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Development of a concussion public policy on prevention, management and education for schools using expert consensus
  1. Swapna Mylabathula1,2,3,
  2. Colin Macarthur4,
  3. Astrid Guttmann5,6,7,
  4. Angela Colantonio6,8,
  5. Charles Tator1,2,3
  1. 1Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2Canadian Concussion Centre, Toronto Western Hospital, Toronto, Ontario, Canada
  3. 3Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
  4. 4The Hospital for Sick Children, The Hospital for Sick Children, Toronto, Ontario, Canada
  5. 5Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
  6. 6The Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
  7. 7Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
  8. 8Department of Occupational Sciences & Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Swapna Mylabathula, Institute of Medical Science, University of Toronto, Toronto, Canada; swapna.mylabathula{at}mail.utoronto.ca

Abstract

Objectives Concussions are a major public health concern, and, thus, specific policies have been developed for implementation targeting vulnerable populations such as school-aged children and youth in the school setting, in whom the majority of concussions are sports related. Currently, concussion policies exist in various jurisdictions, including Canada’s first concussion policy for schools, Ontario’s PPM158, initiated in 2014. However, these policies are often variable in terms of content and comprehensiveness. Our objective was to develop a consensus for the content of concussion policy for schools.

Methods Following a pilot study in one Ontario school board in 2015, which identified missing elements in existing concussion policy, we employed a modified Delphi method to develop consensus for the content of concussion public policy for schools. We used an integrated knowledge translation approach with participation from a multidisciplinary stakeholder group of 20 experts including principals, school board directors, physicians, policymakers, public health representatives and parents.

Results Based on the experts, we created a list of 30 policy recommendations for concussion policy in the school setting. This comprehensive list reflects the diverse perspectives of the experts and addresses the role of parents, teachers, coaches, school administrators, referees, trainers, physicians/nurse practitioners, public health and students.

Conclusions This is the first expert consensus for content of concussion public policy for schools and can be used for policy development or enhancement in schools in other jurisdictions. We provide a comprehensive list of 30 recommendations to guide best practices for policy development and implementation to enhance school-based concussion prevention and management.

  • Concussion
  • Education
  • Legislation
  • Policy
  • Public Health
  • Regulation

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study, other than the resulting recommendations that are shared in this manuscript.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study, other than the resulting recommendations that are shared in this manuscript.

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Footnotes

  • Contributors All authors have contributed to the process of study conception and interpretation of results. In particular, SM conceptualised the study design with guidance from CT and feedback from CM, AC and AG. SM conducted the study with CT. SM completed analysis and wrote the initial draft of the manuscript. CT, CM, AC and AG provided edits to the manuscript. SM and CT are the authors acting as guarantors.

  • Funding Funding was received through the Canadian Concussion Centre (University Health Network).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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