The primary aim of this hybrid-effectiveness-implementation cluster randomised study is to investigate if a supported implementation of an injury prevention exercise program (Happy program) involving a train-the-trainer workshop and coach support during the season is superior to an unsupported implementation of the Happy program involving the availability of the program on webpages, in improving adherence (volume, frequency, duration) of the Happy program among coaches for young (11-17 years of age) Danish female and male handball players during one handball season. Secondary aims are to investigate if the supported implementation is superior to the unsupported implementation in improving behavioural outcomes among the coaches and in reducing the risk for new ankle, knee, and shoulder injuries among young (11-17 years of age) Danish female and male handball players during one handball season. Further, the investigators aim to evaluate how and why adherence and behavioural determinants towards use of the Happy program might improve (or not).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
950
The Happy program consists of handball specific warm-up components and resistance training components and will be available online.
The support consists of a coach workshop at the beginning of the season and the opportunity for additional support for the coaches throughout the season.
University of Southern Denmark
Odense, Southern Denmark, Denmark
Adherence volume at team level
How much the Happy components have been delivered (adherence volume) will be evaluated as the number of Happy components delivered per week at team level over the full season Reports of Happy program usage will be recorded electronically on a weekly basis by the head coach of each team using a web application. A full warm-up session includes 7 components. A full resistance exercise training includes 4 components. The coaches are encouraged to perform all Happy program components with their players twice a week
Time frame: Measured weekly over 7 months
Shoulder, knee and ankle injuries using the Oslo Sports Trauma Research Center Health problems Questionnaire (OSTRC-H2)
The primary injury outcomes will be time to any new handball-related ankle, knee and shoulder injury defined as any tissue damage or other derangement of normal physical function due to participation in handball, resulting from rapid or repetitive transfer of kinetic energy, following a recent consensus statement from the International Olympic Committee Injury status will be monitored weekly during the season using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire distributed electronically to the players via an application. The questionnaire also measures exposure to handball, both training and match, during the last seven days.
Time frame: Measured weekly over 7 months
Adherence volume of the Happy warm-up components at team level
To gain a detailed understanding of the adherence to the warm-up components included in the Happy program, an evaluation of how much the Happy warm-up components have been delivered at team level will be evaluated as the number of Happy warm-up components delivered per week over the full season Reports of Happy program usage will be recorded electronically on a weekly basis by the head coach of each team using a web application. A full warm-up session includes 7 components. A full resistance exercise training includes 4 components. The coaches are encouraged to perform all Happy program components with their players twice a week
Time frame: Assessed weekly over 7 months
Adherence volume of the Happy resistance training components at team level
To gain a detailed understanding of the adherence to the resistance training components included in the Happy program, an evaluation of how much the Happy resistance training components have been delivered at team level will be evaluated as the number of Happy resistance training components completed per week over the full season Reports of Happy program usage will be recorded electronically on a weekly basis by the head coach of each team using a web application. A full warm-up session includes 7 components. A full resistance exercise training includes 4 components. The coaches are encouraged to perform all Happy program components with their players twice a week
Time frame: Assessed weekly over 7 months
Adherence volume of the Happy resistance training components at player level
To support the evaluation at team level, an evaluation of how much the Happy resistance training components has been completed will be evaluated at player level as the number of Happy resistance training components completed per week over the full season Reports of Happy resistance training components usage will be recorded electronically on a weekly basis by the player using an application.
Time frame: Assessed weekly over 7 months
Substantial shoulder, knee and ankle injuries using the Oslo Sports Trauma Research Center Health problems Questionnaire (OSTRC-H2)
Secondary injury outcomes will be time to any substantial handball related ankle, knee and shoulder injury. Injuries will be defined as any tissue damage or other derangement of normal physical function due to participation in handball, resulting from rapid or repetitive transfer of kinetic energy, following the 2020 consensus statement from the International Olympic Committee. Players reporting at least a moderate reduction in training volume or performance due to a health problem with the Oslo Sports Trauma Research Center Health Questionnaire and further classify the health problem as a new shoulder, knee or ankle injury is defined as an substantial injury. Injury status will be monitored weekly during the season using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire distributed electronically to the players via an application. The questionnaire also measures exposure to handball, both training and match, during the last seven days.
Time frame: Assessed weekly over 7 months
Health Action Process Approach (HAPA) Questionnaire responses
A questionnaire will be used to assess between-group differences in HAPA constructs (ie: intentions, outcome expectancies, self-efficacy, action planning and coping planning) between baseline and the mid-season and the end of playing season.
Time frame: Will be assessed at baseline, mid-season (3 months after baseline) and at end season (7 months)
Determinants of Implementation Behavior Questionnaire (DIBQ) responses
To support the Health Action Process Approach (HAPA) Questionnaire responses, The Determinants of Implementation Behavior Questionnaire (DIBQ) constructs focusing on social influences will be measured at baseline, at mid-season and at the end of the season. These questions will be added to the same questionnaire assessing the HAPA constructs.
Time frame: Will be assessed at baseline, mid-season (3 months after baseline) and at end season (7 months)
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