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19 School level implementation of the concussion laws
  1. Jinhong Guo1,
  2. Emily Hahn1,2,
  3. Kathryn Coxe1,3,
  4. Jingzhen Yang1,4
  1. 1US Centre for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, OH
  2. 2College of Public Health, The Ohio State University, Columbus, OH
  3. 3Department of Quality, Planning, and Research, The Ohio Department of Mental Health and Addiction Services, Columbus, OH
  4. 4Department of Paediatrics, College of Medicine, The Ohio State University, Columbus, OH


Objectives While schools play a significant role in concussion prevention and management, few studies have examined school-level concussion law implementation. This study described the actions high schools have taken to implement youth concussion laws.

Methods Semi-structured, computer-assisted telephone interviews were conducted among athletic directors of 71 high schools from High School RIO. Participants were asked to rate how well they believed their school had implemented the state concussion laws from 1 (‘very poor’) to 5 (‘very well’), and how consistently the law was followed on a scale of 0%–100%.

Results All 71 schools implemented the three tenants of their state concussion laws. All schools required that athletes with a suspected concussion be removed from play; 65 schools (92%) implemented this tenant ‘well’ or ‘very well.’ All schools required at least a 24 hour waiting period before returning the athlete to play; 70 schools required clearance from a health professional, and 66 schools (93%) indicated implementing the tenant ‘well’ or ‘very well.’ Only 28 schools (39%) followed both removal from play and return to play tenants consistently. Mandatory concussion training for coaches was indicated in 67 schools (94%). Sixty-two schools (87%) distributed concussion information sheets annually to parents, and 58 schools (82%) to student athletes. Fifty-one schools (72%) indicated implementing all three requirements of the education tenant ‘well’ or ‘very well’, whereas only 28 schools (39%) consistently followed the tenant.

Conclusions Most schools implemented the three tenants of the law well, but were inconsistent in following the laws. Future research should assess how variations in law implementation affect concussion rates in school athletics.

Contribution to Injury Prevention This study provides insight into the translation of state-level concussion laws to the high school level. Successful and consistent implementation of concussion laws by schools is the first step to prevent and manage concussions.

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