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Concussions from sport and recreational activities can negatively impact academic performance in adolescents. This study aims to use reflexive thematic analysis to understand the knowledge, management, and education of concussion among Irish postprimary educators. A cross‐sectional study that involved semistructured interviews with 18 secondary school teachers was conducted. Interviews were recorded and transcribed in preparation for a reflexive thematic analysis process according to research conducted by Braun and Clarke. A total of 664 data items were coded which led to the development of 5 themes (i.e., teacher's background experience, consequences of concussion, concussion in school, educating educators, and existing standards) and 22 subthemes. The implementation of concussion education initiatives for improving student safety, injury management, and recovery through mandatory teacher‐continued professional development should be explored. Teachers' knowledge of concussion is influenced by personal experiences, with safer attitudes observed in those who have witnessed or experienced concussions. The role of the Year Head in concussion management should be explored with a focus on communication pathways and dissemination of materials. Protocols for medical emergencies and academic adjustments for concussed students should be made readily available to secondary school teachers. Practitioner points: There is an immediate need for structured concussion education and concussion recognition protocols in the Irish secondary school system.Concussion education in the Irish secondary schools system requires coordinating within each individual school to disseminate concussion management policies.Secondary school teachers have a broad knowledge of concussion with a better understanding toward concussion if they have experienced a concussion themselves. [ABSTRACT FROM AUTHOR]

Background: Concussions are a public health concern. Underdiagnosis and mismanagement negatively impact patients, risking in persistent symptoms and permanent disability. Objective: This scoping review consolidates the heterogeneous and inconsistent concussion research and identifies key areas for medical education curriculum design to focus on for effective knowledge acquisition and bolstering competency in family physician residency. We analyze the literature on concussion education spanning various healthcare disciplines in North America. Methods: PRISMA-Sc was followed and MEDLINE and EMBASE Classic + EMBASE in the OvidSP search platform were used to find terms for brain concussion AND medical education OR specific education until 2021. Results: There are significant knowledge gaps about concussions, increased clinical exposure is required for competency which bolster physical examination skills and streamlined concussion guidelines are required for family medicine specialists that filter undifferentiated symptoms25% of participants improved adherence to concussion guidelines after an educational intervention and knowledge increased after concussion workshop and clinics. Conclusions: Multifaceted teaching improves concussion diagnosis and management. More research is needed to examine concussion competency and, more importantly, whether these interventions improve patient outcomes. [ABSTRACT FROM AUTHOR]

Concussion education for athletes is essential for informed decision making to aid recovery. Education about concussion symptoms, treatment, and protocols can improve symptom recognition, reporting behaviors, protocol compliance, and overall health outcomes. This pilot study aimed to understand current concussion knowledge, attitudes, and beliefs among female club soccer players aged 12–18 years. Findings identified gaps in concussion education and knowledge among these athletes. Continued concussion education efforts are needed to increase concussion knowledge and players' confidence, focusing on creative education practices. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Concussion awareness became a priority for the Northern Sydney Local Health District as the increase in children, teenagers, and young adults with concussion, had an effect on emergency department (ED) presentations, follow-up, schooling and sports-related activities. Education in some of the local schools from the Neuroscience Clinical Nurse Consultant had been occurring, but the need far outweighed the in-person approach. Therefore, it was decided that the development of an educational concussion video for schools was required. AIM: To produce a 5-minute educational video for use in schools in the PDHPE Program / Sport sessions, that could then be broken down into shorter 1-minute versions for social media bursts. METHOD: A focus group was established and the process of devising and parenting this video took approximately 11months. It is pitched at a 12-year-old and combines animation and realistic scenes. OUTCOME: The video can be found at - https://vimeo.com/674645370 It has been sent to and accessed by schools within the Northern Sydney Local Health District and has been integrated into the NSW Education Department teacher training as a tool for teachers and students. It has been accessed throughout NSW, other Australian states and accepted for use in the New Zealand schooling system. [ABSTRACT FROM AUTHOR]

