Developing and Piloting a School‐Based Online Adolescent Student‐Athlete Concussion Surveillance System

Abstract

BACKGROUND: Despite increased awareness of concussions, epidemiologic surveillance efforts have been scarce, especially among adolescents. This project, which was developed with school stakeholders (certified athletic trainers [ATCs], nurses, athletic directors), piloted a public secondary school-based online surveillance tool for interscholastic and intramural sports and physical education-related concussions in New Jersey during 2014-2017 school years (SY). METHODS:Participating public high schools (5 within 4 districts) and career-technical-vocational education districts (2 with 5 campuses) completed forms anonymously online via PsychData within 5 days. RESULTS:There were 208 concussions reported, 115 in 2015-2016 SY and 93 in 2016-2017 SY. In fall 2015, 86 concussions were reported, including 16 from summer preseason. In fall 2016, 56 concussions were reported; 3 occurred during preseason. There were 7 concussions reported in winter 2016 and 16 in winter 2017. Twenty-two concussions were reported in spring of both 2016 and 2017. Most online forms were completed in <10 minutes, usually using either desktop computers or tablets/iPads. School nurses followed by ATCs were primary sources of data entered online, usually by ATCs. CONCLUSIONS:Cooperation of nurses and ATCs at participating schools suggested online surveillance was valued and viable. Data inform future concussion prevention education and ongoing injury surveillance.Citation: Shendell DG, Gonzalez L, Listwan TA, Pancella J, Blackborow M, Boyd J. Developing and piloting a school-based online adolescent student-athlete concussion surveillance system.

Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities

“…Most prior descriptive epidemiological surveillance of sports‐ and recreation‐related concussions in youth has been conducted among public school students, but this study demonstrated private high school student athletes are also at risk of experiencing concussions. A 2018 study of high school students reported that about 1 in 5 who played on at least 1 sports team had sustained a concussion in the past 12 months .…”

“…A large study of public and private high schools found that 35% of schools have full‐time athletic training services and an additional 30% have part‐time services . Studies have further suggested the presence of athletic trainers at a school can influence – specifically increase – concussion reporting among students . Studies have suggested that athletic trainers may be better at identifying potential symptoms of a concussion after an injury has occurred than coaches .…”

Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review

“…Given the current national spotlight on student health during the coronavirus pandemic, educators have an opportunity to push forward an agenda focused on improving SRC protocols. Therefore, the following specific recommendations are offered for student health educators based on the findings of this systematic review: Use established, current, research‐based concussion education guidelines, such as the CDC's Heads Up 13 ; Investigate alternative delivery methods, such as electronic or app‐based media, to entice adolescents to actively participate in concussion education; Develop educational interventions designed specifically for at‐risk populations, including girls, programs without athletic trainers, and athletes whose primary language is not English 50 ; Incorporate concussion prevention into health education class curricula as a method of reaching all students 54 ; Actively involve parents in concussion education through school functions, community programs, and social media; Ensure all schools (public and private) develop concussion surveillance protocols to track incidents and help prevent secondary concussions in athletes that are still recovering 55 ; Utilize school nurses as a resource in managing the treatment course and advocating for the appropriate restrictions required for recovery; Individualize RTP and/or return‐to‐learn (RTL) plans based on an athlete's injury and recovery progression, in collaboration with medical systems 56,57 ; Advocate for state Departments of Education to endorse appropriate and researched RTL and RTP protocols with demonstrated successful outcomes 58 …”