratings. Results: Participants generated 62 statements from the focus prompt: 'What assistance would benefit sports clubs to become a health-promoting setting?'. Final sorting produced 9 clusters: Tools for health promotion, Communication tools, Stakeholder training courses, Diagnostic and Financing, Awareness and Mobilization, Advocacy, Policies and Methods, Sharing and Networking, as well as Communication and Dissemination. Participant ratings produced 34 statements within the Go-Zone graphs. Conclusion: Understanding stakeholders' needs to increase health promotion activities in sports clubs is crucial to planning and implementing sustainable health promotion policies and practice. Priority areas include increasing awareness of health promotion benefits, mobilizing actors, advocating for support, and educating sports club actors.

Young handball players experience high injury rates. Specific injury prevention programs reduce injury rates but are not well implemented into youth players’ training. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project addresses this challenge. The aim of this study was to investigate how youth handball coaches and players experienced the recently developed I-PROTECT GO pilot program, by focusing on barriers and facilitators. Three focus group interviews were conducted with coaches and players, and their answers were analyzed using a general inductive approach. The participants appreciated the program and found it useful for their context. The participants’ statements about facilitators and barriers centered around the categories of resources, exercises, program design, and learning. Facilitators that emerged were motivating exercises (e.g., handball-specific), a helpful set-up (e.g., variation), having a clear purpose of exercises, the possibility to fulfil basic psychological needs while training, receiving instructions and feedback, and having role models. Barriers that emerged were limited space and material, difficulties with exercises, an unhelpful set-up (e.g., too repetitive), and undisciplined training. It is important to address perceived barriers and facilitators among coaches and players when developing injury prevention training programs to enhance the uptake of such training.

Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The 'Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)' uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT project, the current study aimed to describe the development of holistic injury prevention training specifically for youth handball players through using knowledge from both end-users (coaches and players) and researchers/handball experts. Employing action evaluation within participatory action research, the cyclical development process included three phases: research team preparation, handball expert-based preparation and end-user evaluation to develop injury prevention training incorporating both physical and psychological perspectives. To grow the knowledge of the interdisciplinary research team, rethinking was conducted within and between phases based on participants' contributions. Researchers and end-users cocreated examples of handball-specific exercises, including injury prevention physical principles (movement technique for upper and lower extremities, respectively, and muscle strength) combined with psychological aspects (increase end-user motivation, task focus and body awareness) to integrate into warm-up and skills training within handball practice. A cyclical development process that engaged researchers/handball experts and end-users to cocreate evidence-based, theory-informed and context-specific injury prevention training specifically for youth handball players generated a first pilot version of exercises including physical principles combined with psychological aspects to be integrated within handball practice.

Objectives To engage physiotherapists experienced in female elite sport and athletes to co-create a sport-specific anterior cruciate ligament (ACL) injury risk reduction program. Design Concept Mapping. Methods The Concept Systems Global MAX™ web platform was used to collect and analyse data from 27 context and content experts (22 physiotherapists, 5 athletes). Participants brainstormed statements representing the critical elements that should be included in an ACL injury risk reduction program for women playing elite Australian Football (AF). Results Twenty-two participants brainstormed 56 statements that were synthesised and edited to 62 statements. Statements were sorted into clusters by twenty-three participants and rated on importance and feasibility using six-point scales. Multidimensional scaling and cluster analysis identified a 5-cluster solution as follows: Football-specific preparation (15 statements); Movement skills (17 statements); Strength and conditioning (15 statements); Individual preparation (7 statements); and Education (8 statements). Calculation of mean ratings for each cluster and statement identified the Movement skills cluster as most important (mean = 3.61 out of 5) and the Football-specific preparation cluster as most feasible (3.75 out of 5). By contrast, the Individual preparation cluster was rated the least important (mean = 2.9 out of 5), and the least feasible (3.12 out of 5), to include in the program. Conclusions The five clusters of critical elements to include in an ACL injury risk reduction program for women playing elite AF, in order of most to least importance were: movement skills, football-specific preparation, education, strength and conditioning and individual preparation.

© The Author(s) 2020. Two Australian football clubs—St Kilda and the Sydney Swans—played the first Pride Game in Australian professional sport in 2016 to support and include the lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) community at and through a major sporting event. This study examines the framing of this game in the print and online media and in public responses via comments on media coverage and comments on Facebook posts. The framing of both the media coverage and the public response was predominantly supportive, with the theme of the “inclusion,” of gay Australian Football League players and the broader LGBTIQ community, prominent. However, there was a significant difference in the frames used in media coverage compared to the public response to this coverage. There was a relatively high proportion of unsupportive comments (e.g., a “stick to football” theme), including pernicious homophobia, present, particularly in the public response, compared to other recent related research. Overall, the findings suggest that, while there was strong support for the Pride Game, homophobia in sport remains, and the media, particularly social media, can be a platform for its expression. This study also highlights the value in analysing multiple platforms in media framing research.

