- Professor of Social Medicine and Associate Professor of Medical Informatics at Linköping University.edit
This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from... more
This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex (p = 0.037) and injury history (p = 0.035) and to predisp...
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ABSTRACT Sports organisations and sportspersons often suffer from an "autonomy-gap" obstructing implementation of interventions against overuse injuries. This obstruction has been described as the organisation-practice... more
ABSTRACT Sports organisations and sportspersons often suffer from an "autonomy-gap" obstructing implementation of interventions against overuse injuries. This obstruction has been described as the organisation-practice (OP) barrier. To develop an inter-organisational sports safety promotion model targeted at prevention of overuse injuries by identifying initiatives that lastingly will bridge the OP barrier. Participatory action research with focus group interviews using the quality function deployment (QFD) technique. Swedish athletics involving the Swedish Athletics Association (SAA), clubs, athletes, coaches, and other stakeholders in the sport. Representatives of Swedish athletics; officials from different divisions of the SAA, coaches, athletes, medical personal, club representatives and parents to youth athletes (year 1: n=12; year 2: n=35). Sports needs (Voice of Sports), organizational requirements, organizational changes. Organizational facilitators of sports safety promotion targeted at prevention of overuse injuries. An organic sports safety model resulted from the transformation of identified sports needs and organizational requirements into organisational changes. In this model, a dynamic and constantly active organisation-practice membrane reaches across the OP barrier. This organizational membrane consists of an infrastructure supporting continuous exchange of data and information between different actors in athletics. The central component is an Internet-based safety surveillance system covering Swedish athletics as a whole. A 'Safety Forum' is used for safety discussions between athletes, researchers, and SAA representatives, and a 'Coaches' Corner' allows communication between experienced coaches and younger colleagues. An inter-organizational sports safety model facilitating collaboration between sports organisations and sportspersons was developed in the setting of Swedish athletics. The principal feature in the model is an infrastructure supporting continuous exchange of data and information between different actors. Further research is warranted to prospectively evaluate the effectiveness of the novel model in overuse injury prevention.
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OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches,... more
OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics. DESIGN Cross-sectional. METHODS Data on subjective HL were collected using the Swedish Communicative and Critical Health Literacy (S-CCHL) instrument for mentors and for youth the School-Aged Children (HLSAC) instrument. Questions assessing mentors' literacy on sports injury and return to play were also included. RESULTS The surveys were completed by 159 (91%) mentors and 143 youth athletes (87%). The level of S-CCHL was sufficient in 53% of the mentors. Of youth athletes, 28% reported a high level of HL and the item with least perceived high HL (21%) was critical thinking. Ninety-four percent of the mentors believed that it is quite possible to prevent injuries in athletics and 53% perceived having a very good knowledge about how to prevent injuries. Forty-six percent of the mentors perceived having a very good knowledge of return to sport criteria. CONCLUSIONS The level of health literacy was low with about half of the mentors and one out of three youth athletes having adequate HL levels. Only half of the mentors stated having a good knowledge of various injury prevention strategies. To reduce health consequences in youth sport and enable talent development more work is needed to understand the facilitators and barriers for the uptake of various health promotion and injury prevention strategies.
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In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the Performance... more
In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the Performance Outcome Scoring Template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements of individuals or groups in context, i.e. the resulting performance outcome score (POS) reflects a meaningful measure of performance magnitude with regards to internal and external comparisons. Development of a POS is performed in four steps supported by a statistical framework. Software is supplied for creation of scoring applications in different performance evaluation settings. We demonstrate the POS-T by evaluation of CO2 emissions reduction amongst 36 OECD member countries.
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SYNOPSIS High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in... more
SYNOPSIS High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting. Meeting participants agreed that the definition of sport injury depends on the research question and context. It was considered essential to be explicit about the goal of the research effort and to use frameworks to illustrate the assumptions that underpin measurement and the analytical strategy. Complex systems were discussed to illustrate how potential risk factors can interact in a nonlinear way. This approach is often a useful alternative to identifying single risk factors. Investigating changes in exposure status over time is important when analyzing sport injury etiology, and analyzing recurrent injury, subsequent injury, or injury exacerbation remains challenging. The choice of statistical model should consider the research question, injury measure (eg, prevalence, incidence), type and granularity of injury data (categorical or continuous), and study design. Multidisciplinary collaboration will be a cornerstone for future high-quality sport injury research. Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts. This article has been copublished in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy. J Orthop Sports Phys Ther 2020;50(5):226-233. doi:10.2519/jospt.2020.9876.
