Background: There is an increasing concern over adolescent concussions in sports due to risks of long-term negative effects. This study analyzed data over three school years on reported concussion incidence rates by season, high school grade levels and gender, and reported symptoms by school nurses versus athletic trainers, from New Jersey student-athlete concussion data available from an online school-based surveillance system. Methods: School nurses and athletic trainers reported 300 concussions within five days from when each occurred over three school years, 2015-2018, in team sports and physical education in New Jersey high schools. Analysis was further conducted on symptoms and number of symptoms reported by school nurses versus school athletic trainers for each documented student-athlete concussion. Estimated concussion incidence rates were calculated using state agency verified school enrollment data. Findings: Concussions most commonly occurred during fall, followed by spring, then winter. Concussion incidence rates ranged from 6.3/1000 (4.99, 7.55) -9.1/1000 (7.27, 10.98) students over the three school years of the study. Athletic trainers completed 86% of the reports while nurses completed 11% (position or title of 3%, or n = 7, were not disclosed); the values were similar when considering only fall pre-season and regular season sports (88, 10, 2%, respectively). On average, across the three school years, athletic trainers reported about 3.5 symptoms per report while nurses reported 2.7 (values in fall seasons only were 3.7 and 3.1, respectively.) Conclusions: Certified athletic trainers, compared to school nurses, more often completed concussion report forms and reported more symptoms per injured student, perhaps due partly to closer contact and immediate care provided after injury. Additionally, this study had a higher concussion incidence rate during fall sports seasons compared to winter and spring. Future research can further improve our understanding of concussions among adolescent student-athletes to better inform concussion identification, management and recovery protocols.
Despite increased awareness of concussions among student-athletes, local epidemiologic surveillance efforts are limited, especially among adolescents. We analyzed data reported through a state public-school-based online surveillance tool during the fall (summer preseason and regular season), winter, and spring seasons of the 2015–2017 school years at seven participating public high schools across New Jersey. Concussions were sustained during interscholastic and intramural sports and in physical education classes. There were 208 concussions: 142 in fall (123 regular season), 22 in winter (21 regular season), and 44 in spring. Reports stated 75% were first concussions, but 17% were second and 2% were third concussions.
Secondary or high school (HS) educational professionals expressed concerns about dealing with environmental and occupational health and safety protocols due to COVID-19. Concerns related to fall 2020 school re-opening and getting back into in-person teaching—whether full-time, part-time or some other approved hybrid model—plus ongoing uncertainty with how the state and federal government will be handling matters about mandates for virtual learning, rapid testing, vaccine distribution, etc. These concerns were related to both their experience as educational professionals and genuine interest in personal and student well-being. This study was a cross-sectional online survey in early fall from mid-September–early October 2020. Of a possible maximum participation of 740 New Jersey (NJ) supervisory-level HS teachers and administrators (e.g., department chairs, district and school principals), 100 confirmed unique respondents (13.5%) consented and completed the survey. Of 100 experienced (mean 18 years teaching) participants, 70% responded to the gender identity question (overall, 61% female, 39% male; by NJ region, gender ratios were similar). There were statistically significant differences (using Fischer’s exact test) between NJ regions regarding provision of online counseling and support services for teachers (p < 0.001); for resources and equipment for teachers to mediate online learning (p = 0.02); for assistive video technology tools (p = 0.03) and accessibility to structured online learning and professional development (p = 0.002); concerning learning aids to engage students in online instruction, online counseling, and support services for students and their families (p = 0.006); appropriate protocol is clean and disinfect areas used by a person with COVID-19 (p = 0.002); and, immediately separate staff and students who screen positive for COVID-19 (p = 0.03). There were few statistical differences by gender. This study reported what participants wanted regarding the development of future policies then implemented as reopening practices. Data can inform recommendations in NJ and elsewhere at federal, state, and local levels. Data provide new insights and valuable information to inform the consideration of acceptability of various policy measures among HS education professionals.
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