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Kroshus E, Zhou H, Ledsky R, Sarmiento K, DePadilla L. Randomized Evaluation of Centers for Disease Control and Prevention HEADS UP Concussion Education Materials for Youth Sport Coaches. J Neurotrauma 2023; 40:1584-1595. [PMID: 36694461 PMCID: PMC10440241 DOI: 10.1089/neu.2022.0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The Centers for Disease Control and Prevention (CDC) HEADS UP youth sports coach materials are the most widely adopted form of concussion education for coaches across the United States-reaching millions of youth sports coaches over the last decade. These materials focus on concussion symptom identification, response, and management (e.g., return to school and sports), while also addressing the importance of communicating to athletes and their families about concussion safety. The purpose of this study was to assess the effectiveness of CDC HEADS UP materials on coach knowledge and communication with youth athletes about concussion safety. This is the first randomized control study of the CDC HEADS UP materials in real world youth sport conditions. Participants were 764 coaches at 15 YMCA associations. Cluster randomization was used to assign branches within associations to intervention (CDC HEADS UP) and control (treatment as usual) conditions. Coaches completed surveys prior to and at the end of the competitive season. Communication with athletes about concussion increased among coaches in the intervention group (adjusted risk ratio [aRR] = 1.24, 95% confidence interval [CI] = 1.14, 1.36) but not the control group (aRR = 1.09, 95% CI = 0.90, 1.31), in multi-variate analyses controlling for coach demographic characteristics and baseline communication practices. Concussion symptom knowledge and communication intentions also significantly increased in the intervention group but not in the control group. This study provides evidence that CDC HEADS UP materials increase the likelihood that youth sport coaches communicate with their athletes about concussion safety. As youth sports organizations increasingly mandate concussion education for coaches, CDC HEADS UP materials may be considered a leading resource for adoption and setting-relevant implementation.
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Affiliation(s)
- Emily Kroshus
- University of Washington, Department of Pediatrics, Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Seattle, WA
| | - Hong Zhou
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, GA
| | | | - Kelly Sarmiento
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, GA
| | - Lara DePadilla
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Overdose Prevention, Atlanta, GA
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Daugherty J, Waltzman D, Sarmiento K. Provision of Concussion Information From Coaches and the Presence of Athletic Trainers: Findings From the 2021 YouthStyles Survey. J Athl Train 2023; 58:611-617. [PMID: 36645830 PMCID: PMC10569249 DOI: 10.4085/1062-6050-0454.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Coaches play an important role in concussion safety, and their views on concussion influence those of their athletes and the athletes' reporting behaviors. In this 2021 survey of youth, we examined how often coaches provide concussion safety information to their athletes and the association between coaches' provision of concussion information to athletes and the presence of athletic trainers (ATs) at a team's games and practices. More than 4 in 10 youth who played sports reported that their coaches did not provide any sort of concussion education or information to them in the past 12 months. Among those youth who always or sometimes had ATs at practices or games, 76.3% received some type of coach education on concussion in the past 12 months, compared with 31.9% of those who rarely or never had ATs at practices or games (P < .0001). Increasing access to ATs and adapting current concussion training and educational materials for coaches to increase coach-athlete communication may be beneficial.
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Affiliation(s)
| | - Dana Waltzman
- Centers for Disease Control and Prevention, Atlanta, GA
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Kroshus E, Chrisman SPD, Glang A, Hunt T, Hays R, Lowry S, Peterson A, Garrett K, Ramshaw D, Hafferty K, Kinney E, Manzueta M, Steiner MK, Bollinger BJ, Chiampas G, Rivara FP. Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial. Inj Prev 2023; 29:22-28. [PMID: 36113984 PMCID: PMC9877103 DOI: 10.1136/ip-2022-044665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/21/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Determine whether Pre-Game Safety Huddles, a novel and low-resource approach to concussion education, increase the expected likelihood of concussion reporting for youth athletes. METHODS A cluster-randomised trial compared Safety Huddles to usual care. Safety Huddles bring together athletes and coaches from both teams before the start of each game for coaches to briefly affirm the importance of speaking up if a concussion is suspected. Participants were athletes from 22 competitive community-based American football and girls and boys soccer teams (ages 9-14), and randomisation into intervention or control occurred at the level of the bracket (group of teams that compete against each other during the regular season). The primary outcome was expected likelihood of reporting concussion symptoms to the coach, measured via validated athlete survey at the beginning and end of the season. RESULTS Of 343 eligible participants, 339 (99%) completed baseline surveys and 303 (88%) completed surveys at season end. The mean (SD) age was 11.4 (1.1) years, 26% were female soccer athletes, 27% were male soccer athletes and 47% were football athletes. In adjusted analyses accounting for baseline values and clustering by sport and team via random effects, expected likelihood of concussion reporting at the end of the season was significantly higher in the intervention group compared to controls (mean difference=0.49, 95% CI 0.11 to 0.88; Cohen's d=0.35). CONCLUSIONS AND RELEVANCE Pre-Game Safety Huddles increased the expected likelihood of athletes reporting concussion symptoms. While further study is warranted, sport organisations should consider this approach a promising low-resource option for improving concussion safety in their setting. TRIAL REGISTRATION NUMBER NCT04099329.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA .,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Sara P D Chrisman
