{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:37:00Z","timestamp":1749861420776,"version":"3.37.3"},"reference-count":37,"publisher":"BMJ","issue":"8","funder":[{"name":"Department of Planning and Community Development, Sport and Recreation Victoria Division"},{"DOI":"10.13039\/501100001231","name":"Victorian Health Promotion Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001231","id-type":"DOI","asserted-by":"publisher"}]},{"name":"JLT Sport, a Division of Jardine Lloyd Thompson Australia Pty Ltd"},{"DOI":"10.13039\/501100001226","name":"NSW Sporting Injuries Committee","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001226","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sports Medicine Australia National and Victorian Branches"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010164","name":"Australian Football League","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010164","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2018,8,21]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16\u201350 years while participating in community-level Australian Football. FootyFirst was implemented with \u2018support\u2019 (FootyFirst+S) or \u2018without support\u2019 (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012\/2013; 25 clubs in region 2: FootyFirst+NS in 2012\/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 1\u2009year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2\u2009years in region 1. Compared with before FootyFirst in 2006\u20132011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2\u2009years support); region 2: 21.5% increase (after 2\u2009years without support); region 3: 21.8% increase (after first\u2009year no programme, second year programme with support); rest of Victoria: 12.6% increase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. 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