With growing concerns surrounding exposure to head impacts in youth tackle football, players and parents must understand the exposure level when assenting and consenting to participate. To determine whether youth football players and parents could estimate on-field head-impact frequency, severity, and location. Prospective cohort study. Football field. We administered a 10-question head-impact estimation tool to parents (n = 23; mean age = 36.5 years [95% CI = 31.7, 37.3 years]) and players (n = 16 boys; mean age = 11.1 years [95% CI = 10.3, 11.8 years]). Player on-field head-impact exposure was captured using the Triax SIM-G system. We determined the accuracy between player and parent estimates relative to on-field head-impact exposures using κ and weighted κ values. Youth tackle football players and parents did not accurately estimate on-field head-impact frequency (κ range = −0.09 to 0.40), severity (κ range = −0.05 to 0.34), or location (κ range = −0.30 to 0.13). Players and parents overestimated head-impact frequency in practices but underestimated the frequency in games. Both groups overestimated head-impact severity, particularly in games. Most players and parents underestimated the number of head impacts to the top of the head, particularly during practices. Underestimations of head-impact frequency in games and to the top of the head suggest that informed consent processes aimed at educating players and parents should be improved. Overestimations of head-impact frequency in practices and severity may explain declining rates of youth tackle football participation. [ABSTRACT FROM AUTHOR]

Context: Concussion education and prevention programs require reliable and valid instruments to evaluate the theory, mechanisms, and outcome of these interventions Objective: To assess the psychometric properties of measures evaluating concussion education and prevention programsDesign: Descriptive epidemiological Setting: 10 NCAA-member universities Patients or Other Participants: 841 student-athletes in an RCT control group testing an ecological, peer-led concussion education program Main Outcome Measures: Instruments adapted for assessing concussion knowledge and Theory of Planned Behavior/Theory of Reasoned Action (TPB/TRA) cognitive mediators of reporting behavior (attitudes, subjective norms, perceived control, and intentions to report concussion). Participants completed measures at baseline, after one hour, and after one month Results: Internal consistency and test-retest reliability were moderate for both the concussion knowledge and cognitive mediator measures. TPB/TRA was supported subscale intercorrelation and item factor analysis in the cognitive mediator scale. Factor analysis of the concussion knowledge measure revealed subscales for physical/cognitive, psychological/affective, and non-symptoms. The intermediate TPB/TRA mediators of attitudes, norms, and perceived control predicted greater intention-to-report, which predicted increased likelihood of reporting concussion one month later.Conclusions: Measures of concussion knowledge and cognitive mediators of reporting adapted from the literature show adequate psychometric properties and support TPB/TRA application for concussion reporting behaviors. [ABSTRACT FROM AUTHOR]

Context: Concussion-symptom education remains the primary approach used by athletic trainers to address underreporting of possible sport-related concussions. Social marketing represents an untapped approach to promote concussion reporting by communicating the benefits or consequences of reporting or not reporting, respectively. Objective: To apply expectancy value theory and identify how marketing the possible consequences of concealing concussion symptoms influenced young adults' concussionreporting beliefs to increase the likelihood of reporting. Design: Randomized controlled clinical trial. Setting: Laboratory. Patients or Other Participants: A total of 468 competitive collegiate club sport athletes at a large US university who engaged in 1 of 46 sports with various levels of concussion risk. Intervention(s): Participants were randomly assigned by team to 1 of 3 conditions. The treatment condition was a socialmarketing program focused on the possible consequences of the reporting decision. The control condition was traditional concussion-symptom education based on the National Collegiate Athletic Association's publication, "Concussion: A Fact Sheet for Student-Athletes." An additional condition mirrored the traditional symptom education but included a less clinical delivery. Main Outcome Measure(s): Positive and negative beliefs regarding concussion reporting were assessed. We applied expectancy value theory, which posits that changing beliefs in the short term will produce greater reporting intentions in the long term. Results: Club sport athletes exposed to consequencebased social marketing showed higher levels of positive reporting beliefs and lower levels of negative reporting beliefs than athletes exposed to traditional or revised symptom education. We observed no differences between the traditional and revised symptom-education programs. Exposure to consequence- based marketing decreased negative beliefs about reporting (B =-0.165, P = .01) and increased positive beliefs about reporting (B = 0.165, P=.01). Conclusions: Social marketing offers athletic trainers another strategic tool for motivating athletes to report concussion symptoms by translating scientific findings into marketable statements and then communicating the benefits of reporting or the negative consequences of concealing concussion symptoms. [ABSTRACT FROM AUTHOR]