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA,Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Ann Glang
- Center of Brain Injury, Research and Training, University of Oregon, Eugene, Oregon, USA
| | - Tamerah Hunt
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia, USA
| | - Rachel Hays
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Sarah Lowry
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Alexis Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kimberly Garrett
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Dane Ramshaw
- Center of Brain Injury, Research and Training, University of Oregon, Eugene, Oregon, USA
| | - Kiana Hafferty
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Erin Kinney
- Oregon Health & Science University School of Medicine, Portland, Oregon, USA
| | - Maria Manzueta
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Mary Kathleen Steiner
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Beth J Bollinger
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | | | - Frederick P Rivara
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA,Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
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Mallory KD, Saly L, Hickling A, Colquhoun H, Kroshus E, Reed N. Concussion Education in the School Setting: A Scoping Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:605-618. [PMID: 35259774 PMCID: PMC9311225 DOI: 10.1111/josh.13156] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Concussions are a prevalent injury among youth, and concussion education has the potential to promote positive concussion-related behaviors. Recent recommendations and legislation have increased concussion education provided in schools; however, little is known about the education context, delivery method, development, and evaluation. A scoping review was conducted to identify peer-reviewed literature on concussion education delivered in the school setting. METHODS Six databases were searched (MEDLINE, CINAHL, EMBASE, PsycINFO, SPORTDiscus, and ERIC) to identify published articles from 2002 to July 16, 2020 that delivered concussion education in the school setting. Included studies described the concussion education and were written in English. RESULTS A total of 11,373 articles were identified and screened, with 27 studies meeting eligibility criteria and therefore, included. The studies delivered education to various stakeholders including students (n = 12; 44.4%), coaches (n = 5; 18.5%), educators (n = 3; 11.1%), parents (n = 1; 3.7%), and a mixed audience (n = 6; 22.2%). The education format varied and six studies (22.2%) developed the education based on a theory, model, or framework. CONCLUSIONS This study found substantial variability in the context, delivery method, development, and evaluation of education delivered in schools and further evaluation of this education is needed to ensure it is best-suited for school-based stakeholders.
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Affiliation(s)
- Kylie D. Mallory
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160TorontoONCanadaM5G 1V7
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital 150 Kilgour RoadTorontoONM4G 1R8
| | - Lauren Saly
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour RoadTorontoONM4G 1R8
| | - Andrea Hickling
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital; Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto 150 Kilgour RoadTorontoONM4G 1R8
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto 160‐500 University Avenue, Room 924TorontoOntarioM5G 1V7
| | - Emily Kroshus
- Department of Pediatrics, University of Washington; Center for Health, Behavior and Development, Seattle Children's Research Institute 1920 Terry AvenueSeattleWA98101
| | - Nick Reed
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital 160‐500 University Avenue, Room 936TorontoOntarioM5G 1V7
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McMurray N, Reinke E, Riboh J, Pyles C, Bytomski J. Medical Diagnoses in a University Athlete Training Room Clinic. Clin J Sport Med 2022; 32:e35-e39. [PMID: 33852438 DOI: 10.1097/jsm.0000000000000895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 08/31/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Approximately 560 000 student-athletes participate in university athletic programs every year. These athletes develop a variety of medical injuries and illnesses during their time at the university. There is currently a paucity of data with regarding medical encounters in a dedicated university athlete training room clinic. OBJECTIVE This study aims to provide data regarding medical diagnoses from a university athlete training room clinic. STUDY DESIGN Descriptive epidemiology study. SETTING University athlete training room clinic. PATIENTS University athletes. METHODS The electronic medical record for a year-round, athlete-only training room clinic at a private US university was reviewed. Athlete age, sex, sport, date of medical encounter, and encounter diagnoses across 5 calendar years were recorded; medical diagnoses were then manually stratified into diagnostic categories and subgroups. RESULTS A total of 1258 university athletes were evaluated during 5303 medical encounters. Approximately two-thirds of athletes were evaluated one or more times per year. Average number of encounters per athlete per year was 2.2 (0.6-3.8, 95% confidence interval). The football team accounted for the greatest number of encounters (15.2% of total encounters). The most common medical diagnosis category was otorhinolaryngology (30.6% of total diagnoses). The most common diagnosis subgroup was upper respiratory infection (14.8% of total diagnoses). CONCLUSIONS Approximately two-thirds of athletes were evaluated annually with an average of 2 encounters per athlete per year. Upper respiratory infection represented the most common individual diagnosis. The results reported in this study may be useful in directing future care and research of university athletes.
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Affiliation(s)
- Nathan McMurray
- Duke Sports Science Institute, Duke Division of Sports Medicine. Duke Orthopedics Department. Duke University Health System. Durham, North Carolina
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