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Putting Policy Into Practice: School-Level Compliance With and Implementation of State Concussion Laws.

Lindsay Sullivan1, Hosea H Harvey, Gary A Smith

  • 1Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio (Drs Sullivan, Smith, and Yang); formerly Beasley School of Law, Temple University, Philadelphia, Pennsylvania (Dr Harvey); and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio (Drs Smith and Yang).

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Summary

Most high schools comply with state concussion laws, including removal from play and return-to-play protocols. However, policy compliance doesn't always correlate with effective implementation of these concussion safety measures.

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Area of Science:

  • Pediatric Traumatic Brain Injury
  • Sports Medicine
  • Public Health Policy

Background:

  • Millions of children in the US sustain concussions annually, a form of mild traumatic brain injury (TBI) with potential long-term health consequences.
  • State concussion laws, enacted to improve awareness and reduce injury, typically mandate removal from play, medical clearance for return-to-play (RTP), and education for athletes, parents, and coaches.

Purpose of the Study:

  • To evaluate high school concussion policy compliance with state laws.
  • To examine the relationship between policy compliance and the actual implementation of concussion laws at the school level.

Main Methods:

  • A study involving 71 school officials who provided written concussion policies and participated in semistructured telephone interviews.
  • Analysis of school concussion policies for compliance with state law tenets.
  • Assessment of school-reported implementation of concussion law requirements.

Main Results:

  • High compliance rates were observed for removal-from-play (90.1%), RTP (97.2%), and concussion education (76.1%) tenets in written policies.
  • Schools generally reported good to very good implementation of removal-from-play (91.5%), RTP (93.0%), and concussion education (80.6%).
  • No significant correlation was found between researcher-rated policy compliance and school-reported implementation.

Conclusions:

  • Most surveyed high schools demonstrate strong adherence to state concussion laws in their written policies and reported implementation.
  • Further research is needed to identify specific barriers and facilitators influencing the effective school-level implementation of concussion laws.