Interventions and Implementation Flashcards
Injury Prevention Frameworks
The ‘van Mechelen’ model - 1992
Translating Research into Injury Prevention Practice (TRIPP) - Finch, 2006
The ‘van Mechelen’ Model - 1992
1 - Establishing the extent of the injury problem
2 - Establishing the aetiology and mechanism of injury
3 - Introducing preventive measures
4 - Assessing their effect on injury rates
Translating Research into Injury Prevention Practice (TRIPP) - Finch, 2006
1 - Injury surveillance
2 - Establish aetiology and mechanisms of injury
3 - Develop preventative measures
4 - ‘Ideal conditions’ - scientific evaluation
5 - Describe intervention context to inform implementation strategies
6 - Evaluate effectiveness of preventative measures in implementation context
Identifying Intervention Targets
From surveillance
- what constitutes highest injury burden in the population?
- what are the most common injury mechanisms?
- what is the potential cost-benefit ratio?
From risk factor analysis
- what are the risk factors for specific injuries?
- what risk factors are potentially modifiable?
Develop an intervention
Group of international experts selected
Develop of programme to reduce the most frequent and/or most severe injuries
Focus on modifiable risk factors
Evidence-based or best practice exercise
Developing preventative measures
Passive
- changing policy
- changing environment/hazard signs
Active
- change way game is officiated
- introduce protective equipment
- change nature of sport
‘Ideal conditions’ evaluation
Efficacy - benefit of intervention compared to a control or standard program
Describe implementation context
Target population
- demographics
- role
- skill level
Setting
- sport culture
- existing systems
- tradition vs innovation
Barriers - perceived and actual
Resources - perceived and actual
Intervention types
Elimination - take risk away
Substitution - change the risk
Engineering controls - change the environment
Administrative control - change behaviour
PPT - equipment
How theory can help
Identify predictors of behaviour
Map out relationships between predictors
Point toward delivery strategies
Differential effects
Many interventions have a dose-response relationship with injury risk
People must keep using them to maintain their effect
Health action process approach model
Focus on:
- task self-efficacy
- action planning
- behavioural intention
‘Real world’ evaluation
Efficacy
- benefit of intervention compared to a control or standard program
- provides info about the behaviour of variables under controlled, randomised conditions
Effectiveness
- benefit and use of the intervention in a ‘real world’ setting, where all conditions cannot be controlled
Why do interventions fail
Wrong match between the risk factors and outcomes - not robust enough
Low compliance/adherence - problem with content/delivery
Wrong intervention level - who is actually responsible, how do levels of influence work together
