Identifying the challenges to implementing a neuromuscular warm-up in pre-elite netball

Objective: To identify challenges for implementing Netball Australia’s ‘Knee injury prevention for Netballers and Enhance performance and Extend play’ (KNEE) program for 17/U & 19/U State (i.e. regional/provincial representative) teams. Design: Concept mapping, a mixed-methods approach incorporating qualitative and quantitative data collection and analyses. Setting: Pre-elite netball. Participants: Thirty-nine netball coaches, strength & conditioning coaches and physiotherapists working with State 17/U & 19/U teams. Methods: Participants brainstormed challenges to implementing the KNEE program, sorted the challenges into groups based on similar meaning and rated the importance and difficulty of overcoming each challenge on a scale from 0 (least important/easiest to overcome) to 5 (most important/hardest to overcome). Results: Forty-six statements (i.e. challenges) were identified and organised into the following eight clusters (mean importance rating out of 5, mean difficulty rating out of 5): ‘athlete engagement’ (3.31, 2.48); ‘supervision and correction of technique’ (3.03, 2.67); ‘time constraints’ (2.79, 2.59); ‘athlete technique’ (2.70, 2.64); ‘education’ (2.56, 2.16); ‘support staff resourcing’ (2.51, 2.67); ‘program flexibility and adaptability’ (2.02, 1.85); and ‘coach and support staff prioritisation’ (1.95, 1.81). Nineteen statements/challenges had above average ratings for importance (2.63) and difficulty (2.41). Conclusions: This study identified ‘athlete engagement’, ‘supervision and correction of technique’, ‘time constraints’, ‘athlete technique’, ‘education’ and ‘support staff resourcing’ as the most important and difficult challenges to implementing the KNEE program in pre-elite netball. These multi-factorial challenges are the main barriers to implementing the KNEE program. They can be addressed using the implementation driver’s framework.