{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T21:12:03Z","timestamp":1781212323724,"version":"3.54.1"},"reference-count":52,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Research Council for Health, Working life, and Welfare","award":["2023-01041"],"award-info":[{"award-number":["2023-01041"]}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["2021-02178"],"award-info":[{"award-number":["2021-02178"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005350","name":"Swedish Research Council for Sport Science","doi-asserted-by":"crossref","award":["2024\/13"],"award-info":[{"award-number":["2024\/13"]}],"id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005350","name":"Swedish Research Council for Sport Science","doi-asserted-by":"crossref","award":["D2025-0030"],"award-info":[{"award-number":["D2025-0030"]}],"id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,29]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Injury prevention exercise programmes with multiple components are efficacious in reducing injuries in youth and adult football. However, obtaining high adherence to the programmes over time is an unsolved challenge. Previous studies report that players lack motivation for injury prevention training and that coaches need ongoing support when using these programmes. The overall purpose of this study is to compare the added value of implementation support on the implementation and preventive efficacy of the Knee Control+programme in male and female, youth and adult amateur football teams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a type 3 hybrid cluster-randomised controlled trial with adherence to the Knee Control+ injury prevention programme as the primary outcome and preventive efficacy as secondary outcomes. The study will take place during the 2025 football season (April\/May to October\/November) in Sweden, and we aim to enrol a minimum of 117 teams with players 10 years of age and older. All teams will have access to Knee Control+ via\u2009the Swedish Football Association (FA) website and are instructed to use the programme throughout the season. Teams randomised to the intervention group will receive support for implementation of Knee Control+, and the control group will receive no implementation support. This support primarily targets coaches and consists of a smorgasbord of activities and material including physical and digital workshops, leaflets, digital material and site visits to the teams. Codesign with coaches and players was employed during the design of the implementation support. Players report use of Knee Control+ and\u2009any injuries or complaints monthly, and coaches report training and use of Knee Control+ weekly, via web-based questionnaires. Adherence to Knee Control+ (primary) and preventive effects on injury incidence and prevalence (secondary) will be compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study was approved by the Swedish Ethical Review Authority (Dnr 2024-07394-01). Implementation support interventions that are appreciated by the players and\/or coaches will be made available and free to use on the Swedish FA website after the study\u2019s conclusion. Fitness trainers will be able to hold workshops and make site visits after the study has been completed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Clinicaltrials.gov (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06748443\">NCT06748443<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102008","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T14:25:41Z","timestamp":1756218341000},"page":"e102008","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Enhancing Prevention of Injuries in Community youth and adult amateur football teams (EPIC) via implementation support for an exercise-based intervention: study protocol for a type 3 hybrid implementation\u2013effectiveness cluster-randomised controlled trial"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06748443","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00894595","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1533-6872","authenticated-orcid":false,"given":"Hanna","family":"Lindblom","sequence":"first","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Health, Medicine and Caring Sciences, Sport Without Injury ProgrammE (SWIPE), Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8670-5666","authenticated-orcid":false,"given":"Sofi","family":"Sonesson","sequence":"additional","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Health, Medicine and Caring Sciences, Sport Without Injury ProgrammE (SWIPE), Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6790-4042","authenticated-orcid":false,"given":"Markus","family":"Wald\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Capio Ortho Center Sk\u00e5ne, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0338-3647","authenticated-orcid":false,"given":"Ida","family":"\u00c5kerlund","sequence":"additional","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Health, Medicine and Caring Sciences, Sport Without Injury ProgrammE (SWIPE), Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Ivarsson","sequence":"additional","affiliation":[{"name":"School of Health and Welfare, Halmstad University, Halmstad, Sweden"},{"name":"Department of Sport Science and Physical Education, University of Agder, Kristiansand, Vest-Agder, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6883-1471","authenticated-orcid":false,"given":"Martin","family":"H\u00e4gglund","sequence":"additional","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Health, Medicine and Caring Sciences, Sport Without Injury ProgrammE (SWIPE), Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"2025123106480118000_15.8.e102008.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2010.074377"},{"key":"2025123106480118000_15.8.e102008.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-105890"},{"key":"2025123106480118000_15.8.e102008.