School districts need to increase compliance with concussion legislation to ensure the adequate implementation necessary for the law to impact health and educational outcomes. The results provide important information to individuals charged with the responsibility of implementation and ultimately reducing the negative outcomes associated with brain injuries in schools.
Objective(s): To examine the extent to which the concussion management policies of 42 New York State (NYS) school districts are in compliance with the State's Concussion Awareness and Management Act (the Act). To identify critical gaps in the school districts' implementation of the Act and evaluate their management of concussions within the school setting. Design: All forty-seven school districts in Westchester County, NY were asked to provide their written concussion policies for compliance with the Act under the Freedom of Information Act. Policy documents were analysed qualitatively for compliance with mandates of the Act. Setting: Policy documents were collected from suburban school districts in NYS. Data was analysed at an urban medical research center. Participants: Forty-two school districts in Westchester County, NY who supplied their concussion policies. Main Outcome Measure: A coding scheme was developed to analyse compliance of the school districts' policies with the Act. Three independent raters utilized this coding scheme during preliminary analyses, yielding high rates of inter-rater reliability (>90%). Further analysis was then completed, with raters independently determining whether school district policies met specific criteria outlined in three sections of the Act: a) Formal Education and Instruction, b) Development and Dissemination of Pamphlet, and c) the Concussion Team. Interventions: Not applicable. Results: Findings suggest varying levels of compliance among school districts, with many school districts failing to implement crucial aspects of the Act. Analysis of compliance levels across districts with varying characteristics (e.g., financial resources) also provides important information regarding potential facilitators and barriers to implementation of concussion policies by NYS school districts. Conclusions: Laws have recently been enacted to guide effective management of concussions within the school setting, compelling schools to create policies in accordance with the laws. The results of the current study help shed light on the quality of concussion management policies of school districts and help identify potential barriers and facilitating factors affecting implementation of the Act.
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