Background
The importance of understanding and considering behavioural approaches in sports injury prevention lies in the evidence suggesting that implementing prevention or rehabilitation programs in real-world settings rely extensively upon the implementation context that is composed of behaviours and their determinants in different levels: individual; societal (e.g. groups and providers); organisational (e.g. clinics, clubs and hospitals); and structural (e.g. health systems). Therefore, knowing how to influence and change behaviours related to an individual’s environment is key for physical therapists to achieve the desired adherence and effectiveness of a proposed intervention program.
Study aim
Hence, we raised a question to explain running-related injury preventive behaviour in our recent study. Specifically, we investigated (1) the association between intention and running-related injury preventive behaviour; (2) the association of attitude, subjective norm, and perceived behavioural control with intention toward running-related injury prevention; (3) the association among attitude, subjective norm, and perceived behavioural control; and (4) the mediators of the effects between the determinants of behaviour and running-related injury preventive behaviour.
The outcomes in brief
The Theory of Planned Behavior explained 50% of the intention toward preventive behaviour.
A 1-point increase in Theory of Planned Behavior determinants increased the likelihood of preventive behaviour by 54%.
Intention increased by 0.66 points when the other determinants increased by 1 point.
Methods
We conducted a six-month prospective cohort study based on data gathered from a randomized controlled trial. From a total of 1,512 invited trail runners, 232 were included in this study. Preventive behaviors and their determinants were assessed at baseline, and two and six months after baseline. Five-point Likert scales were used to assess the determinants of preventive behavior. A Bayesian path analysis was conducted applying mixed models and mediation analysis.
Results
A 1-point increase in intention, attitude, subjective norm, and perceived behavioral control predicted an increase of 54% (95% Bayesian credible interval [BCI]: 38, 71) in the rate of performing running-related injury preventive behavior, explaining 49% (R2 0.49; 95% BCI: 0.41, 0.56) of the variance around preventive behavior. Intention and perceived behavioral control predicted running-related injury preventive behavior directly, while 40% (95% BCI: 21, 61) and 44% (95% BCI: 20, 69) of the total effect of attitude was mediated by intention and perceived behavioral control, respectively. Attitude, subjective norm, and perceived behavioral control predicted intention.
The Theory of Planned Behavior with the regression coefficients (b) showing the relationship between preventive behaviour toward running-related injury and its determinants.
Conclusions
The Theory of Planned Behavior may have the potential to explain half of the variance around running-related injury preventive behaviour and intention. Therefore, such theory may be considered a relevant and useful tool in developing, investigating, and/or implementing programs aimed at preventing running-related injuries. The Theory of Planned Behavior explained 49% of running-related injury preventive behaviour.
The full study can be accessed here (Open Access)
L. Hespanhol, C.S. Vallio, W. van Mechelen, E. Verhagen. Can we explain running-related injury preventive behavior? A path analysis. Brazilian Journal of Physical Therapy (2021). https://doi.org/10.1016/j.bjpt.2021.04.007