Original articleConsistency and Variation in School-Level Youth Sports Traumatic Brain Injury Policy Content
Section snippets
Study participants and data
Electronic copies of 71 concussion policies (one per high school) were collected from certified athletic trainers (ATs) or athletic directors from schools that participated in High School Reporting Information Online (RIO). High School RIO is a prospective, longitudinal Internet-based surveillance system established in 2005 that collects sports-related injury data, including TBI data, among a nationally representative sample of high schools [14]. An invitation was first sent via the listserv to
High school demographics
Seventy-one high schools from 26 states and the DC were included in the study sample (Table 2). Of these, nine states had one school, six states had two schools, and six states had three and 4+ schools, respectively. The earliest law effective date in this sample was 2009, while the latest was 2014. Of the 71 high schools, the majority (91.5%) were public schools. Over half (54.9%) of the schools had student enrollment greater than or equal to 1000. The majority of schools (88.8%) included more
Discussion
Existing research on youth sports TBI laws primarily focuses on analyzing law implementation at the state level [9], [10], [12] or among select sports [10], [19], or the impact of TBI laws on emergency department visits for concussed youth [20], [21], [22], [23]. This study is the first to analyze implementation of state TBI laws at the school level by examining the content specificity of high school TBI policies situated against the three tenets of state-level TBI laws [6], [7], [8].
Limitations
This study has several limitations. First, despite drawing from a national sample, our study sample only included high schools with ATs, and consisted of high schools from 26 states and the DC, with over half of states having only one to two participating schools. Therefore, our sample did not convey the full range of laws existing across states nor within each state. Our results could not be generalized to all high schools in the United States or high schools without ATs. Second, this study
Acknowledgments
The authors express their appreciation to High School RIO (Reporting Information Online) and to athletic directors and athletic trainers who participated in this project.
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Conflicts of Interest: The authors have no conflicts of interest to disclose.
Pursuant to the IRB and RIO agreements, schools were not named throughout this manuscript to provide anonymity to study participants.