Young handball players experience high injury rates. Specific injury prevention programs reduce injury rates but are not well implemented into youth players' training. The 'Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)' project addresses this challenge. The aim of this study was to investigate how youth handball coaches and players experienced the recently developed I-PROTECT GO pilot program, by focusing on barriers and facilitators. Three focus group interviews were conducted with coaches and players, and their answers were analyzed using a general inductive approach. The participants appreciated the program and found it useful for their context. The participants' statements about facilitators and barriers centered around the categories of resources, exercises, program design, and learning. Facilitators that emerged were motivating exercises (e.g., handball-specific), a helpful set-up (e.g., variation), having a clear purpose of exercises, the possibility to fulfil basic psychological needs while training, receiving instructions and feedback, and having role models. Barriers that emerged were limited space and material, difficulties with exercises, an unhelpful set-up (e.g., too repetitive), and undisciplined training. It is important to address perceived barriers and facilitators among coaches and players when developing injury prevention training programs to enhance the uptake of such training.

Summary The health promoting sports club describes the development of the settings-based approach in sports clubs. Based on this model, a questionnaire was developed to measure health promotion perceptions in sports clubs (e-PROSCeSS). The objective of this study was to assess the psychometric properties of a French version of the e-PROSCeSS measurement tool. The questionnaire includes three scales measuring stakeholder’s perceptions of club (macro), managers (meso) and coaches (micro) activities toward promoting health. Five steps were undertaken to assess perceptions. First, scales were translated into French. Second, each item’s content clarity was tested in three populations: managers, coaches, sports participants. Third, descriptive statistics were analyzed for each scale. Fourth, confirmatory factorial analysis was used to select items for each level. Predictive validity found positive relationships between health promotion perceptions and managing/coaching positions, and negative relationships with drop-out intentions. Positive relationships were found between sports participants’ perceptions of health promotion and their self-rated performance and quality of life, while negative relationships were detected with drop-out intentions. The French e-PROSCeSS subscales showed good psychometric properties in measuring health determinants at multiple levels. However, the tool did not measure health promotion as an overarching concept that questions its applicability in the sports club setting.

Objectives: To explore the challenges that Victorian sporting organisations experience when developing, delivering or scaling non‐traditional social sport products to engage insufficiently active people. Methods: Online Concept Mapping was used to gather qualitative data and analyse it quantitatively. Results: A total of 68 participants (27 organisations) brainstormed 158 challenges. The research team synthesised these to 71 unique challenges for participants to sort into groups and rate for importance (0–5) and ease of overcoming (0–5). A nine‐cluster solution – Deliverers; Capacity to drive the product; Facilities and partnerships; Product development; Sustainable business model; Marketing to insufficiently active; Attracting the insufficiently active; Clubs and volunteers; and Shifting traditional sport culture – was considered most appropriate. Participants rated the Deliverers challenges as the most important (mean=3.52), and the Marketing to insufficiently active challenges as the easiest to overcome (2.72). Conclusions: Key ingredients to successfully developing and delivering non‐traditional sport opportunities for insufficiently active populations are: recruiting appropriate product deliverers; building the capacity of delivery organisations and systems; and developing products relevant to the delivery context that align with the needs and characteristics of the target population. Implications for public health: A system‐wide response is required to address the challenges associated with sport organisations developing, scaling and delivering innovative social sport products for insufficiently active populations.

Children with severe needle phobia find vaccination extremely distressing and can remain unvaccinated, which puts them at an increased risk of contracting and transmitting vaccine preventable disease. Referral to a specialist or hospital service may occur when they cannot be safely vaccinated in the community, but engagement of allied health services can be inconsistent. The aim of the study was to assess the impact of a multidisciplinary, consumer-oriented model of care on vaccinations for needle phobic children.Needle phobic children aged between 6 and 16 years attended multidisciplinary consultation, as part of a care package, to assess previous experiences and determine the level of intervention that was required to support vaccination. A multidisciplinary case meeting followed this appointment and an individualised plan formulated for each patient. The main outcome of the project was rate of successful vaccination.The care package resulted in a successful vaccination rate of 83% (n = 20) with 69 vaccines administered across three clinics. Of those successful, 90% required multiple injections per visit. The majority of patients indicated moderate to high level of anxiety. Supportive care was escalated and de-escalated as tolerated.Results demonstrate the diversity of patients presenting with needle phobia and indicate an individualised, collaborative approach is preferable to a 'one size fits all' model of care. The study highlights a need for the development of guidelines that streamline the assessment and individualisation of procedural anxiety plans to meet patient needs and embed these processes into standard care.

