Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa

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dc.contributor.advisorvan Mechelen, Willemen_ZA
dc.contributor.advisorLambert, Mikeen_ZA
dc.contributor.advisorVerhagen, Everten_ZA
dc.contributor.advisorDraper, Catherineen_ZA
dc.contributor.authorBrown, James Craigen_ZA
dc.date.accessioned2015-05-04T07:07:07Z
dc.date.available2015-05-04T07:07:07Z
dc.date.issued2014en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractIntroduction and objectives: Rugby union ('rugby') is a popular sport that has a high risk of injury. The sport has particular popularity in South Africa with about 500,000 players. Based on concerns about the number of rugby-related catastrophic injuries, the BokSmart nationwide injury prevention programme was launched in July 2009 by South African Rugby Union (SARU). This programme educates coaches and referees on safe techniques during a Rugby Safety Workshop (RSW). To assess real-world injury prevention efforts, researchers have suggested using the six Translating Research into Injury Prevention Practice (TRIPP) stages. Stage 1 and 2 investigate the incidence, severity and aetiology of injuries. Stage 2 investigates the aetiology of injuries. Stage 3 is the introduction of an intervention. Stage 4 is an investigation of the effectiveness of the intervention under ideal conditions. Stages 5 and 6 investigate the real-world implementation of the intervention. Thus, the objective of this thesis is to comprehensively evaluate the BokSmart programme using the TRIPP framework. Methods: TRIPP stages 1 and 2 are investigated in Chapters 2, 3, 4 and 5. Chapter 2 investigates the incidence, severity and aetiology of injuries at four competitive youth tournaments. Chapter 3 used Chapter 2's data to investigate the economic burden of these injuries. Chapter 4 investigates the incidence and severity of catastrophic injuries. Chapter 5 investigates the risk of both general and catastrophic injury specific to the scrum phase of play using the data from Chapters 2 and 4. TRIPP stages 3 and 4 were conducted by SARU and are thus outside the scope of this thesis. TRIPP stages 5 and 6 are investigated in Chapters 6, 7 and 8. Chapter 6 evaluates the effect of BokSmart in on catastrophic injury rates. Chapter 7 evaluates the effect of BokSmart on targeted player behaviours. Chapter 8 uses qualitative methods to investigate coaches and referees' perceptions of BokSmart. Results: Through TRIPP Stages 1 and 2 it was established that South Africa has comparable general and catastrophic injury rates to other countries. Senior players were at significantly (p<0.05) greater risk of suffering a catastrophic injury than younger players. The economic investigation indicated that injury rehabilitation was affected by whether the player had medical insurance or not – this may be unique to South Africa. Through TRIPP stages 5 and 6 BokSmart was associated with a reduction in catastrophic injuries in junior, but not senior players. BokSmart was also associated with a significant improvement in targeted player behaviours. Coaches' perceptions of the programme varied by socioeconomic status (SES). All coaches and referees agreed that the programme was capable of reducing catastrophic injuries in players. However, high SES coaches described difficulties in changing coach and player behaviour, while low SES coaches mentioned their lack of necessary infrastructure as barriers to adoption. There was also negativity about the delivery of BokSmart: coaches and referees felt the course was not practical enough, was too long and should not be compulsory. Conclusions: From BokSmart's perspective, the lack of effectiveness of the programme in senior players should be of concern, considering this age group's greater risk of catastrophic injury. This greater effect in juniors could be explained either by the higher number of players, or greater adoption in this age group. Future research should attempt to elucidate this reason. The barriers and suggestions described by low and high SES coaches and referees should be addressed to optimise the programme's impact. The programme should continue to be evaluated to assess the impact of these suggestions.en_ZA
dc.identifier.apacitationBrown, J. C. (2014). <i>Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology. Retrieved from http://hdl.handle.net/11427/12713en_ZA
dc.identifier.chicagocitationBrown, James Craig. <i>"Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2014. http://hdl.handle.net/11427/12713en_ZA
dc.identifier.citationBrown, J. 2014. Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Brown, James Craig AB - Introduction and objectives: Rugby union ('rugby') is a popular sport that has a high risk of injury. The sport has particular popularity in South Africa with about 500,000 players. Based on concerns about the number of rugby-related catastrophic injuries, the BokSmart nationwide injury prevention programme was launched in July 2009 by South African Rugby Union (SARU). This programme educates coaches and referees on safe techniques during a Rugby Safety Workshop (RSW). To assess real-world injury prevention efforts, researchers have suggested using the six Translating Research into Injury Prevention Practice (TRIPP) stages. Stage 1 and 2 investigate the incidence, severity and aetiology of injuries. Stage 2 investigates the aetiology of injuries. Stage 3 is the introduction of an intervention. Stage 4 is an investigation of the effectiveness of the intervention under ideal conditions. Stages 5 and 6 investigate the real-world implementation of the intervention. Thus, the objective of this thesis is to comprehensively evaluate the BokSmart programme using the TRIPP framework. Methods: TRIPP stages 1 and 2 are investigated in Chapters 2, 3, 4 and 5. Chapter 2 investigates the incidence, severity and aetiology of injuries at four competitive youth tournaments. Chapter 3 used Chapter 2's data to investigate the economic burden of these injuries. Chapter 4 investigates the incidence and severity of catastrophic injuries. Chapter 5 investigates the risk of both general and catastrophic injury specific to the scrum phase of play using the data from Chapters 2 and 4. TRIPP stages 3 and 4 were conducted by SARU and are thus outside the scope of this thesis. TRIPP stages 5 and 6 are investigated in Chapters 6, 7 and 8. Chapter 6 evaluates the effect of BokSmart in on catastrophic injury rates. Chapter 7 evaluates the effect of BokSmart on targeted player behaviours. Chapter 8 uses qualitative methods to investigate coaches and referees' perceptions of BokSmart. Results: Through TRIPP Stages 1 and 2 it was established that South Africa has comparable general and catastrophic injury rates to other countries. Senior players were at significantly (p<0.05) greater risk of suffering a catastrophic injury than younger players. The economic investigation indicated that injury rehabilitation was affected by whether the player had medical insurance or not – this may be unique to South Africa. Through TRIPP stages 5 and 6 BokSmart was associated with a reduction in catastrophic injuries in junior, but not senior players. BokSmart was also associated with a significant improvement in targeted player behaviours. Coaches' perceptions of the programme varied by socioeconomic status (SES). All coaches and referees agreed that the programme was capable of reducing catastrophic injuries in players. However, high SES coaches described difficulties in changing coach and player behaviour, while low SES coaches mentioned their lack of necessary infrastructure as barriers to adoption. There was also negativity about the delivery of BokSmart: coaches and referees felt the course was not practical enough, was too long and should not be compulsory. Conclusions: From BokSmart's perspective, the lack of effectiveness of the programme in senior players should be of concern, considering this age group's greater risk of catastrophic injury. This greater effect in juniors could be explained either by the higher number of players, or greater adoption in this age group. Future research should attempt to elucidate this reason. The barriers and suggestions described by low and high SES coaches and referees should be addressed to optimise the programme's impact. The programme should continue to be evaluated to assess the impact of these suggestions. DA - 2014 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa TI - Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa UR - http://hdl.handle.net/11427/12713 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/12713
dc.identifier.vancouvercitationBrown JC. Safer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2014 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/12713en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Human Biologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.titleSafer rugby through BokSmart? Evaluation of a nationwide injury prevention programme for rugby union in South Africaen_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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