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To examine associations between lifetime sexual and physical abuse, and the likelihood of injury within and outside sport in athletes involved in competitive athletics. A cross sectional study was performed among the top 10 Swedish... more
To examine associations between lifetime sexual and physical abuse, and the likelihood of injury within and outside sport in athletes involved in competitive athletics. A cross sectional study was performed among the top 10 Swedish athletics athletes using 1 year prevalence of sports and non-sports injuries as the primary outcome measure. Associations with sociodemographic characteristics, lifetime abuse history and training load were investigated. Data were analysed using simple and multiple logistic regression models. 11% of 197 participating athletes reported lifetime sexual abuse; there was a higher proportion of women (16.2%) than men (4.3%) (P=0.005). 18% reported lifetime physical abuse; there was a higher proportion of men (22.8%) than women (14.3%) (P=0.050). For women, lifetime sexual abuse was associated with an increased likelihood of a non-sports injury (OR 8.78, CI 2.76 to 27.93; P<0.001). Among men, increased likelihood of a non-sports injury was associated with mo...
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Engaging in competitive sports as a youth can have many health benefits, but recent studies also report a high risk for injury. The long‐term purpose of this Swedish research program is to develop a framework for safe track and field... more
Engaging in competitive sports as a youth can have many health benefits, but recent studies also report a high risk for injury. The long‐term purpose of this Swedish research program is to develop a framework for safe track and field training for young athletes (aged 12‐15 years). The aim of this study was to establish what is perceived to contribute and cause injuries in youth track and field by compiling the best available experiential knowledge about the underlying factors and use this knowledge to identify appropriate areas to handle these in practical ways. Nine focus group interviews with in total 74 participants and confirming interviews with five individuals were performed in seven Swedish regions. Qualitative research methods were used for data analysis. Injuries in youth athletes were not considered to be strictly the result of individual factors but rather the result of the interactions between factors at different levels. Three major factors emerged as follows: Insuffici...
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Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An... more
Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female...
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The term hybrid immunity is used to denote the immunological status of vaccinated individuals with a history of natural infection. Reports of new SARS-CoV-2 variants of concern motivate continuous rethought and renewal of COVID-19... more
The term hybrid immunity is used to denote the immunological status of vaccinated individuals with a history of natural infection. Reports of new SARS-CoV-2 variants of concern motivate continuous rethought and renewal of COVID-19 vaccination programs. We used a naturalistic case-control study design to compare the effectiveness of the BNT162b2 mRNA vaccine to hybrid immunity 180 days post-vaccination in prioritized and non-prioritized populations vaccinated before 31 July 2021 in three Swedish counties (total population 1,760,000). Subjects with a positive SARS-CoV-2 test recorded within 6 months before vaccination (n = 36,247; 6%) were matched to vaccinated-only controls. In the prioritized population exposed to the SARS-CoV-2 Alpha and Delta variants post-vaccination, the odds ratio (OR) for breakthrough infection was 2.2 (95% CI, 1.6–2.8; p < 0.001) in the vaccinated-only group compared with the hybrid immunity group, while in the later vaccinated non-prioritized population, ...
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Background Recurrence is a problem for many patients who have episodes of depression. In experimental settings, hyporeactivity in the Electrodermal Orienting Reactivity (EDOR) test has been observed to be more frequent in these patients.... more
Background Recurrence is a problem for many patients who have episodes of depression. In experimental settings, hyporeactivity in the Electrodermal Orienting Reactivity (EDOR) test has been observed to be more frequent in these patients. The aim of this study was to investigate the clinical value of this test with regard to a prognosis of episode recurrence in patients hospitalized for depression. Methods The study was performed using a cohort design at a specialized psychiatric clinic in Warsaw, Poland. The primary endpoint measure was relapse or recurrence of depression. Data on electrodermal reactivity measured by the EDOR test, clinical status, and psychiatric history were collected at the clinic. Relapse and recurrence data were collected by clinical interviews 1 year after the EDOR test. The predictive (adjusting for confounders) and comparative (relative to other predictors) performance of electrodermal hyporeactivity was assessed using simple and multiple binary logistic reg...