Primary: To gain a system-wide perspective on factors leading to athlete attrition from a high-performance sport system (HPSS). Secondary: To identify what a sample of system-wide stakeholders and past athletes value as the most important and feasible attrition factors to address to retain talented athletes.Mixed-methods.Concept mapping was used for qualitative data collection and quantitative data analysis. Sixty-one participants including: (i) past athletes from an Australian state sporting institute; (ii) their families; and (iii) internal and external stakeholders to a HPSS who supported past athletes.Participants brainstormed 83 unique statements (i.e. attrition factors) that were mapped into 13 clusters of attrition factors following multidimensional scaling and hierarchical cluster analysis performed on the participants sorting data: 'abuse and mismanagement of health'; 'athlete health'; 'limited support/resourcing'; 'coaching'; 'inconsistent processes'; 'financial and career support'; 'pathway structure'; 'organisational dynamics'; 'competitive stress'; 'performance potential'; 'challenges with selection and transition'; 'psychological state'; and 'competing non-sport priorities'. 'Abuse and mismanagement of health' had the highest mean importance (3.76 out of 5) and feasibility (3.31) rating. The 13 clusters were further grouped into four overarching domains: 'sport system policy, structure and processes'; 'pathway structure, transition and support'; 'individual athlete health and capability'; and 'whole-of-life demands and priorities'. The domain 'sport system policy, structure and processes' contained the most important and feasible clusters.Macro (system-level) and micro (intrapersonal and interpersonal) level athlete attrition factors should be considered together. Athlete health was considered the most important athlete retention issue to address.

Interagency partnerships and collaborations underpin a settings-based approach to health promotion in all settings, including sport. This study used an online concept mapping approach to explore the challenges that Regional Sports Assemblies (RSAs) in Victoria, Australia experienced when working in partnerships to develop and deliver physical activity programs in a community sport context. Participants from nine RSAs brainstormed 46 unique partnership-related challenges that they then sorted into groups based on similarity of meaning and rated for importance and capacity to manage (6-point scale, 0 = least, 5 = most). A six cluster map (number of statements in cluster, mean cluster importance and capacity ratings)—Co-design for regional areas (4, 4.22, 2.51), Financial resources (3, 4.00, 2.32), Localised delivery challenges (4, 3.72, 2.33), Challenges implementing existing State Sporting Association (SSA) products (9, 3.58, 2.23), Working with clubs (8, 3.43, 2.99), and Partnership engagement (18, 3.23, 2.95)—was considered the most appropriate interpretation of the sorted data. The most important challenge was Lack of volunteer time (4.56). Partnerships to implement health promotion initiatives in sports settings involve multiple challenges, particularly for regional sport organisations working in partnership with community sport clubs with limited human and financial resources, to implement programs developed by national or state-based organisations.

Women in rural and regional communities experience social, cultural, and geographical constraints to sport, physical activity, and leisure participation. This study uses leisure constraints theory ...

Objectives Energy-dense, nutrient-poor food and drink (‘junk food’) brands sponsoring sport is a growing public health concern. This study explored sports administrators' perceptions of the barriers to rejecting junk food sponsorship. Study design This study used concept mapping. Methods The Concept Systems Global MAX™ web platform was used to collect and analyse data from 29 sports administrators across all levels of sport in Victoria, Australia. Results Brainstorming generated 33 barriers to rejecting junk food sponsorship. After the barriers were synthesised and edited, participants sorted and rated 32 barriers. Multidimensional scaling and hierarchical cluster analysis identified a four-cluster solution: community attitudes and values (seven barriers); junk food is the easy sell (retail; five barriers); financial viability (16 barriers); and organisational capability (policy and governance; four barriers). The financial viability barriers were rated the most important (mean = 3.65 of 5) and the hardest to overcome (1.42). The organisational capability (policy and governance) barriers were rated the least important (2.14) and the easiest to overcome (3.20). Conclusions Sports administrators clearly perceive that rejecting junk food sponsorship could place significant financial strain on their organisations. There appears to be considerable scope to build the capacity of sporting organisations to rejecting junk food sponsorship. Despite the literature indicating that most parents think junk food companies are not suitable sponsors, sports administrators perceive that there is a broad public acceptance of junk food sponsorship in sport. The fact that sports administrators perceive a link between junk food sponsorship and the lack of healthy options at club canteens and venue food outlets adds an additional, not previously identified, level of complexity to the junk food sponsorship in sport debate.

Background Developing context-specific, evidence-informed, and implementable injury-prevention programs is challenging. Women playing in the elite Australian Football League for Women are at high risk of serious knee injuries, and no specific injury-prevention program exists. The objective of the study was to describe the collaborative process used to create a context-specific injury-prevention program. Methods A previously used intervention-development process was modified to incorporate a partnership with the sport's governing organization and focus on engaging program implementers. The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) Sports Setting Matrix guided program development and implementation strategies. Results The 7-step process, aligned with the RE-AIM Sports Setting Matrix, was applied to develop the injury-prevention program and was titled Prep to Play PRO. The steps were: (Step 1) gaining organizational support and establishing a project partnership; (Step 2) using research evidence and clinical and context experience; (Step 3) consulting content and context experts; (Step 4) engaging the organization, experts, program implementers, and end-users in cocreating the intervention and implementation strategies; (Step 5) testing the intervention acceptability and feasibility; (Step 6) evaluating the intervention and implementation strategies against theory; and (Step 7) obtaining feedback from early implementers and end-users. Conclusion Engaging critical stakeholders at multiple ecological levels (organization, team, athlete) throughout program development and implementation planning supported real-world use. The processes and activities described can guide future sports injury-prevention program development and implementation.