The Development, Validation and Reliability of the Sports Injury Prevention Behavior Determinants Questionnaire

Valid data on behavioral determinants are essential to enhance adherence to injury prevention (IP) programs. This study reports the development and validation of the Sports Injury Prevention Behavior Determinants Questionnaire for youth handball and football players (12-17 years) and their coaches. Using the Health Action Process Approach framework, we followed consensus-based guidelines, including conceptualisation, focus groups, cognitive interviews, and a cross-sectional study for both players and coaches. Confirmatory factor analysis (CFA), reliability testing, and principal component analysis (PCA) were performed for the coach questionnaire only. Focus groups identified training load management, pain and injury management, and injury prevention training as key IP elements. These were integrated with relevant HAPA constructs during item development and refined through cognitive interviews. A cross-sectional study (337 coaches, 528 players) and CFA informed the final coach version, which was subsequently evaluated using a test-retest design. PCA included 59 coaches while the reliability analysis included 45 due to drop out. Intraclass correlation coefficients indicated good reliability (> 0.75) for all constructs in the coach questionnaire, although self-efficacy constructs showed small systematic differences (≤ 0.04; 95% CI 0.00 to 0.06). PCA led to minor refinements of the questionnaire. The Sports Injury Prevention Behavior Determinants Questionnaire is the first validated tool to assess IP behavioral determinants in youth handball and football coaches, with applicability across team sports. The player version followed the initial steps to ensure good face and content validity but requires refinement based on CFA and further reliability testing and PCA.