KENYA MEDICAL RESEARCH INSTITUTE

Baseline mapping of research gaps in sports-related injuries, mental wellbeing, and psychological
support: a case study of Kenyan athletes

Proposal Concept

Investigators and Institutional Affiliations

Name Department Institution

Dr. Judy Mwai
James Kariuki
David Mathu
Ismail Adow
Dr. Joesph Mutai
Dr. Fred Kirui
Lucy Kanyara

Introduction

Empirical findings indicate that the number of male athletes who were injured was higher than female
athletes in most sports within various years. The awareness of high-performance athletes’ physical,
mental, and spiritual health has significantly increased locally and internationally during the past five
years (Najmeh Arabnejad, 2023)1. In the last 20 years, Kenyan athletes have witnessed a significant
increase in sports-related injuries and anti-doping allegations which have raised concerns about the
well-being of the sporting fraternity. The increase in sports-related injuries has become a “silent
epidemic” among the sporting community as well as a public health problem.

Lippeveld et al (2000)2 identified 5 strategic and operational issues that make public health information
systems in Africa non-responsive to supporting disease management. They include irrelevance of the
information gathered; poor quality of data; duplication and waste among parallel health information
systems; lack of timely reporting and feedback; and poor adaption of available information. Modern
machine learning approaches such as deep learning theory (DLT) can be used where decisions such as
prediction, adoption and to be made are complex and depend on many input variables. Such algorithms
have the ability to identify significant attributes and predict and adapt to the changing environment.
1
Najmeh Arabnejad (2023) - Managerial Analysis of Sports Injuries in Ten Sports. Commentary Article. Unpublished.
https://www.researchgate.net/publication/372751369_Managerial_analysis_of_sports_injuries_in_ten_sports/references
2
Lippeveld, T., Sauerborn, R., Bodart, C., & World Health Organization. (2000). Design and implementation of
health information systems. World Health Organization.

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This presents an innovative way to address the changing socio-economic factors that reduce adherence
to immunization rates.

Problem statement

In Kenya, the extent to which sports injuries contribute to injury among school athletes is poorly
documented. Further research is needed to obtain a more accurate estimate of the prevalence of sports-
related injuries among secondary school athletes in Kenya. In addition, there exists a large database of
injuries among Kenya's elite runners within the Athletic Kenya Headquarters. This data set is utilized
and serves as a potential of big data to support predictive modeling. Data generated from this study
will provide ministries of health and education, athletes, and trainers/coaches with knowledge on the
burden of sports injuries and risk patterns of different types of sports. This information can be used to
prioritize injury prevention by implementing proper training protocols and providing adequate data-
driven evidence to address the anti-doping issues among athletes.

Objective

The objective of this study is to conduct a baseline mapping of data gaps relating to sports-related
injuries among Kenya athletes. Qualitative approaches will also be used to document the mental well-
being and psychological support requirements for long-term injuries among athletes.

Specific aims

1. To conduct a situation analysis (mapping and matching) characterization and combination of

existing sports-related injuries based on a database archived at the Athletic Kenya Headquarters.
2. Explore the mental well-being and psychological support requirements for long-term injuries
among athletes.
3. Elucidate the lived experiences of athletes in managing sports-related injuries through the use of
group concept mapping.

Methodology

Study design

This will be a convergent parallel mixed methods study. Data science will be used to harness models
relating to insights and patterns relating to sports-related injuries incurred by Kenyan athletes. While
qualitative approach will be used to collect data on the risk factors for sports-related injuries and
explore reasons for non-management of treatable conditions, including impediments to returning to
sports.

Data Management

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Primary data collection will involve in-depth interviews to explore participants’ views on the type of
injury, degree of severity, treatment performed, quality of care, and the treatment outcome. The
questions will be semi-structured and designed to generate discussion around key thematic areas
relevant to the study but with the flexibility to allow further exploration of emerging themes. We will
also explore the risk factors for sports-related injuries, how the injuries were managed and impediments
to returning to sport. Interviews will be conducted by two individuals (interviewer and notetaker). All
interviews will be audio-recorded with permission from participants.

Data analysis

The audio-recorded data will be transcribed verbatim into Microsoft word. Two qualitative research
experts will read and re-read through the scripts to familiarize themselves with the data. Thereafter
these data will be categorized into themes and subthemes for purposes of thematic analysis and report
writing. Data categorization will be done using NVivo 11 Pro. Reporting will be done using verbatim
quotes to reinforce the priori and emerging themes.

