Effectiveness of a School-Based Physical Activity Injury Prevention Program

OBJECTIVE: To study the effects of a school-based injury prevention program on physical activity injury incidence and severity. DESIGN: Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007. SETTING: Forty Dutch primary schools. PARTICIPANTS: A total of 2210 children (aged 10-12 years). INTERVENTION: Schools were randomized to receive either the regular curriculum or an intervention program that targeted physical activity injuries. OUTCOME MEASURES: Incidence and severity of physical activity injuries per 1000 hours of physical activity participation. RESULTS: A total of 100 injuries in the intervention group and 104 injuries in the control group were registered. Nonresponse at baseline or follow-up was minimal (8.7%). The Cox regression analyses adjusted for clustering showed a small nonsignificant intervention effect on total (HR, 0.81; 95% confidence interval CI, 0.41-1.59), sports club (0.69; 0.28-1.68), and leisure time injuries (0.75; 0.36-1.55). However, physical activity appeared to be an effect modifier. In those who were less physically active, the intervention had a larger effect. The intervention reduced the total and leisure time injury incidence (HR, 0.47; 95% CI, 0.21-1.06; and 0.43; 0.16-1.14; respectively). Sports club injury incidence was significantly reduced (HR, 0.23; 95% CI, 0.07-0.75). CONCLUSION: We found a substantial and relevant reduction in physical activity injuries, especially in children in the low active group, because of the intervention. This school-based injury prevention program is promising, but future large-scale research is needed.