Implementing sports injury prevention programmes during and beyond effectiveness trials: a mixed methodologies study

There is a gap between the evaluation of injury prevention programmes in controlled trials and their use in real-world practice, and implementation research seeks to bridge this gap by supporting programme uptake beyond research settings. This study explored implementation processes and influencing factors during and after effectiveness trials of injury prevention programmes, and examined strategies used for scale-up following trials. Using a mixed methodologies design, corresponding authors of published injury prevention trials were contacted and invited to complete a survey on implementation activities conducted during their trial and, where applicable, during scale-up. A subsample of respondents also participated in semi-structured interviews. In total, 107 injury prevention studies were identified, of which 39 authors completed the survey and nine took part in interviews. Implementation strategies applied during trials were often underreported in published studies but were identified through the survey, with common strategies including in-person training, staff education, and the provision of supportive materials. Only approximately one-third of the studies resulted in scale-up beyond the trial context. Survey responses and interview data highlighted several facilitators and barriers relevant to both trial implementation and scale-up, such as programme context, coach and athlete motivation, and organisational support. Other factors were phase-specific: trial implementation benefited from structured programme development and close researcher involvement, whereas scale-up was more strongly influenced by limited resources and external momentum, such as public events. These findings suggest that to enhance implementation and scale-up of injury prevention programmes, implementation factors should be considered throughout both the development and evaluation phases. Systematic reporting and assessment of facilitators and barriers during trials and broader scale-up initiatives, along with transparent descriptions of implementation strategies used in effectiveness studies, are essential to improve the translation of research findings into practice.