Ethical consideration

Ethical review

Ethical and scientific approval from the Kenya Medical Research Institute Scientific and Ethics Review
Unit (SERU). Additional application for a research permit from the National Commission for Science,
Technology, and Innovation (NACOSTI) and also seek permission to conduct the research from the
Ministry of Sports.

Risks and Benefits

Benefits: There are no direct benefits to participants. The information gathered from this study will help
us to determine the prevalence of and risk factors for sports injury among athletes involved in
competitive sports activities. Our findings will benefit the ministry of health, and relevant partners to
develop policies and interventions to prevent and manage injuries related to sports activities. This will
ensure a reduction in sports injuries and will keep the athletes active in sports.

Risk: There are minimal risks involved in this study. Some athletes may experience psychological
discomfort when asked about existing or previous injuries, particularly if the injury is/was severe. The
second risk is that of inadvertent breach of confidential information. We will put the following
measures in place to mitigate these risks:

● Train the research assistants to protect privacy and confidentiality during data collection and
pilot the tools to ensure the wording of the questions is appropriate and acceptable. We will
revise the tools further if any issues arise during training and piloting.
● Interviews will be conducted in a confidential setting where other people will not be able to hear
the responses.

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 ● Data will be collected using password-protected android tablets. Access to the server will be
granted to a limited number of individuals. Data backed up on a hard drive will be password
protected and each participant will be given a unique identifier.
Consent

We will seek parental/caregiver written consent for all athletes. In addition, athletes will provide written
assent to participate in the study. Consent and assent will be voluntary. Athletes will be provided with
ample details prior to providing consent and assent. Athletes will be able to decline to provide consent
or assent. Athletes and coaches will be able to decline to answer as many questions are they wish, and
this will not affect their participation in any sports activities.

Dissemination of study findings

A workshop involving the Ministry of Health, Ministry of Sports and Athletes including sporting events
will be used to disseminate the findings to the community. We will also publish our findings in peer-
reviewed journals, and present abstracts at national, regional, and/or international conferences.

Expected application of the results

We will use the findings of this study to engage policymakers, athletes, and coaches to develop
interventions geared toward the prevention and management of injuries related to sports activities. We
will further engage these stakeholders in subsequent studies to co-create potential interventions that can
be tested and later scaled up to improve the management of sports injuries and to create a safer
environment for athletes, enabling them to enjoy the benefits of sports while minimizing the risk of
injuries.

Work Plan

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Activity 2023 2024
Jun Jul Aug Sep Oct Nov Dec Jan Feb
Inception phase
CSC application and approval
SERU and ISERC application and approval
NACOSTI application and approval
County approvals
Data collection and analysis
Training of data collectors and piloting of
tools
Data collection
Transcription, data cleaning and analysis
Report writing and dissemination
Report and manuscript writing
Dissemination

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Proposed Budget

Item Unit/ Quantity Unit price Year 1 Year 2

Days/ (KShs.) Total Total
No *Ksh *Ksh
1 Personnel (Honorarium for investigators)
a Honorarium for investigators 4 4 75,000.00 1,200,000.00 1,200,000.00
Sub Total 1 1,200,000.00 1,200,000.00

2 Scientific and Ethical Approvals

a SERU 1 1 25,000.00 25,000.00
b NACOSTI 1 1 10,000.00 10,000.00
c County Approvals 1 13 10,000.00 130,000.00
Sub Total 2 165,000.00 -

3 Pre- study Visit and Sensitization Meetings

a Ministries of Health & Sports 1 130 1,000.00 130,000.00 210,000.00
workshop facilitation
b DSA Study Team 20 3 10,500.00 630,000.00 630,000.00
c DSA Driver 20 1 6,000.00 120,000.00 120,000.00
d Fuel 1 1 150,000.00 150,000.00 150,000.00
e Vehicle Maintenance 1 1 20,000.00 20,000.00 20,000.00
f Stationery 1 1 30,000.00 30,000.00 25,000.00
g Printing 1 1 50,000.00 50,000.00
h Airtime 1 10 1,000.00 10,000.00 10,000.00
f Venue 1 13 5,000.00 65,000.00 100,000.00
Sub Total 3 1,205,000.00 1,265,000.00

4 Data Collection and Storage / Anaytics

4i. a. Training for Research Team
a Conference Package 3 55 3,500.00 577,500.00 577,500.00
b Transport Reimbursement 2 52 2,000.00 208,000.00 208,000.00
Participants Two- way
c Accommodation Allowance RA's 4 52 3,000.00 624,000.00 624,000.00
d Pre- Test Transport Allowance 1 1 20,000.00 20,000.00 20,000.00
Participants
e DSA Driver 4 1 6,000.00 24,000.00 24,000.00
f DSA Study Team 4 3 10,500.00 126,000.00 126,000.00
g Fuel 1 1 50,000.00 50,000.00 50,000.00
h Printing 1 1 10,000.00 10,000.00 10,000.00
i Airtime 1 10 1,000.00 10,000.00 10,000.00
Sub- Total 4i 1,649,500.00 1,649,500.00

