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Journal Article


Sewry N, Verhagen E, Lambert M, Van Mechelen W, Brown J. BMJ Open 2017; 7(11): e018575.


Department of Public and Occupational Health, Amsterdam Collaboration on Health and Safety in Sports, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.


(Copyright © 2017, BMJ Publishing Group)






OBJECTIVES: Rugby has a high injury incidence and therefore BokSmart introduced the Safe Six injury prevention programme in 2014 in an attempt to decrease this incidence. In 2015, BokSmart used a 'targeted marketing approach' to increase the awareness and knowledge of the Safe Six. Therefore, the aim of this study was to determine the change in the knowledge of coaches and players of the Safe Six programme, compared with the launch year, following a 'targeted marketing approach'.

DESIGN: Ecological cross-sectional questionnaire study SETTING: The 2014-2016 South African rugby union youth week tournaments. PARTICIPANTS: Questionnaires were completed by 4502 players and coaches who attended any of the four youth week tournaments during 2014-2016. OUTCOME MEASURES: Logistic regression (adjusted OR, 95% CI) was performed in comparison to year prior to targeted marketing, separately for coaches and players, for changes in awareness and knowledge.

RESULTS: The awareness of the Safe Six increased significantly for players in 2015 (1.74 times (95% CI 1.49 to 2.04)) and in 2016 (1.54 times (95% CI 1.29 to 1.84)). Similarly for coaches, there was a 3.55 times (95% CI 1.23 to 9.99) increase in 2015 and a 10.11 times (95% CI 2.43 to 42.08) increase in 2016 compared with 2014. Furthermore, a player was significantly more likely to be aware of the Safe Six if his coach was aware of the programme (p<0.05).

CONCLUSIONS: The knowledge and awareness of the BokSmart Safe Six of both players and coaches increased in 2015 and 2016 (compared with 2014) since the launch of the programme. Coaches, the Unions/the South African Rugby Union and social media were the largest contributors to knowledge in coaches and players. While the 'targeted marketing approach' was associated with an increase in awareness, future studies should determine if this translates into behavioural change.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Language: en


awareness; cross-sectional; injury prevention; social media


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