Background: For 15 years, the US Centers for Disease Control and Prevention's (CDC) HEADS UP education campaign has focused on increasing awareness of concussion among children to reduce adverse outcomes from this injury. Objective: To keep pace with the rapid expansion in media coverage, research, state laws and education efforts on concussion, the CDC embarked on a comprehensive evaluation effort to assess the campaign's brand. Method: The CDC conducted a multi-step process to evaluate HEADS UP. This included surveying partner organisations and focus groups targeting key audiences. Results: The analysis demonstrated that most (70%) partner organisations have used the materials for 4 years or longer, and more than half (51%) found the materials very useful or extremely useful. Focus groups with the campaign's target audiences yielded insights and opportunities to refresh the CDC HEADS UP brand. The need for more compelling images, prevention facts and use of eye-catching colours was signalled by all the campaign's target audiences. Updates focused on the use of data visualisation, more emotionally compelling images and more engaging colours. The CDC also created a new tagline to focus on concussion prevention that encourages children and young people to think about protecting their brains from concussion so that they can have a safer future. Conclusion: This paper describes the process used to update the branding of an educational health promotion campaign in order to meet the needs of key audiences. Findings can help others working to keep their educational campaigns relevant and aligned with expanding and changing public health problems. [ABSTRACT FROM AUTHOR]

Social network analysis (SNA) is a uniquely situated methodology to examine the social connections between players on a team, and how team structure may be related to self-reported team cohesion and perceived support for reporting concussion symptoms. Team belonging was positively associated with number of friend.ship ties (degree, r = .23, p < .05), intermediate ties between teammates (betweenness; r = .21, p < .05), and support from both teammates (r =.21, p < .05) and important others (r = .21, p < .05) for reporting concussion symptoms. Additionally, an SNA-derived measure of social influence, eigenvector centrality, was associated with football identity (r = .34, p <.01), and less support from important others (r = -.24, p < .05) regarding symptom reporting. Discussion focuses on why consideration of social influence dynamics may help improve concussion-related education efforts. [ABSTRACT FROM AUTHOR]

Sport-related concussion (SRC) is a growing health concern, particularly in younger, at-risk athletic populations. These injuries commonly present with a wide range of clinical signs (i.e., poor coordination, behavioral, mood changes) and symptoms (i.e., headache, dizziness, difficulty concentrating), along with neurocognitive and vestibular/ocular impairments. This review of SRCs in youth athletes focuses on individuals 5-18 years of age and includes an overview of concussion (i.e., definition, signs/symptoms, epidemiology), as well as concussion education and awareness. This is followed by a review of SRC assessment and management strategies, along with common recovery, return-to-play, and treatment approaches. Finally, suggestions are made for future research and recommendations pertaining to SRC in youth athletes. [ABSTRACT FROM AUTHOR]

Objective: The ability of athletes in underserved communities to recognise sport-related concussion (SRC) may be complicated by the lack of a qualified professional, such as an athletic trainer, present. An active learning educational activity (Concussion Bingo) was developed to assist in SRC identification. This study examined learning outcomes following the use of this activity by athletes in two US Title I (low socioeconomic status) high schools. Design: Cross-sectional study. Setting: High school sports. Methods: Participants (n = 102 athletes) completed 10-minute SRC knowledge of concussion surveys before and after participating in a Concussion Bingo activity. The 45-question survey assessed SRC knowledge through questions about SRC signs/symptoms, general injury information relating to loss of consciousness, the injured anatomical structure, complications of multiple SRCs and premature return to play. Participants had to mark key SRC terms on a Bingo card as they appeared throughout an SRC presentation including content from published consensus/position statements. Descriptive and parametric statistics were used to analyse the data. Results: Analysis of covariance revealed significant differences between pre- and post-Concussion Bingo scores. Athletes had the greatest knowledge increase of fogginess (n = 30, 29.5%), mood changes (n = 29, 28.5%), nausea (n = 27; 26.5%) and sleep problems (n = 27, 29.5%). On questions pertaining to the injury itself, athletes had the greatest increase on 'you have to be hit in the head to get a concussion' (n = 51, 50%), 'what kind of an injury is a concussion' (n = 31, 40.2%) and a concussion only occurs if you 'black out' (n = 24, 23.4%). Conclusion: Concussion Bingo increased Title I high school athletes' knowledge of SRCs, suggesting that it may be an effective active learning tool for increasing SRC knowledge. [ABSTRACT FROM AUTHOR]

