Integrating Athlete Perspectives and Head Kinematics in Youth American Football

The objectives of this study were to examine youth football athletes' individual head acceleration event (HAEs) exposure, explore athletes' perspectives and experiences playing youth football, and investigate relationships between their perspectives and HAE exposure. Thirteen middle-school-aged football athletes wore instrumented mouthpieces to measure HAEs for 1 season and participated in a one-on-one interview, discussing motivations, mental focus, safety, and perceptions of contact. Kinematic data were integrated with qualitative data using triangulation to examine relationships between athlete perspectives and HAEs. Two thousand six hundred seventy-one true-positive HAEs were collected and analyzed. Topics discussed in interviews included aspirations, mental focus, potential for injury, and perceptions of contact. Athletes with the greatest HAE frequency discussed wanting to advance to higher levels of football (eg, college). Several athletes expressed an affinity for contact, many of whom had more HAEs per session than other athletes; however, some athletes disliked the risk of injury in football. Athletes reported that hits to the head felt the hardest, consistent with greater magnitudes measured among head impacts compared with body impacts. Athletes' perceptions of collisions and safety topics may inform our understanding of factors that influence HAE exposure in football and help guide identification of individual-level targets to reduce exposure and concussion risk.