4ii. Field Work Data Collection

a Research Assistant's Allowance 1 52 2,000.00 104,000.00 104,000.00
b DSA Study Team 26 2 10,500.00 546,000.00 546,000.00
c DSA Driver 26 1 6,000.00 156,000.00 156,000.00

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 Item Unit/ Quantity Unit price Year 1 Year 2
Days/ (KShs.) Total Total
No *Ksh *Ksh
d Fuel 1 1 150,000.00 150,000.00 150,000.00
e Vehicle Maintenance 1 1 10,000.00 10,000.00 10,000.00
f Airtime 1 10 1,000.00 10,000.00 10,000.00
g Printing 1 1 20,000.00 20,000.00 20,000.00
Sub Total 4(b) 996,000.00 996,000.00

5 Data Management, report writing and dissemination

a a. Quantitative 1 1 150,000.00 150,000.00 150,000.00
b b. Qualitative
bi. i. Transcription costs 1 1 150,000.00 150,000.00 150,000.00
bii. ii. Qualitative Data Analysis 1 1 150,000.00 150,000.00 350,000.00
c Report Writing Workshop 1 1 450,000.00 450,000.00 650,000.00
d Dissemination Workshop 1 1 500,000.00 500,000.00 650,000.00
e Conference Costs 1 1 150,000.00 150,000.00 50,000.00
f Publication 1 1 150,000.00 150,000.00 250,000.00
Sub Total 5 1,700,000.00 2,550,000.00

6 Total 6,915,500.00 7,660,500.00

Administrative fee (10%) 691,550.00 766,050.00

Grand Total 7,607,050.00 8,426,550.00

Overall Total 16,033,600.00

Justification of the budget

Line 1a: Ksh. 1,200,000 has been budgeted to cover the honorarium of 4 investigators

Line 2a-c: The cost of Ksh 165,000 has been budgeted for institutional and administrative clearance
fees for the study proposal by KEMRI SERU, NACOSTI, and for the thirteen counties.

Line 3: This line will cover costs for pre-study visits and sensitization meetings.

-In a., Ksh 130,000 has been budgeted for to cover lunch allowance costs for ten athletes
representatives from each of the 13 counties during the sensitization meeting.

-Line b- c will cover DSA expenses for the study team and the driver for 20 days to cover all 13
counties.

-Lines d and e will cover fuel and vehicle maintenance costs at Ksh.150,000 and Ksh.20,000
respectively.

-Lines f, g, h, and f will cover stationery, study-related materials printing costs, and Airtime.

-Line f will cover venue costs if the Counties will not provide a meeting space.

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Line 4: Data Collection activities will involve prior training of Research assistants (Ras) from the 13
counties. The study proposes to use 4 RA’s per county.

-Lines 4i a- d will cover training-related costs for the conference package at Ksh. 3,500 per person for
4 RA’s per county and 3 investigators for 3 days, two- ways transport reimbursement for the RA’s, 4
days’ accommodation allowance for the RA’s at Ksh. 3000 per person during training, transport costs
for an additional vehicle to be used during the pre-test.

-Lines e and f will be used for DSA for the study team and the driver during this field activity.

-Line g will cover fuel expenses for the whole trip at a cost of Ksh.50,000, line h will cover the printing
of training materials, and line i will support communication units for the period.

Line 4ii: Field Work for data collection: This covers costs related to data collection in the counties.

-a will cover RA’s field allowances during data collection at Ksh. 2000 per person.

-b and c are DSA-related expenses for 2 study team members who will supervise quantitative data
collection and also, collect qualitative data. Data collection is planned for 2 days per county.

-d to g are proposed costs for fuel at Ksh. 150,000, vehicle maintenance at Ksh. 10,000, Airtime for
Ksh.10,000, and Printing costs at Ksh. 20,000 during the field data collection respectively.

Line 5 a to b: A cost of Ksh.450,000 has been budgeted for Data management for both qualitative and
quantitative data.

Line 5 c to f: Ksh 450, 000 has been proposed to support report writing costs which will include
conference package and study team-related costs. We will hold one dissemination workshop at a
central place with representatives from all 13 counties including national-level representatives for
study-related ministries, and this is estimated to cost Ksh. 500,000. Publications and conference
registration costs for the presentation of the study findings are estimated at Ksh.150,000 each.