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Since 2000, a problem-solving model has been taught to the Society for Protecting the Rights of the Child, and teachers and students of social work, in two universities in Iran. Since 2006, with the initiation of UNICEF, social workers,... more
Since 2000, a problem-solving model has been taught to the Society for Protecting the Rights of the Child, and teachers and students of social work, in two universities in Iran. Since 2006, with the initiation of UNICEF, social workers, psychologists and even some psychiatrists in Iran have been learning this model. In 2008, a group of researchers created an empowerment-oriented psychosocial group and private intervention project to assess if a group of Iranian single mothers could use this model, which was traditionally used by professionals only, to effectively and independently meet challenges in their own lives. Our results show that all women used the model effectively, and consequently, made more deliberate decisions to improve their life situations. Some of the women succeeded in finding a job and many improved their family relationships. This study suggests that empowerment-oriented social work can help many clients to achieve their goals, and that this psychosocial interven...
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This exploratory study aimed to investigate whether data from track and field athletes support a conceptual model where the perception of pain affects self-evaluated health directly, yet is also indirectly mediated through personal... more
This exploratory study aimed to investigate whether data from track and field athletes support a conceptual model where the perception of pain affects self-evaluated health directly, yet is also indirectly mediated through personal factors and external stressors. A cross-sectional study was performed among athletes (n = 278) competing at the highest national level in the sport. Data for the dependent and independent variables were collected using the EuroQol-5 dimensions (EQ-5D) standardized measure of health status, and the mediator variables were collected by the Body Consciousness Scale (BCS-HA), Perceived Motivational Climate in Sport Questionnaire (PMCSQ), Commitment to Exercise Scale (CtES), and Brief Cope survey instruments. Two hundred and twenty-five (81%) athletes provided complete data sets. A strong direct association (c = −16.49; p < 0.001) was found between pain and self-estimated health, and a global mediation was found through the mediators (mediation effect (ME),...
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SUMMARYWorkplaces are one of the most important regular meeting places in society. The aim of this study was to use simulation experiments to examine the impact of different workplace cultures on influenza dissemination during pandemics.... more
SUMMARYWorkplaces are one of the most important regular meeting places in society. The aim of this study was to use simulation experiments to examine the impact of different workplace cultures on influenza dissemination during pandemics. The impact is investigated by experiments with defined social-mixing patterns at workplaces using semi-virtual models based on authentic sociodemographic and geographical data from a North European community (population 136 000). A simulated pandemic outbreak was found to affect 33% of the total population in the community with the reference academic-creative workplace culture; virus transmission at the workplace accounted for 10·6% of the cases. A model with a prevailing industrial-administrative workplace culture generated 11% lower incidence than the reference model, while the model with a self-employed workplace culture (also corresponding to a hypothetical scenario with all workplaces closed) produced 20% fewer cases. The model representing an ...
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The objective of this study was to provide an epidemiologic basis for planning community programmes preventing injuries during leisure physical activity, especially participation in sports. A total population survey of unintentional... more
The objective of this study was to provide an epidemiologic basis for planning community programmes preventing injuries during leisure physical activity, especially participation in sports. A total population survey of unintentional injuries was carried out in an area with a population of over 41,000. All sports injuries ( n = 933) occurring within a 12-month period and requiring medical care were noted, giving a ratio of 22.5 per 1000 inhabitants. The majority of the injuries occurred in soccer (38.9%), followed by injuries in basketball/volleyball/handball (10.9%), and bandy/hockey (9.2%). The results correspond to previous studies in southern Scandinavia. In northern communities, the proportion of injuries in winter sports has been shown to be higher. Identification of these similarities and differences between the studies makes it possible to use the findings together in the design of general community-based sports injury prevention programmes suited to northern European conditi...
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As policy makers and funders have become more concerned with allocating scarce resources effectively, attention to the sustainability of health intervention programs has increased. However, the empirical knowledge base about factors... more
As policy makers and funders have become more concerned with allocating scarce resources effectively, attention to the sustainability of health intervention programs has increased. However, the empirical knowledge base about factors facilitating or working against sustainability remains at an early stage. The aim of this study was to contribute to improved understanding of the conditions under which community-based injury prevention programs are most likely to attain sustainability. Ten Swedish community-based injury prevention programs were analysed with respect to factors that contribute to or detract from program sustainability. All the programs are integrated within existing municipality structures. Data were collected by means of semi-structured telephone interviews with key informants.The results suggested that different factors are interrelated, with no one factor being either primary or by itself sufficient for program sustainability. Financial, human, and relational resources lay the groundwork for the long-term operation of a program. The “integrated” program model appears to facilitate sustainability, but program intensity is vulnerable to changes in the financial status of the municipality and the priority-setting by municipality political decision makers. Sustainability may be compromised if a program becomes too dependent on a few key individuals. In contrast to financial, human, and relational resources, structural resources (e.g., injury surveillance and goals) appeared to have limited influence on sustainability. The programs were sustained with little evidence of effectiveness, resulting in limited feedback about how to improve a program in order to achieve and maintain long-term effectiveness.
