Perceptions of implementation of Massachusetts sports concussion regulations: results of a survey of athletic directors

Abstract

Background: In 2011 the Massachusetts Department of Public Health issued regulations pursuant to 2010 Massachusetts youth sports concussion legislation that provided policies and procedures for persons engaged in the prevention, training, management, and return-to-activity for students who sustain head injury during interscholastic athletics, including Athletic Directors (ADs).

Concussion Public Policy in Elementary and High Schools in Ontario, Canada: A Cross‐Sectional Survey to Examine Implementation Compliance, Barriers, and Facilitators

“…33 Athletic Directors in the same state were reported to rate the state law a 9.2 on a 10-point scale in terms of how important the law was for student safety. 28 Compliance with policy requirements such as return-to-play and return-tolearn protocols was high in our study in Ontario, and similar results were found in Sullivan et al's 2020 assessment of high schools' compliance to RTP protocols in over half of American states. 16 Thompson et al noted that only 8 state laws require return-to-learn protocols, whereas all publicly-funded elementary and high schools in Ontario are required to implement both RTPPs and RTLPs.…”

“…Despite these challenges, a majority of respondents indicated that they believed that concussion policy benefits student health, a sentiment that Howland et al also found in their examination of the Massachusetts concussion policy, where school nurses and athletic trainers felt that the policy empowered them to manage student concussions 33 . Athletic Directors in the same state were reported to rate the state law a 9.2 on a 10‐point scale in terms of how important the law was for student safety 28 . Compliance with policy requirements such as return‐to‐play and return‐to‐learn protocols was high in our study in Ontario, and similar results were found in Sullivan et al's 2020 assessment of high schools' compliance to RTP protocols in over half of American states 16 .…”

“…Understanding implementation compliance, barriers, and facilitators is important to inform and improve policy implementation, and researchers have identified the need for such research in the context of concussion policy 18 . There has been little research on concussion public policy implementation in the Canadian context, where the inclusion of a RTLP component is a major policy difference compared to many American policies 22,28,29 . The purpose of the present study was to assess the compliance of Ontario school board concussion policies in terms of CE, RTPP, and RTLP protocols, and to identify barriers to and facilitators of PPM158 implementation.…”

Implementation of Return to Learn Protocols for Student Athletes with Sport and Recreation Related Concussion: An Integrative Review of Perceptions, Challenges and Successes

“…Massachusetts has set an example by providing legislation regarding the management of RTL following SRRC. In the study conducted by Howland et al (2020), the institution of guiding laws pushed schools to develop regulations for returning to learn following SRRC. 87% of the athletic directors surveyed were in support of concussion management teams and had favorable outcomes following the formation of the teams (Howland et al, 2020).…”

“…In the study conducted by Howland et al (2020), the institution of guiding laws pushed schools to develop regulations for returning to learn following SRRC. 87% of the athletic directors surveyed were in support of concussion management teams and had favorable outcomes following the formation of the teams (Howland et al, 2020). There does continue to be a lack of definitive guideline for the creation of a concussion management team and RTL programs, but the regulation of these supports increases the likelihood for favorable outcomes in RTL.…”