Dataset Information

Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial.

ABSTRACT:

Objectives

Determine whether Pre-Game Safety Huddles, a novel and low-resource approach to concussion education, increase the expected likelihood of concussion reporting for youth athletes.

Methods

A cluster-randomised trial compared Safety Huddles to usual care. Safety Huddles bring together athletes and coaches from both teams before the start of each game for coaches to briefly affirm the importance of speaking up if a concussion is suspected. Participants were athletes from 22 competitive community-based American football and girls and boys soccer teams (ages 9-14), and randomisation into intervention or control occurred at the level of the bracket (group of teams that compete against each other during the regular season). The primary outcome was expected likelihood of reporting concussion symptoms to the coach, measured via validated athlete survey at the beginning and end of the season.

Results

Of 343 eligible participants, 339 (99%) completed baseline surveys and 303 (88%) completed surveys at season end. The mean (SD) age was 11.4 (1.1) years, 26% were female soccer athletes, 27% were male soccer athletes and 47% were football athletes. In adjusted analyses accounting for baseline values and clustering by sport and team via random effects, expected likelihood of concussion reporting at the end of the season was significantly higher in the intervention group compared to controls (mean difference=0.49, 95% CI 0.11 to 0.88; Cohen's d=0.35).

Conclusions and relevance

Pre-Game Safety Huddles increased the expected likelihood of athletes reporting concussion symptoms. While further study is warranted, sport organisations should consider this approach a promising low-resource option for improving concussion safety in their setting.

Trial registration number

NCT04099329.

SUBMITTER: Kroshus E

PROVIDER: S-EPMC9877103 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial.

Kroshus Emily E Chrisman Sara P D SPD Glang Ann A Hunt Tamerah T Hays Rachel R Lowry Sarah S Peterson Alexis A Garrett Kimberly K Ramshaw Dane D Hafferty Kiana K Kinney Erin E Manzueta Maria M Steiner Mary Kathleen MK Bollinger Beth J BJ Chiampas George G Rivara Frederick P FP

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention 20220916 1

<h4>Objectives</h4>Determine whether Pre-Game Safety Huddles, a novel and low-resource approach to concussion education, increase the expected likelihood of concussion reporting for youth athletes.<h4>Methods</h4>A cluster-randomised trial compared Safety Huddles to usual care. Safety Huddles bring together athletes and coaches from both teams before the start of each game for coaches to briefly affirm the importance of speaking up if a concussion is suspected. Participants were athletes from 22 ...[more]

PMID: 36113984

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Project description:ContextAlthough it has been suggested that developmental and sociological factors play a role in concussion reporting, the empirical evidence related to this is limited.ObjectiveTo examine the influences of sex, school level, school location, concussion-reporting history, and socioeconomic status on concussion-related knowledge, attitudes, and reporting intentions among middle school and high school athletes.DesignCross-sectional study.SettingMaster students and High School athletes attending pre-participation examinations (PPEs) were asked to complete paper-based surveys.Patients or other participantsOverall, 541 athletes representing 18 sports returned fully completed surveys.Main outcome measure(s)Outcomes were concussion-related knowledge, perceived seriousness, positive feelings about reporting, and self-reporting intentions. We examined group differences in these outcomes across levels of the explanatory variables of sex, school level (middle school versus high school), school location (urban versus rural), concussion self-reporting history (yes or no), and socioeconomic status (free or reduced-price lunch versus no free or reduced-price lunch) using Wilcoxon rank sum tests. Then we used multivariable ordinal logistic regression models to identify predictors of higher score levels for each outcome. Odds ratio (OR) estimates with 95% confidence intervals (CIs) excluding 1.00 were deemed significant.ResultsOdds of higher levels of knowledge were higher in urban versus rural school student-athletes (ORAdjusted = 1.81; 95% CI = 1.03, 3.17), and lower in student-athletes on free or reduced-price lunch versus those not on free or reduced-price lunch (ORAdjusted = 0.52; 95% CI = 0.36, 0.77). Similarly, odds of higher levels of seriousness were lower in male versus female student-athletes (ORAdjusted = 0.48; 95% CI = 0.32, 0.72). Further, odds of higher levels of self-reporting intentions were lower among male versus female student-athletes (ORAdjusted = 0.53; 95% CI = 0.37, 0.75).ConclusionsDevelopmental and sociological factors were differentially associated with concussion-related knowledge, attitudes, and self-reporting intentions. These results can inform medical providers, parents, and coaches with regard to context-specific clinical assessments of concussion symptoms.

