The FIFA 11 + : Why is adherence so challenging? Insights from a cross-sectional study of stakeholders in Australian amateur football (soccer)

To explore the usage and awareness of the FIFA 11 + (11 + ) across multiple stakeholders involved with amateur football. Coaches, players, non-coaching staff and medical personnel in New South Wales (NSW), Australia, were invited to complete a cross-sectional online survey, which was disseminated using a targeted email to two Football NSW member organisations and a social media campaign. Categorical data (including age-groups and sex) are presented as counts and percentages and analysed using a Chi-square or Fisher's exact test. A significance level of 0.05 was used for all analyses. In total 328 players, 55 coaches, 37 non-coaching staff and 16 medical personnel completed the survey (n  =  436). Awareness of the 11  +  was lowest among non-coaching staff (16.2%) and players (32.6%) but higher among coaches (52.7%) and medical personnel (93.8%). Once aware of the 11 + , 75.8% of all respondents used the program although 89.5% of them did so with modifications. In addition, only 40.0% of players reported completing all three parts of the 11  +  program. Veteran players were less likely to complete any type of warm-up compared with junior players (63.7% vs. 96.3%, respectively). Although awareness of the 11  +  varied amongst survey respondents, 3 out of 4 respondents who were aware of the 11  +  adopted the program. However, respondents reported modifying the 11  +  and not completing the program as intended, which suggests modification guidance is required to maintain the efficacy of the 11  +  .