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Research Interests: Health Promotion, Participatory Action Research, Community Development, Political Science, Injury Prevention, and 14 morePublic Health, Adolescent, Medicine, Sweden, Humans, Child, Infant, Newborn Infant, Aged, Public health systems and services research, Process Evaluation, Wounds and Injuries, Child preschool, and Community health services
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Research Interests: Information Systems, Engineering, Sociology, Computer Science, Primary Care, and 14 moreDocumentation, Participatory Design, Organizational Culture, Primary Health Care, Health Care, Ideology, Grounded Theory, Group Processes, Medicine, Software Design, Social Environment, Video Recording, Information System, and Medical and Health Sciences
Research Interests: Medical Education, Evaluation, Interprofessional Education, Medicine, Interdisciplinary Studies, and 15 moreCurriculum, Problem Solving, Humans, Nursing Education, Female, Male, Nurses, Curricula, Questionnaires, InterProfessional Education in Health Care, Public health systems and services research, Interdisciplinary Communication, Cooperative Behavior, interprofessional relations, and Medical and Health Sciences
Research Interests: Engineering, Computer Science, Artificial Intelligence, Expert Systems, Systems Analysis, and 9 moreDecision Support Systems, Medicine, Systems Integration, Knowledge Based System, Software Design, Artificial Intelligence in Medicine, Theoretical Models, Computer Science Neural Networks, and Decision Support Techniques
The goal has been to study the feasibility and implications of technical support for integrating the design expression notations of RP3: Argumentative Design (aRD), Design Space Development (DSD) and Design Space Analysis (DSA). In... more
The goal has been to study the feasibility and implications of technical support for integrating the design expression notations of RP3: Argumentative Design (aRD), Design Space Development (DSD) and Design Space Analysis (DSA). In effect, we have been investigating ideas for a design support tool in which designers can express design reasoning using any of the three notations. The tool is structured in analogy with a database management system, where information entities related to the design are stored in an information base and the different notations ...
Movement towards sport safety in Athletics through the introduction of preventive strategies requires consensus on definitions and methods for reporting epidemiological data in the various populations of athletes. To define health-related... more
Movement towards sport safety in Athletics through the introduction of preventive strategies requires consensus on definitions and methods for reporting epidemiological data in the various populations of athletes. To define health-related incidents (injuries and illnesses) that should be recorded in epidemiological studies in Athletics, and the criteria for recording their nature, cause and severity, as well as standards for data collection and analysis procedures. A 1-day meeting of 14 experts from eight countries representing a range of Athletics stakeholders and sport science researchers was facilitated. Definitions of injuries and illnesses, study design and data collection for epidemiological studies in Athletics were discussed during the meeting. Two members of the group produced a draft statement after this meeting, and distributed to the group members for their input. A revision was prepared, and the procedure was repeated to finalise the consensus statement. Definitions of ...
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Little is known about provision of medical services to adolescents prior to participating in international top-level sports. This study aimed to investigate experiences of medical service provision among high-level adolescent athletics... more
Little is known about provision of medical services to adolescents prior to participating in international top-level sports. This study aimed to investigate experiences of medical service provision among high-level adolescent athletics (track and field) athletes from three continents. A thematic narrative analysis was applied to data collected from 14 athletes by semi-structured interviews. Although competing at the highest international level, these adolescent athletes had difficulties making sense of symptoms of ill health, especially on their own. With increasing exercise loads, the athletes’ medical support needs had extended beyond the capacity of parents and local communities. As there was no organized transfer of the responsibility for medical support to sports organizations, the athletes often had to manage their health problems by themselves. There were major variations among the adolescent athletes with regards to medical service access and quality. The services used range...
