Improving the diffusion of safety initiatives in community sport.

OBJECTIVES: The "Mayday Safety Procedure" (MSP) is included in the Australian Rugby Union (ARU) Medical and Safety Recommendations and the mandatory SmartRugby training for coaches. Previous research indicates that translating the Mayday Safety Procedure into practice among community rugby coaches is challenging. This study investigated whether Mayday Safety Procedure translation could be enhanced by systematically planning and implementing a range of theory-informed and context-specific diffusion strategies. DESIGN: A controlled before-and-after study. METHODS: Coaches of senior community rugby teams in five zones in New South Wales (Australia) were invited to complete a questionnaire about their Mayday Safety Procedure knowledge and practice at the end of the 2010 and 2011 rugby seasons. During 2011, coaches in the intervention zone were exposed to a range of strategies to promote Mayday Safety Procedure diffusion which were planned by following Step 5 of the Intervention Mapping protocol. Coaches in the other four zones were exposed to usual strategies to promote Mayday Safety Procedure diffusion. RESULTS: Using the RE-AIM evaluation framework, statistically significant improvements were found among intervention zone coaches in: knowledge of most Mayday Safety Procedure key criteria; the number of coaches recognising their zone policy requiring them to train players in the Mayday Safety Procedure; frequency of provision of Mayday Safety Procedure training to players; coach perceptions of the quality of Mayday Safety Procedure training for players; and in confidence that referees could implement the Mayday Safety Procedure during a game if required. CONCLUSIONS: The findings suggest that the translation of injury prevention policy into community practice can be enhanced by developing and implementing a theory-informed, context-specific diffusion plan, undertaken in partnership with key stakeholders.