Project description:ObjectivesExplore the acceptability and feasibility of a randomised controlled trial (RCT) to assess game jams-participatory events to cocreate digital or board games in a time-constrained environment-in cultural safety training of medical students. The pilot tests methods and procedures and explores the validity and reliability of our research instrument.DesignTwo-arm parallel-group pilot RCT with a 1:1 allocation ratio.SettingFaculty of Medicine in Chia, Colombia.Participants79 final-year medical students completed the baseline questionnaire. 64 completed the assessment immediately after the intervention: 31 in the intervention group (20 female) and 33 in the control group (18 female). 35 completed the final assessment (18 control and 17 intervention) 4 months after the intervention.InterventionsThe intervention group joined a 5-hour game jam composed of a 1-hour lecture and a 4-hour session to create and to play educational games about cultural safety. The control group had a 1-hour conventional lesson, followed by a 4-hour study session of selected readings on cultural safety.Primary and secondary outcome measuresThe instrument, an online self-administered Likert-type questionnaire, assessed a self-reported cultural safety results chain based on a planned behaviour theory. Student recruitment, retention and perception of the activity determined acceptability. The methodological and logistical factors for a full-scale study determined feasibility.ResultsAfter the intervention, students randomised to that arm reported a slightly higher cultural safety score (26.9) than those in the control group (25.9) (difference -1, 95% CI -3.0 to 1.0). Students described game jam learning in favourable terms and considered cultural safety training relevant. The university authorised the conduct of the full-scale trial.ConclusionGame jam learning is feasible and acceptable for cultural safety training of Colombian medical students. Researchers and educators may find our results informative in the design of RCTs assessing educational interventions.Trial registration numberISRCTN14261595 (stage: pilot study results).

Project description:BackgroundCultural safety, whereby health professionals respect and promote the cultural identity of patients, could reduce intercultural tensions that hinder patient access to effective health services in Colombia. Game jams are participatory events to create educational games, a potentially engaging learning environment for Millennial medical students. We set out to determine whether medical student participation in a game jam on cultural safety is more effective than more conventional education in changing self-reported intended patient-oriented behavior and confidence in transcultural skills.MethodsWe conducted a parallel-group, two-arm randomized controlled trial with 1:1 allocation. Colombian medical students and medical interns at University of La Sabana participated in the trial. The intervention was a game jam to create an educational game on cultural safety, and the reference was a standard lesson plus an interactive workshop on cultural safety. Both sessions lasted eight hours. Stratified randomization allocated the participants to the intervention and control groups, with masked allocation until commencement.Results531 students completed the baseline survey, 347 completed the survey immediately after the intervention, and 336 completed the survey after 6 months. After the intervention, game jam participants did not have better intentions of culturally safe behaviour than did participants in the reference group (difference in means: 0.08 95% CI - 0.05 to 0.23); both groups had an improvement in this outcome. Multivariate analysis adjusted by clusters confirmed that game jam learning was associated with higher transcultural self-efficacy immediately after the intervention (wt OR 2.03 cl adj 95% CI 1.25-3.30).ConclusionsGame jam learning improved cultural safety intentions of Colombian medical students to a similar degree as did a carefully designed lecture and interactive workshop. The game jam was also associated with positive change in participant transcultural self-efficacy. We encourage further research to explore the impact of cultural safety training on patient-related outcomes. Our experience could inform initiatives to introduce cultural safety training in other multicultural settings.Trial registrationRegistered on ISRCTN registry on July 18th 2019. Registration number: ISRCTN14261595 .

