Di Huang, MBBS
Graduate Student in MPH
Bloomberg school of Public Health, Johns Hopkins University
baltimore, Maryland, United States
Chatuthanai Savigamin, MD
Graduate Student in MPH
Bloomberg school of Public Health, Johns Hopkins University
baltimore, Maryland, United States
Miho Tanaka, MD
Associate Professor
Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School
boston, Massachusetts, United States
This review aims to identify and categorize barriers to accessing and implementing preventive training programs among youth athletes across all type of sports.
Design:
A systematic review was conducted following PRISMA guidelines. Comprehensive searches were performed in PubMed, Scopus, and Embase. Two independent reviewers screened 4,212 articles after removing 1,205 duplicates. Following title, abstract, and full-text screening, 19 articles met the criteria for data extraction. Data were categorized to examine educational, logistical, socioeconomic and motivational barriers impacting program reach and adherence.
Results: Four major barriers were identified: (1) Educational and Knowledge Barriers: A lack of coach awareness and training emerged as a significant obstacle across sports. Many coaches felt inadequately prepared to implement preventive training exercises, citing limited knowledge on program benefits and low perceived relevance to performance goals. Additionally, athletes often reported a limited understanding of the purpose and potential benefits of these programs, leading to lower adherence rates. (2) Logistical Barriers: Time constraints, inadequate staffing, and resource limitations were frequently cited barriers, particularly in school-based and community sports programs.(3) Socioeconomic factors also impacted program availability, with lower-resourced schools and communities facing greater challenges in sustaining preventive training initiatives. (4) Motivational and Attitudinal Barriers: Coaches and athletes often perceived these programs as monotonous or misaligned with sport-specific needs, which decreased motivation and adherence. Programs that lacked immediate, visible performance benefits or engaging elements were particularly challenging to implement sustainably.
Conclusions:
Barriers to accessing and sustaining youth preventive training programs are multifaceted, involving gaps in education, logistical challenges, and motivation. Enhancing coach education, creating adaptable program formats, and fostering awareness of injury prevention benefits are critical steps to improving reach and adherence. Addressing socioeconomic disparities through targeted resource allocation may further support program accessibility across diverse youth sports settings. Future research should explore innovative strategies for overcoming these barriers, particularly in under-resourced environments.