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.a2469","article-title":"Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial","volume":"337","author":"Soligard","year":"2008","journal-title":"BMJ"},{"key":"2025123106480118000_15.8.e102008.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e3042","article-title":"Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial","volume":"344","author":"Wald\u00e9n","year":"2012","journal-title":"BMJ"},{"key":"2025123106480118000_15.8.e102008.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2007.00703.x"},{"key":"2025123106480118000_15.8.e102008.6","first-page":"321","article-title":"Efficacy of the FIFA 11+ Warm-Up Programme in Male Youth Football: A Cluster Randomised Controlled Trial","volume":"13","author":"Owoeye","year":"2014","journal-title":"J Sports Sci Med"},{"key":"2025123106480118000_15.8.e102008.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091277"},{"key":"2025123106480118000_15.8.e102008.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097066"},{"key":"2025123106480118000_15.8.e102008.9","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s40279-022-01797-7","article-title":"Efficacy of Multi-Component Exercise-Based Injury Prevention Programs on Injury Risk Among Footballers of All Age Groups: A Systematic Review and Meta-analysis","volume":"53","author":"Ob\u00ebrtinca","year":"2023","journal-title":"Sports Med"},{"key":"2025123106480118000_15.8.e102008.10","doi-asserted-by":"crossref","unstructured":"Bullock GS , R\u00e4is\u00e4nen AM , Martin C , et al . Prevention strategies for lower extremity injury: a systematic review and meta-analyses for the Female, Woman and Girl Athlete Injury Prevention (FAIR) Consensus. Br J Sports Med 2025. doi:10.1136\/bjsports-2025-109910","DOI":"10.1016\/j.jsams.2025.07.106"},{"key":"2025123106480118000_15.8.e102008.11","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093298"},{"key":"2025123106480118000_15.8.e102008.12","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13012"},{"key":"2025123106480118000_15.8.e102008.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092644"},{"key":"2025123106480118000_15.8.e102008.14","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.070672"},{"key":"2025123106480118000_15.8.e102008.15","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091886"},{"key":"2025123106480118000_15.8.e102008.16","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2023-106934"},{"key":"2025123106480118000_15.8.e102008.17","doi-asserted-by":"crossref","unstructured":"Lindblom H , Sonesson S , H\u00e4gglund M . \u201cWe may need some help; we are just parents who have chosen to engage in football\u201d: a qualitative study on amateur coaches\u2019 experiences of use of and support for injury prevention training in Sweden. Inj Prev 2024. doi:10.1136\/ip-2024-045289","DOI":"10.1136\/ip-2024-045289"},{"key":"2025123106480118000_15.8.e102008.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2024-002009","article-title":"Players are positive regarding injury prevention exercise programmes, but coaches need ongoing support: a survey-based evaluation using the Health Action Process Approach model across one season in amateur and youth football","volume":"10","author":"Lindblom","year":"2024","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2025123106480118000_15.8.e102008.19","doi-asserted-by":"crossref","DOI":"10.1186\/s40798-023-00608-1","article-title":"Adherence to Injury Prevention Exercise Programmes in Amateur Adolescent and Adult Football: A Detailed Description of Programme Use from a Randomised Study","volume":"9","author":"Lindblom","year":"2023","journal-title":"Sports Med Open"},{"key":"2025123106480118000_15.8.e102008.20","doi-asserted-by":"publisher","DOI":"10.1136\/ip-2023-044978"},{"key":"2025123106480118000_15.8.e102008.21","doi-asserted-by":"crossref","first-page":"119","DOI":"10.15517\/ap.v30i121.23458","article-title":"Health Action Process Approach (HAPA) as a Theoretical Framework to Understand Behavior Change","volume":"30","author":"Schwarzer","year":"2016","journal-title":"AP"},{"key":"2025123106480118000_15.8.e102008.22","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13532"},{"key":"2025123106480118000_15.8.e102008.23","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2474-10-75","article-title":"Preventing knee injuries in adolescent female football players - design of a cluster randomized controlled trial [NCT00894595]","volume":"10","author":"H\u00e4gglund","year":"2009","journal-title":"BMC Musculoskelet Disord"},{"key":"2025123106480118000_15.8.e102008.24","doi-asserted-by":"publisher","DOI":"10.1136\/ip-2023-044863"},{"key":"2025123106480118000_15.8.e102008.25","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2024-002260","article-title":"Injury prevention in youth football (soccer): a comprehensive description of the development process of the \u201cFUNBALL\u201d programme","volume":"10","author":"Ob\u00ebrtinca","year":"2024","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2025123106480118000_15.8.e102008.26","doi-asserted-by":"crossref","DOI":"10.1186\/s13102-023-00800-6","article-title":"Co-creating holistic injury prevention training for youth handball: Development of an intervention targeting end-users at the individual, team, and organizational levels","volume":"16","author":"Ageberg","year":"2024","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"2025123106480118000_15.8.e102008.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2023-001711","article-title":"Injury prevention for women and girls playing Australian Football: programme cocreation, dissemination and early adopter coach feedback","volume":"10","author":"Patterson","year":"2024","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2025123106480118000_15.8.e102008.28","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1071\/HE16056","article-title":"Improving the translation of health promotion interventions using effectiveness-implementation hybrid designs in program evaluations","volume":"27","author":"Wolfenden","year":"2016","journal-title":"Health Promot J Austr"},{"key":"2025123106480118000_15.8.e102008.29","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance","volume":"350","author":"Moore","year":"2015","journal-title":"BMJ"},{"key":"2025123106480118000_15.8.e102008.30","doi-asserted-by":"crossref","unstructured":"Ryan RM , Deci EL . Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. New York, NY: Guilford, 2017.","DOI":"10.1521\/978.14625\/28806"},{"key":"2025123106480118000_15.8.e102008.31","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000728"},{"key":"2025123106480118000_15.8.e102008.32","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.55.1.68"},{"key":"2025123106480118000_15.8.e102008.33","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1111\/sms.14348","article-title":"Motivation, injury prevention, and the incidence of sports injuries: A three-wave longitudinal test of self-determination theory","volume":"33","author":"Chiu","year":"2023","journal-title":"Scand J Med Sci Sports"},{"key":"2025123106480118000_15.8.e102008.34","doi-asserted-by":"crossref","unstructured":"Deci EL , Ryan RM . Intrinsic Motivation and Self-Determination in Human Behavior. New York: Plenum, 1985.","DOI":"10.1007\/978-1-4899-2271-7"},{"key":"2025123106480118000_15.8.e102008.35","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyl148"},{"key":"2025123106480118000_15.8.e102008.36","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.jsams.2012.03.016","article-title":"Self-determined forms of motivation predict sport injury prevention and rehabilitation intentions","volume":"15","author":"Chan","year":"2012","journal-title":"J Sci Med Sport"},{"key":"2025123106480118000_15.8.e102008.37","doi-asserted-by":"crossref","unstructured":"Martela F , Ryan RM . Assessing autonomy, competence, and relatedness briefly: Validating single-item scales for basic psychological need satisfaction. Eur J Psychol Assess 2024. doi:10.1027\/1015-5759\/a000846","DOI":"10.1027\/1015-5759\/a000846"},{"key":"2025123106480118000_15.8.e102008.38","first-page":"82","article-title":"An exploratory examination of the Coaching Behavior Scale for Sport","volume":"5","author":"C\u00f4t\u00e9","year":"1999","journal-title":"Avante"},{"key":"2025123106480118000_15.8.e102008.39","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/sms.12359","article-title":"The Coaching Behavior Scale for Sport (CBS-S): A psychometric evaluation of the Swedish version","volume":"26","author":"Carlsson","year":"2016","journal-title":"Scand J Med Sci Sports"},{"key":"2025123106480118000_15.8.e102008.40","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1123\/jsep.11.3.251","article-title":"Toward a Model of Exercise Motivation","volume":"11","author":"Dzewaltowski","year":"1989","journal-title":"J Sport Exerc Psychol"},{"key":"2025123106480118000_15.8.e102008.41","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1123\/jsep.15.4.363","article-title":"Predicting Aerobic Exercise Participation: Social Cognitive, Reasoned Action, and Planned Behavior Models","volume":"15","author":"Yordy","year":"1993","journal-title":"J Sport Exerc Psychol"},{"key":"2025123106480118000_15.8.e102008.42","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2014.998780"},{"key":"2025123106480118000_15.8.e102008.43","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1177\/1094428105280055","article-title":"Construct Validity of a General Training Climate Scale","volume":"8","author":"Tracey","year":"2005","journal-title":"Organ Res Methods"},{"key":"2025123106480118000_15.8.e102008.44","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph13070657","article-title":"Predictors of FIFA 11+ Implementation Intention in Female Adolescent Soccer: An Application of the Health Action Process Approach (HAPA) Model","volume":"13","author":"McKay","year":"2016","journal-title":"Int J Environ Res Public Health"},{"key":"2025123106480118000_15.8.e102008.45","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-101337"},{"key":"2025123106480118000_15.8.e102008.46","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-101969"},{"key":"2025123106480118000_15.8.e102008.47","doi-asserted-by":"crossref","unstructured":"Skivington K , Matthews L , Simpson SA , et al . A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ 2021;374. doi:10.1136\/bmj.n2061","DOI":"10.1136\/bmj.n2061"},{"key":"2025123106480118000_15.8.e102008.48","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz237"},{"key":"2025123106480118000_15.8.e102008.49","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.jshs.2021.10.002","article-title":"Epidemiology of injuries in male and female youth football players: A systematic review and meta-analysis","volume":"11","author":"Robles-Palaz\u00f3n","year":"2022","journal-title":"J Sport Health Sci"},{"key":"2025123106480118000_15.8.e102008.50","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5114\/biolsport.2023.109961","article-title":"Injury incidence and risk factors in youth soccer players: a systematic literature review. Part I: epidemiological analysis","volume":"40","author":"Mandorino","year":"2023","journal-title":"Biol Sport"},{"key":"2025123106480118000_15.8.e102008.51","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"2025123106480118000_15.8.e102008.52","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-062483","article-title":"Evaluation of an injury prevention programme (Prep-to-Play) in women and girls playing Australian Football: design of a pragmatic, type III, hybrid implementation-effectiveness, stepped-wedge, cluster randomised controlled trial","volume":"12","author":"Patterson","year":"2022","journal-title":"BMJ Open"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-102008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:50:36Z","timestamp":1767192636000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-102008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":52,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,26]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bmjopen-2025-102008"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-102008","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}