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International middle- and long-distance running competitions attract millions of spectators in association with city races, world championships, and Olympic Games. It is therefore a major concern that ill health and pain, as a result of... more
International middle- and long-distance running competitions attract millions of spectators in association with city races, world championships, and Olympic Games. It is therefore a major concern that ill health and pain, as a result of sports overuse, lead to numerous hours of lost training and decreased performance in competitive runners. Despite its potential for sustenance of performance, approval of mHealth self-report monitoring (mHSM) in this group of athletes has not been investigated. The objective of our study was to explore individual and situational factors associated with the acceptance of long-term mHSM in competitive runners. The study used qualitative research methods with the Technology Acceptance Model as the theoretical foundation. The study population included 20 middle- and long-distance runners competing at national and international levels. Two mHSM apps asking for health and training data from track and marathon runners were created on a platform for web surv...
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The mothers’ nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3... more
The mothers’ nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with one intervention arm and one control arm (n = 110; 1:1 ratio) and was performed at one well-child clinic in Urmia, Iran. An educational smartphone application was delivered to the intervention group for a 6-month period while the control group received treatment-as-usual (TAU) with regular check-ups of the child’s development at the well-child centre and the provision of standard nutritional information. The primary outcome measure was change in the indicator of acute undernourishment (i.e., wasting) which is the weight-for-height z-score (WHZ). Children in the smartphone group showed greater wasting status improvement (WHZ +0.65 (95% Conf...
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There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain... more
There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain management. The aim of this study was to determine whether tendon thickness and morphological changes in the Achilles tendon detected in ultrasound examinations are associated with local symptoms in middle-age recreational long-distance runners. Forty-two Achilles tendons (21 middle-aged runners) were investigated by ultrasound examination measuring tendon thickness and a morphology score indicating tendinosis. The Generalized Estimating Equations method was applied in multiple models of factors associated with reporting a symptomatic tendon. Eleven symptomatic and 31 asymptomatic Achilles tendons were recorded. In the multiple model that used tendon thickness measured 30 mm proximal to the distal insertion, an association was found between thickness and r...
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Purpose: This review set out to summarise, define, and provide future direction towards the use of performance outcome measures as endpoints in research performed at international benchmark events in athletics. Methods: Scoping review... more
Purpose: This review set out to summarise, define, and provide future direction towards the use of performance outcome measures as endpoints in research performed at international benchmark events in athletics. Methods: Scoping review methodology was applied through a search of the PubMed and Sports Discus databases and a systematic article selection procedure. Articles that met the inclusion criteria underwent triage for further quantitative and qualitative analysis. A concept chart was generated to describe the methods by which performance had been measured and introduce descriptive labels for theoretical and practical application. Results: None of 2972 articles primarily identified from the database search met the triage standards for quantitative data extraction. Eleven articles were included in a qualitative analysis. The analysis identified the common methods by which performance has been measured, reported and analysed. The resulting concept chart collates labels from the qua...
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The quality of epidemiological injury data depends on the reliability of reporting to an injury surveillance system. Ascertaining whether all physicians/physiotherapists report the same information for the same injury case is of major... more
The quality of epidemiological injury data depends on the reliability of reporting to an injury surveillance system. Ascertaining whether all physicians/physiotherapists report the same information for the same injury case is of major interest to determine data validity. The aim of this study was therefore to analyse the data collection reliability through the analysis of the interrater reliability. Cross-sectional survey. During the 2016 European Athletics Advanced Athletics Medicine Course in Amsterdam, all national medical teams were asked to complete seven virtual case reports on a standardised injury report form using the same definitions and classifications of injuries as the international athletics championships injury surveillance protocol. The completeness of data and the Fleiss' kappa coefficients for the inter-rater reliability were calculated for: sex, age, event, circumstance, location, type, assumed cause and estimated time-loss. Forty-one team physicians and physi...
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Due to the dominance of overuse injuries among runners, knowledge of how use of non-steroidal anti-inflammatory drugs (NSAIDs) and behavioural factors contribute to injury events is important. The aim of this study was to explore... more
Due to the dominance of overuse injuries among runners, knowledge of how use of non-steroidal anti-inflammatory drugs (NSAIDs) and behavioural factors contribute to injury events is important. The aim of this study was to explore recreational marathon runners' strategies for coping with injury and illness, including use of drugs for control of pain and inflammation, and to investigate whether these strategies were associated with the 1-year prevalence of time-loss injury and illness. An online questionnaire was used for data collection in this cross-sectional study. The population consisted of runners who had registered for a marathon (n=341). Strategies used to understand and manage perceptions of injury and illness were measured with the Brief COPE instrument and the use of NSAIDs was investigated. Complete survey data were provided by 161 runners (47%). 42% reported NSAID use. A notable injury in the past year was reported by 43%, and 19% reported having had a time-loss illne...