Context: Currently, significant attention is focused on improving care for patients with concussions through legislative mandates that include educational interventions. Few researchers have examined young athletes' concussion knowledge and the factors that may influence their knowledge. Objective: To use the socioecological model to examine demographic, parental, and personal factors associated with youth athletes' knowledge of concussion. Our ultimate goal is to inform the planning and implementation of youth sport concussion-related interventions. Design: Cross-sectional survey. Setting: Gymnasium and classroom. Patients or Other Participants: North Carolina and Arizona youth athletes (n = 225; age = 8 to 15 years) active in football, boys' or girls' soccer, boys' or girls' ice hockey, or boys' or girls' lacrosse in 2012-2013. Main Outcome Measure(s): Participants completed a validated, self-administered survey. The intention and belief measures were guided by the theory of planned behavior. Perceptions of concussion and intention to seek care were examined using descriptive statistics. Athletes' concussion knowledge was modeled using linear regressions and generalized estimating equations, with child demographic and personal factors and parental knowledge and attitudes about concussion as predictors. Results: Geography, sport, parental attitudes toward concussion, and athlete age were associated with athlete knowledge in the univariable analyses (P < .10). In the multivariable model, geographic location (North Carolina versus Arizona, mean difference [MD] = 2.2, 95% confidence interval [CI] = 1.1, 3.2), sport (girls' soccer versus girls' lacrosse, MD = 2.2, 95% CI = 0.7, 3.6), more favorable parental attitudes toward concussion (MD = 1.2 for a 2-standard deviation shift; 95% CI = 0.3, 2.1), and older age (>12 years, MD = 1.6; 95% CI = 0.5, 2.6) were associated with better knowledge about concussion. Conclusions: Geographic location, sport, parental attitudes about concussion, and athlete's age influenced athletes' concussion-related perceptions, indicating the need to address multiple levels of the socioecological model when targeting youth sport interventions. Parental interventions that translate to an improved culture of youth sport by improving youth athletes' perceptions and experiences are key areas for future work. [ABSTRACT FROM AUTHOR]

Context: Concussions remain misunderstood, underreported, and undiagnosed. Although most concussion symptoms resolve within 2 weeks, some patients experience persistent symptoms that adversely affect physical, emotional, social, or cognitive functioning or a combination of these. Minimal evidence delineating the effect of concussions on recently retired collegiate athletes currently exists. Objective: To examine the lived experiences of retired collegiate athletes with a history of 1 or more concussions to discern individual concussion histories, knowledge and perceptions of concussions, and postconcussion quality of life. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Former National Collegiate Athletic Association Division I athletes (n=14) with a history of 1 or more concussions and retired from 1 to 5 years. Data Collection and Analysis: Fourteen semistructured telephone interviews (8 men and 6 women) were audiotaped. Interviews were transcribed and inductively analyzed by 3 athletic trainers with 34 combined years of professional experience. Themes were negotiated through consensual review. Participant checks were completed to ensure trustworthiness of the findings. Results: Participants sustained their first concussion during adolescence and often experienced difficulties transitioning back into the postconcussion academic environment. Judgments of injury severity were clearly evident in participants' knowledge and perceptions of concussions. Participants experienced an array of emotional, physical, cognitive, and social challenges during the immediate postconcussion period but did not feel their concussion history decreased their current quality of life. Conclusions: Adolescent exposure to concussions is of concern due to the risk imposed on the developing brain and the potential for adverse outcomes later in life. Although a graduated return to play is heavily emphasized in concussion management, researchers need to investigate barriers inhibiting the implementation of return-to-learn protocols. Concussion education should aim to modify indifferent attitudes toward concussive injuries. Additionally, investigators should continue to assess how a history of concussion affects quality of life in recently retired collegiate athletes. [ABSTRACT FROM AUTHOR]

