Applying integrated behaviour change theories and mobile health technology for promoting sport injury prevention and rehabilitation

Abstract

Sport injury is one of the leading causes of injury among youth. The medical and economic burdens for sport injury are always being overlooked. Injury may not only lead to temporary impairment of sport performance and absence from sport, but it can also result in early retirement from competitive sport, lower future commitment to physical activity and prolonged recovery when following a rehabilitation programme. Sport injury prevention strategies and rehabilitation programmes have been developed to lower the risk of occurrence and negative impacts of sport injury. However, the prevention of sport injury and compliance of rehabilitation are self-regulatory behaviours that require motivation and perseverance to maintain. In the current thesis, two inter-related integrated behaviour change models were adopted, (1) the integrated model of self-determination theory (SDT) and the theory of planned behaviour (TPB), and (2) trans-contextual model (TCM). Under these two integrated models, concepts of motivation, social cognitive beliefs, and intention were applied to better understand the psychological processes involved in the management of sport injury. In this PhD thesis, a total of five studies (Chapter 2-6) were employed with an aim to explain and promote individuals’ sport injury prevention and rehabilitation behavioural adherence using the integrated behaviour change theories. Chapter 2 describes a qualitative study that aimed to explore junior secondary school students’ experiences and perspectives of in-school and out-of-school sport-safety, with a particular focus on the meaning and content that they applied to the motivational and social cognitive factors within the TCM. Chapter 3 records a three-month prospective study that adopted the TCM to investigate if students’ motivation of learning sport safety in an in-school context was transferrable to the motivation, social cognitive factors, and intention of sport injury prevention in an out-of-school context. Chapter 4 presents a TCM-driven intervention study, which included components of mHealth and conventional intervention to facilitate secondary students’ behavioural adherence to sport injury prevention. Chapter 5 reports a two-month prospective study that applied the integrated model of SDT and TPB in the prediction of patients’ adherence to rehabilitation programme following sport injury. Chapter 6 documents a mHealth interventional study which aimed at promoting patients’ rehabilitation adherence to sport injury by applying the integrated model of SDT and TPB. The final chapter (Chapter 7) summarises the findings from the five studies and highlights the implications, limitations of the current thesis, and future directions. This thesis provides fundamental evidence of the integrated models in explaining and promoting sport injury management behaviours. With the advancement of technology, it is believed that the application of theory-driven mHealth can be extended to other health behaviours.