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Sports-related concussion education

Evidence Rating
Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Disparity Rating
No impact on disparities likely
Community Conditions
Safety and social support
Authors
Lead: Bomi Kim Hirsch
Contributor(s): Alison Bergum, Lael Grigg
Acknowledgements: Kate Austin Stanford, Jessica Rubenstein, Jennifer Russ
Date Last Updated
April 8, 2019

Education regarding sports-related concussion informs youth and college athletes, coaches, and parents of the severity of concussions in sports, as well as proper prevention, detection, reporting, and treatment. Concussion education can be delivered through a combination of in-person lessons, videos, mobile applications, fact sheets, or quizzes. Concussion is a type of mild traumatic brain injury (TBI) that can occur through a fall or collision, or a blow to the head which causes the brain to move rapidly back and forth (CDC-Concussion, Harmon 2013).

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced sports-related concussion

What does the research say about effectiveness? -+

There is insufficient evidence to determine whether educating coaches, athletes, and parents about sports-related concussions reduces concussion among athletes, prevents athletes from playing with concussion symptoms, or increases reporting of concussions (Enniss 2018, Sarmiento 2017b, Caron 2015, Kerr 2015b). Available evidence suggests that educating middle school and high school football coaches may reduce youth athletes’ likelihood of concussion during practice but not during games (Kerr 2015a, Kerr 2015b). A Canada-based study suggests that concussion education for youth ice hockey players may reduce high-risk contacts such as cross-checking or checking from behind (Cook 2003). Concussion education for coaches may also be associated with better identification and response to concussion (Enniss 2018, Sarmiento 2017b, Kroshus 2016). In some cases, concussion education may increase knowledge about concussion and improve attitudes about concussion reporting among high school and college athletes (Enniss 2018, Caron 2015, Kurowski 2015, Kroshus 2015, Kroshus 2014) and increase knowledge of concussion recognition among coaches (Sarmiento 2017b). However, additional evidence is needed to confirm effects.

Implementation Examples -+

The Center for Disease Control and Prevention’s Heads Up provides an online concussion training course and educational materials tailored to parents of youth athletes, coaches, school officials, and health care providers (CDC-Concussion). The National Federation of State High School Associations provides free online concussion courses for youth athletes and their parents and coaches (NFHS-Concussion). Brain 101: The Concussion Playbook is another example of a web-based concussion education program (Brain 101).

As of June 2017, all states have enacted a youth sports traumatic brain injury (TBI) law; 34 states require TBI-specific trainings for coaches and 41 states require youth athletic organizations to distribute a TBI information sheet to parents of student athletes and collect the signed sheet for students to participate in athletic activities (LawAtlas-TBI). Most laws include education for coaches, parents, and athletes, and require that an athlete who is suspected of having a concussion be removed from play (CDC-Concussion).

Implementation Resources -+

CDC-Heads Up training - Centers for Disease Control and Prevention (CDC). HEADS UP online training courses.

NCAA-Concussion - National Collegiate Athletic Association (NCAA). Concussion educational resources.

NFHS-Concussion - National Federation of State High School Associations (NFHS). Concussion courses.

NPHL-Concussion - The Network for Public Health Law (NPHL). Youth sports concussion laws.

Citations -+

* Journal subscription may be required for access.

Brain 101 - The Oregon Center for Applied Science (ORCAS). Brain 101: The Concussion Playbook.

Caron 2015* - Caron JG, Bloom GA, Falcão WR, Sweet SN. An examination of concussion education programmes: A scoping review methodology. Injury Prevention. 2015;21(5):301-308.

CDC-Concussion - Centers for Disease Control and Prevention (CDC). Heads Up: Minimize the risk of concussion or other serious brain injury in sports.

Cook 2003 - Cook D, Cusimano M, Tator C, Chipman M, Macarthur C. Evaluation of the ThinkFirst Canada, Smart Hockey, brain and spinal cord injury prevention video. Injury Prevention. 2003;9(4):361-366.

Enniss 2018 - Enniss TM, Basiouny K, Brewer B, et al. Primary prevention of contact sports-related concussions in amateur athletes: A systematic review from the Eastern Association for the Surgery of Trauma. Trauma Surgery & Acute Care Open. 2018;3(1):e000153.

Harmon 2013 - Harmon KG, Drezner JA, Gammons M, et al. American Medical Society for Sports Medicine position statement: Concussion in sport. British Journal of Sports Medicine. 2013;47(1):15-26.

Kerr 2015a - Kerr ZY, Yeargin S, Valovich McLeod TC, et al. Comprehensive coach education and practice contact restriction guidelines result in lower injury rates in youth American football. Orthopaedic Journal of Sports Medicine. 2015;3(7):2325967115594578.

Kerr 2015b - Kerr ZY, Yeargin SW, Valovich McLeod TC, et al. Comprehensive coach education reduces head impact exposure in American youth football. Orthopaedic Journal of Sports Medicine. 2015;3(10):2325967115610545.

Kroshus 2014* - Kroshus E, Daneshvar DH, Baugh CM, Nowinski CJ, Cantu RC. NCAA concussion education in ice hockey: An ineffective mandate. British Journal of Sports Medicine. 2014;48(2):135-140.

Kroshus 2015* - Kroshus E, Baugh CM, Hawrilenko M, Daneshvar DH. Pilot randomized evaluation of publically available concussion education materials: Evidence of a possible negative effect. Health Education & Behavior. 2015;42(2):153-162.

Kroshus 2016* - Kroshus E, Baugh CM, Daneshvar DH. Content, delivery, and effectiveness of concussion education for U.S. college coaches. Clinical Journal of Sport Medicine. 2016;26(5):391-397.

Kurowski 2015 - Kurowski BG, Pomerantz WJ, Schaiper C, Ho M, Gittelman MA. Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes. Journal of Trauma and Acute Care Surgery. 2015;79(3 Suppl 1):S21-S28.

LawAtlas-TBI - LawAtlas. Youth sports traumatic brain injury (TBI) laws map.

NFHS-Concussion - National Federation of State High School Associations (NFHS). Concussion courses.

Sarmiento 2017b - Sarmiento K, Donnell Z, Hoffman R. A scoping review to address the culture of concussion in youth and high school sports. Journal of School Health. 2017;87(10):790-804.

WI DPI-TBI - Wisconsin Department of Public Instruction (WI DPI). Traumatic brain injury (TBI).

WIAA-Concussions - Wisconsin Interscholastic Athletic Association (WIAA). Concussion information.