Applying the Socio-Ecological Model to barriers to implementation of ACL injury prevention programs: A systematic review

(整期优先)网络出版时间:2019-01-11
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Background:Preventinganteriorcruciateligament(ACL)injuriesisimportanttoavoidlong-termadversehealthconsequences.Identifyingbarrierstoimplementationofthesepreventionprogramsiscrucialtoreducingtheincidenceoftheseinjuries.OurpurposewastoidentifybarriersofimplementationforACLinjurypreventionprogramsandsuggestmechanismsforreducingthebarriersthroughapplicationofaSocioEcologicalModel(SEM).Methods:StudiesinvestigatingACLpreventionprogrameffectivenessweresearchedinMedlineviaPubMedandtheCochraneLibrary,andasubsequentreviewofthereferencesoftheidentifiedarticles,yielded15articlestotal.Inclusioncriteriaencompassedprospectivecontrolledtrials,publishedinEnglish,withACLinjuriesastheprimaryoutcome.Studieswereindependentlyappraisedby2reviewersformethodologicalqualityusingthePEDroscale.Barrierstoimplementationwereidentifiedwhenreportedinatleast2separatestudies.ASEMwasusedtosuggestwaystoreducetheidentifiedbarriers.Results:Fivebarrierswereidentified:motivation,timerequirements,skillrequirementsforprogramfacilitators,compliance,andcost.TheSEMsuggestedwaystominimizethebarriersatalllevelsofthemodelfromtheinpidualthroughpolicylevels.Conclusion:IdentificationofbarrierstoprogramimplementationandsuggestinghowtoreducethemthroughtheSEMisacriticalfirststeptowardenablingACLpreventionprogramstobemoreeffectiveandultimatelyreducingtheincidenceoftheseinjuries.