Economic evaluations of strategies to prevent sports and recreational injury among children and adolescents: a systematic review

Sleep characteristics and adolescent physical activity-related injuries in sports clubs, leisure time and schools

OBJECTIVE

Sleep has been identified as an important factor in relation to physical activity-related injury (PARI) in adolescents. The study aimed to explore associations between sleep duration, sleep problems and PARI among Slovak adolescents in three different settings: sports clubs, leisure time and schools.

METHODS

We analysed data from the cross-sectional Health Behaviour in School-aged Children study conducted in 2022 on a representative sample of 10 163 Slovak adolescents aged from 10.5 to 18.3 (mean age 13.4 (SD=1.5); 50.9% boys). Data were collected through self-administered online questionnaires completed by respondents in schools during the classes. Multiple logistic regression models were used to assess associations between sleep duration during schooldays and weekends, sleep problems and PARI in sports clubs, leisure time and schools.

RESULTS

Adolescents with normal sleep duration during schooldays and those who reported no problems with falling asleep, waking up at night and day sleepiness had a higher chance of not being injured during PA in sports clubs, leisure time and schools compared with adolescents with short sleep duration and sleep problems. Sufficient sleep duration during the weekend increased the probability of not having PARI in leisure time and schools, with the strongest association between long sleep duration and PARI in leisure time.

CONCLUSION

Good sleep quality and sufficient sleep duration were found to play a protective role in relation to PARI in adolescents. The findings suggest implementing sleep interventions in PARI prevention programmes, which must be considered a key component of adolescent PA promotion.

Systematic Review of Cost-Effectiveness of Injury Prevention Interventions in Soccer-Evidence Why Health Agencies Should Address It

Soccer injuries are a recognized problem worldwide. Several injury prevention programs have been confirmed to reduce the number of injuries in female and male players. Unfortunately, there is a lack of data about their cost, burden, and benefit for the health care system. In this paper we aim to systematically review the literature and critically evaluate the economic quality of injury prevention interventions implemented across different populations of soccer players. Web of Science, Medline, SPORTDiscus, Ovid, and other databases were searched from January 2011 through July 2021. Research articles were only selected for analysis if they focused on the cost-effectiveness of injury prevention, were experimental papers written in English, and were published following the peer-review process. Three cluster RCT and one retrospective study met the criteria. Cost data on incremental cost-effectiveness ratios (ICERs) were extracted. The included studies had a good/average quality of economic evaluation. Based on ICERs, injury prevention interventions were cost-effective in three out of the three comparisons. One study did not report the ICER value. However, since economic analyses were reported with varying methodological approaches and results, more data are required to recognize the cost-effectiveness of soccer-specific injury prevention interventions and their benefit for the health care system.

An Economic Evaluation of Disallowing Body Checking in 11- to 12-Year-Old Ice Hockey Leagues

Background:

After a national policy change in 2013 disallowing body checking in Pee Wee ice hockey games, the rate of injury was reduced by 50% in Alberta. However, the effect on associated health care costs has not been examined previously.

Hypothesis:

A national policy removing body checking in Pee Wee (ages 11-12 years) ice hockey games will reduce injury rates, as well as costs.

Study Design:

Cost-effectiveness analysis alongside cohort study.

Level of Evidence:

Level 3.

Methods:

A cost-effectiveness analysis was conducted alongside a cohort study comparing rates of game injuries in Pee Wee hockey games in Alberta in a season when body checking was allowed (2011-2012) with a season when it was disallowed after a national policy change (2013-2014). The effectiveness measure was the rate of game injuries per 1000 player-hours. Costs were estimated based on associated health care use from both the publicly funded health care system and privately paid health care cost perspectives. Probabilistic sensitivity analysis was conducted using bootstrapping.

Results:

Disallowing body checking significantly reduced the rate of game injuries (−2.21; 95% CI [−3.12, −1.31] injuries per 1000 player-hours). We found no statistically significant difference in public health care system (−$83; 95% CI [−$386, $220]) or private health care costs (−$70; 95% CI [−$198, $57]) per 1000 player-hours. The probability that the policy of disallowing body checking was dominant (with both fewer injuries and lower costs) from the perspective of the public health care system and privately paid health care was 78% and 92%, respectively.

Conclusion:

Given the significant reduction in injuries, combined with lower public health care system and private costs in the large majority of iterations in the probabilistic sensitivity analysis, our findings support the policy change disallowing body checking in ice hockey in 11- and 12-year-old ice hockey leagues.