Context: Previous research suggests that health care providers, in general, are not adequately trained in sport-related concussion (SRC) recognition and management. However, it is unclear if athletic training educators are instructing athletic training students on evidence-based SRC assessment and management protocols. Objective: To examine and identify which SRC resources and management tools are being used to teach and prepare athletic training students to clinically evaluate and manage SRCs. Design: Cross-sectional study. Setting: Single Web-based survey. Patients or Other Participants: One hundred two athletic training educators. Main Outcome Measure(s): Survey questions collected education level, years of experience as an athletic trainer, sex, role within the athletic training program, and the type of athletic training program at their institution. Participants were asked which position statement or consensus statement was used to teach SRC and, finally, which SRC management tools were taught to students in regard to SRC evaluation, management, and return to play. Results: Respondents have been certified athletic trainers for an average of 17.9 ± 6.5 years and accumulated a mean of 9.9 ± 6.8 years of clinical experience before transitioning into educational roles. Among the respondents to the survey, 99% of educators are using the National Athletic Trainers' Association position statement to teach SRC. The clinical examination (100%) was the most widely taught evaluation tool among respondents. Out of all the respondents, over 80% of educators are teaching clinical use and application of the Sport Concussion Assessment Tool 3, Balance Error Scoring System, and computerized neurocognitive testing; however, only 71% are teaching the stepwise progression, and less than 30% are teaching newer tools documented in SRC literature. Conclusions: Educators are following recommended practices of teaching a multifaceted approach to SRC evaluation and management. However, instruction is lacking on the use of a stepwise return-to-play progression and newer SRC management tools that assess vestibular and ocular-motor impairment. [ABSTRACT FROM AUTHOR]

Available financial and personnel resources often dictate the specifics of concussion policies and procedures in the secondary school setting. The purpose of this qualitative study was to explore athletic trainers' perceived challenges toward comprehensive concussion management in the secondary school setting. The findings indicate several challenges exist toward concussion management in the secondary school, including facility, personnel, and community resources, education levels of various stakeholders, and general perceptions of concussion and athletic trainers. It is important to identify challenges athletic trainers may face in order to develop strategies to align current concussion management procedures with current best practices. [ABSTRACT FROM AUTHOR]

Although experts have noted that adolescent athletes should be educated about concussions to improve their safety, there is no agreement on the most effective strategy to disseminate concussion education. The purpose of this study was to develop, implement and assess a concussion education programme. More precisely, four interactive oral presentations were delivered to high school student-athletes (N = 35,Mage = 15.94,SD = 0.34) in a large urban centre. Participants completed a questionnaire at three time-points during the season to measure changes in their knowledge (CK) and attitudes (CA) of concussions, and focus group interviews were conducted following the concussion education programme. Questionnaire data revealed participants’ post-intervention CK scores were higher than their pre-intervention scores. During the focus groups, the student-athletes said they acquired CK about the role of protective equipment and symptom variability, and in terms of CA, they intended to avoid dangerous in-game collisions in the future. Our study was the first to create and deliver a concussion education intervention across multiple time-points, and to use mixed-methods in its assessment. These findings may be of interest to researchers, practitioners and stakeholders in sport who are invested in making the sport environment safer through concussion education and awareness. [ABSTRACT FROM AUTHOR]

Research has shown that exposure to a concussion definition (CD) increases self-reported concussion history (SRCH) immediately, however, no research has been performed that examines the effects of exposure to a CD on SRCH over time. Collegiate recreational student-athletes (RSAs) have limited access to monitoring and supervision by medical staff. As such, recognition of concussion symptoms and need for medical management oftentimes falls upon the RSA. The purpose of this study was to assess the effect of a novel questionnaire on the SRCH of RSAs. A two-part questionnaire was sent to RSAs participating is sports with a greater than average risk of concussion at a university in Arizona. Data from 171 RSAs were analyzed to assess the change in RSAs' suspected concussion estimates pre- and post-exposure to a CD and concussion symptom worksheet, as well as over the short-term (2.5 months). Approximately one-third of RSAs reported an increase in suspected concussion estimates immediately following exposure to the questionnaire, but the change was not maintained over the short-term. The results suggest that a single exposure to a CD is ineffective at increasing short-term SRCH estimates. [ABSTRACT FROM AUTHOR]