(Image: Will Lion Information Hydrant CC-BY-NC-ND 2.0)
My first published paper (also first PhD paper) is now available online. This forms one element of my PhD research into the complexity of safety in sport.
People often suspect that, as an injury prevention/safety researcher, my goal is to wrap people in cotton wool – yet this could not be further from the truth. Rather, my research focuses on finding ways to make sport, and the environment in which we participate in sport, safer – hopefully making it more freely enjoyable because causes of harm have been minimised.
There exists a wealth of research that shows simple steps can prevent harm and improve safety, yet this information is often not particularly appealing or useful to the people who need it most: children and athletes and coaches and parents.
There are many simple answers to that question. Including one that I hear often: that this evidence often languishes in scientific journals in the form of research papers, and that a better way must be found to share this information. Better formats may include developing consensus statements or guidelines or posters or apps, or – in the latest craze – infographics. This approach sees the issue as a knowledge formatting one (as an element of knowledge translation).
The problem remains that even if people do know about the scientific evidence, they fail to use it anyway
In fact, a large amount of resources in readable, easy-to-use formats already exist.
This research shows that there are at least 284 different sport safety resources available from 5 key Australian organisations alone, and…
…that they exist in a variety of different types of online resources
(Image: Bekker & Finch, BMJ Open, CC BY NC 4.0)
…in addition, that they cover a variety of different sports, sport safety issues, and settings
(Image: Bekker & Finch, BMJ Open, CC BY NC 4.0)
Therefore, the fact that people are not using guidelines must be more than a mere format issue.
It is worthwhile for sports injury prevention researchers, in this context, to remember that the vast majority of people who need, and are potential users of, our injury prevention interventions and guidelines are not involved in sport professionally. Rather, they are normal people who likely participate in sport a few times a week. They simply do not have the time to sift through this vast ‘rivalry of resources’, and in turn to make judgement calls about what is necessary and useful to their setting. Merely providing them with more information in more formats only adds to this problem. Of course, it is often understood that overarching sporting bodies make these calls and provide such information to their member clubs, however this is often not the case, or else these are presented as a myriad of suggestions rather than clear guidance. This problem is the same in a myriad of other fields of healthcare.
Life, and the choices we make on a day-to-day basis, are varied and infinite. This boils down, not to a simple either-or choice between simply using or not using a set of guidelines for a single problem (such as concussion guidelines from an app in a contact sport environment). Rather, the problem lies in making the choice of which guidelines to choose and use over a plethora of other guidelines – which exist both for the same problem (such as concussion apps and posters and…) and also the other problems that can arise in a complex sporting setting (forms of non-accidental violence such as harassment). Furthermore, people need to integrate these with what they already know and do in that setting for that particular problem, and the myriad of other risks they seek to mitigate every day.
This is not a knowledge format issue, this is a research relevancy issue
This study is the first step in supporting this theory by showing that there is a wealth of lay sport safety information available online, and theorizes that this proliferation may be doing more harm than good:
“We have become a society hallmarked by the aphorism ‘too much information’, or simply ‘TMI’, as the World Wide Web has ushered in an era in which information is at our fingertips. It has been suggested that, for up to 61% of American adults, and 78% of Australian adults, their first port of call for healthcare information is searching the internet, or what is colloquially referred to as ‘Dr Google’. Moreover, it has been shown that if a doctor working in primary care were to relay all of the recommended primary healthcare information to patients at every opportunity that presented itself, it would take an average of 7.4 h of their time each day” (from Bekker & Finch, BMJ Open, CC BY NC 4.0)
The idea that people will implement guidelines merely because they are ‘evidence-based’, and further presented in an eye-catching format is naive. A new shiny resource does not necessarily replace an old one, rather it just adds to the pile.
As Caroline Finch recently tweeted: When is too much information not enough?