Coaches' perspectives on the implementation of injury prevention training in youth handball: a qualitative study

Injury prevention programmes can reduce injuries in youth team sports, including handball. However, real-world effectiveness and impact of such programmes are limited due to poor implementation. To address this in Swedish youth handball, the 'Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball' (I-PROTECT) programme was co-created with end-users, including coaches. Despite tailoring the programme and its strategies to the context and needs of end-users, weekly adherence and programme fidelity remain low. Understanding coaches' experiences of I-PROTECT may provide insights to revise existing and inform new strategies to support the implementation of injury prevention training in youth handball. The aim of this qualitative study was to explore coaches' perceptions of the implementation and usability of I-PROTECT. Six coaches (two women), purposively recruited, participated in a 1.5-hour online workshop, including two group activities. They provided feedback on using I-PROTECT and identified challenges and driving conditions for its implementation. Data were collected via an online whiteboard, and audio and video were recorded and transcribed verbatim. The data were analysed using reflexive thematic analysis, guided by self-determination theory (SDT). Three themes were developed: (1) Navigating choices and chores, (2) Learning by doing and (3) Sharing is caring. Coaches responded positively to I-PROTECT and suggested strategies to enhance motivation for using injury prevention training, primarily focusing on app improvements, education and organisational support. Strategies that support coaches' autonomy, competence and relatedness could be applied in future studies to support the implementation of injury prevention training in youth sports.