Contributors to negative biopsychosocial health or performance outcomes in rugby players (CoNBO): A systematic review and Delphi Study Protocol

Sam McCormack, Kevin Till, Jessica Wedlock, Keith Stokes, Mark Bitcon, James C. Brown, Matthew Cross, Phil Davies, Éanna Cian Falvey, Sharron Flahive, Sharief Hendricks, Rich Johnston, Stephen Mellalieu, James Parmley, Gemma Phillips, Carlos Ramirez, Joshua Stein, Sean Scantlebury, Stephen West, Ben Jones

Research output: Contribution to journalReview articlepeer-review

1 Citation (SciVal)


The importance of contributors that can result in negative player outcomes in sport and the feasibility and barriers to modifying these to optimise player health and well-being have yet to be established. Within rugby codes (rugby league, rugby union and rugby sevens), within male and female cohorts across playing levels (full-time senior, part-time senior, age grade), this project aims to develop
a consensus on contributors to negative biopsychosocial outcomes in rugby players (known as the CoNBO study) and establish stakeholder perceived importance of the identified contributors and barriers to their management. This project will consist of three parts; part 1: a systematic review, part 2: a three-round expert Delphi study and
part 3: stakeholder rating of feasibility and barriers
to management. Within part 1, systematic searches
of electronic databases (PubMed, Scopus, MEDLINE, SPORTDiscus, CINAHL) will be performed. The systematic review protocol is registered with PROSPERO. Studies will be searched to identify physical, psychological and/ or social factors resulting in negative player outcomes
in rugby. Part 2 will consist of a three-round expert Delphi consensus study to establish additional physical, psychological and/or social factors that result in negative player outcomes in rugby and their importance. In part 3, stakeholders (eg, coaches, chief executive officers and players) will provide perceptions of the feasibility and barriers to modifying the identified factors within their setting. On completion, several manuscripts will
be submitted for publication in peer-reviewed journals. The findings of this project have worldwide relevance for stakeholders in the rugby codes.
PROSPERO registration number
Original languageEnglish
Article number001440
JournalBMJ Open Sport & Exercise Medicine
Issue number4
Early online date11 Oct 2022
Publication statusPublished - 11 Oct 2022

Bibliographical note

he authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Funding Information:
SMcC, SS research fellowships are part-funded by the Rugby Football League. KT and BJ are employed by Leeds Rhinos Rugby League club in a consultancy capacity. JW PhD is part-funded by Leeds Rhinos Rugby League club. KS and MB are employed by Rugby Football Union. MC is employed by Premiership Rugby. JB research fellowship is funded by World Rugby. PD and EF are employed by World Rugby. SF and JS are employed by the National Rugby League. JP PhD is part-funded by the Rugby Football League. BJ and GP are employed by the Rugby Football League in a consultancy capacity. CR research fellowship is part-funded by Scottish Rugby Union. AG concussion consultant to RugbyAU.

Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.


  • Health promotion
  • Injury
  • Performance
  • Rugby
  • Well-being

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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