PT - JOURNAL ARTICLE AU - Nicola Sewry AU - Evert Verhagen AU - Mike Lambert AU - Willem van Mechelen AU - James Brown TI - Players’ and coaches’ knowledge and awareness of the BokSmart <em>Safe Six</em> injury prevention programme: an ecological cross-sectional questionnaire study AID - 10.1136/bmjopen-2017-018575 DP - 2017 Nov 01 TA - BMJ Open PG - e018575 VI - 7 IP - 11 4099 - http://bmjopen.bmj.com/content/7/11/e018575.short 4100 - http://bmjopen.bmj.com/content/7/11/e018575.full SO - BMJ Open2017 Nov 01; 7 AB - Objectives Rugby has a high injury incidence and therefore BokSmart introduced the Safe Six injury prevention programme in 2014 in an attempt to decrease this incidence. In 2015, BokSmart used a ‘targeted marketing approach’ to increase the awareness and knowledge of the Safe Six. Therefore, the aim of this study was to determine the change in the knowledge of coaches and players of the Safe Six programme, compared with the launch year, following a ‘targeted marketing approach’.Design Ecological cross-sectional questionnaire studySetting The 2014–2016 South African rugby union youth week tournaments.Participants Questionnaires were completed by 4502 players and coaches who attended any of the four youth week tournaments during 2014–2016.Outcome measures Logistic regression (adjusted OR, 95% CI) was performed in comparison to year prior to targeted marketing, separately for coaches and players, for changes in awareness and knowledge.Results The awareness of the Safe Six increased significantly for players in 2015 (1.74 times (95% CI 1.49 to 2.04)) and in 2016 (1.54 times (95% CI 1.29 to 1.84)). Similarly for coaches, there was a 3.55 times (95% CI 1.23 to 9.99) increase in 2015 and a 10.11 times (95% CI 2.43 to 42.08) increase in 2016 compared with 2014. Furthermore, a player was significantly more likely to be aware of the Safe Six if his coach was aware of the programme (p&lt;0.05).Conclusions The knowledge and awareness of the BokSmart Safe Six of both players and coaches increased in 2015 and 2016 (compared with 2014) since the launch of the programme. Coaches, the Unions/the South African Rugby Union and social media were the largest contributors to knowledge in coaches and players. While the ‘targeted marketing approach’ was associated with an increase in awareness, future studies should determine if this translates into behavioural change.