Can we explain running-related injury preventive behavior? A path analysis.

Abstract Background Behavioral and social sciences theories/models have been gaining attention in sports injury prevention. Objective To investigate the potential of the Theory of Planned Behavior in explaining running-related injury preventive behavior. Methods Six-month prospective cohort study based on data gathered from a randomized controlled trial. From a total of 1512 invited trail runners, 232 were included in this study. Preventive behaviors and their determinants were assessed at baseline and two and six months after baseline. Five-point Likert scales were used to assess the determinants of preventive behavior. A Bayesian path analysis was conducted applying mixed models and mediation analysis. Results A 1-point increase in intention, attitude, subjective norm, and perceived behavioral control predicted an increase of 54% (95% Bayesian credible interval [BCI]: 38, 71) in the rate of performing running-related injury preventive behavior, explaining 49% (R2 0.49; 95% BCI: 0.41, 0.56) of the variance around preventive behavior. Intention and perceived behavioral control predicted running-related injury preventive behavior directly, while 40% (95% BCI: 21, 61) and 44% (95% BCI: 20, 69) of the total effect of attitude was mediated by intention and perceived behavioral control, respectively. Attitude, subjective norm, and perceived behavioral control predicted intention. Conclusions The Theory of Planned Behavior may have the potential to explain half of the variance around running-related injury preventive behavior and intention. Therefore, such theory may be considered a relevant and useful tool in developing, investigating, and/or implementing programs aimed at preventing running-related injuries.