Project description:Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To date, return-to-activity decision-making has been anchored in the monitoring of self-reported concussion symptoms and neurocognitive testing. However, multi-modal assessments that corroborate objective physiological measures with traditional subjective symptom reporting are needed and can be valuable. Heart rate variability (HRV) is a non-invasive physiological indicator of the autonomic nervous system, capturing the reciprocal interplay between the sympathetic and parasympathetic nervous systems. There is a dearth of literature exploring the effect of concussion on HRV in youth athletes, and developmental differences preclude the application of adult findings to a pediatric population. Further, the current state of HRV methodology has primarily included short-term (5-15 min) recordings, by using resting state or short-term physical exertion testing to elucidate changes following concussion. The novelty in utilizing a 24 h recording methodology is that it has the potential to capture natural variation in autonomic function, directly related to the activities a youth athlete performs on a regular basis. Within a prospective, longitudinal research setting, this novel approach to quantifying autonomic function can provide important information regarding the recovery trajectory, alongside traditional self-report symptom measures. Our objectives regarding a 24 h recording methodology were to (1) evaluate the physiological effects of a concussion in youth athletes, and (2) describe the trajectory of physiological change, while considering the resolution of self-reported post-concussion symptoms. To achieve these objectives, non-invasive sensor technology was implemented. The raw beat-to-beat time intervals captured can be transformed to derive time domain and frequency domain measures, which reflect an individual's ability to adapt and be flexible to their ever-changing environment. By using non-invasive heart rate technology, autonomic function can be quantified outside of a traditional controlled research setting.

Project description:Aims: Recent research suggests that aerobic exercise can be performed safely within the first week following a concussion injury and that early initiation of exercise may speed recovery. To better understand the physiological changes during a concussion, we tested the hypothesis that mild-to-intense exercise testing can be performed within days immediately following injury, and can be used to discern differences between the concussed and normal healthy state. Thus, the purpose was to observe the cerebral hemodynamic responses to incremental exercise testing performed acutely post-concussion in high-performance athletes. Methods: This study was a within- and between-experimental design, with seven male university ice hockey teams participating. A subgroup of five players acted as control subjects (CON) and was tested at the same time as the 14 concussed (mTBI) players on Day 2, 4, and 7 post-concussion. A 5-min resting baseline and 5-min exercise bouts of mild (EX1), moderate (EX2), and high (EX3) intensity exercise were performed on a cycle ergometer. Near-infrared spectroscopy was used to monitor pre-frontal cortex oxy-haemoglobin (HbO2), deoxy-haemoglobin (HHb), and total blood volume (tHb) changes. Results: ANOVA compared differences between testing days and groups, and although large percentage changes in HbO2 (20-30%), HHb (30-40%), and tHb (30-40%) were recorded, no significant (p ? 0.05) differences in cerebral hemodynamics occurred between mTBI vs. CON during aerobic exercise testing on any day post-injury. Furthermore, there was a linear relationship between exercise intensity vs. cerebral hemodynamics during testing for each day (r 2 = 0.83-0.99). Conclusion: These results demonstrate two novel findings: (1) mild-to-intense aerobic exercise testing can be performed safely as early as Day 2 post-concussion injury in a controlled laboratory environment; and (2) evidence-based objective measures such as cerebral hemodynamics can easily be collected using near-infrared spectroscopy (NIRS) to monitor physiological changes during the first-week post-injury. This research has important implications for monitoring physiological recovery post-injury and establishing new rehabilitation guidelines.

Project description:ObjectivesTo examine the association between self-reported exposure to concussion education and knowledge, beliefs and self-reported behaviour among parents and coaches of youth ice hockey players.DesignCross-sectional.SettingCommunity ice hockey teams from Calgary and Edmonton, Alberta, Canada.ParticipantsParents and coaches of ice hockey players (ages 11-17, all divisions of play).Primary and secondary outcome measuresParticipants completed a questionnaire developed and validated to measure concussion knowledge, beliefs and concussion management behaviour (ie, coaches removing athletes from play; parents taking children with suspected concussions to physicians) consistent with the Health Action Process Approach (HAPA). The questionnaire examined specific HAPA constructs (ie, risk perception, outcome expectancies, action self-efficacy, intention, action planning, maintenance self-efficacy, recovery self-efficacy) relevant to concussion management behaviour.ResultsParticipants included 786 parents (31.8% with coaching experience) and 10 non-parent coaches. Of the participants, 649 (82.6%) previously received concussion education. Based on a multivariable regression analysis adjusting for coaching experience, previous history of a child sustaining one or more concussions, first aid experience and cluster by team, exposure to concussion education was associated with a mean score difference of 1.36 (95% CI 0.68 to 2.03), p<0.0001, in the knowledge score. Exposure to concussion education was not significantly associated with any of the HAPA constructs based on Wilcoxon rank-sum tests.ConclusionExposure to concussion education may be associated with small overall differences in concussion knowledge but may not be associated with significant differences in beliefs or intended behaviours related to concussion management among youth hockey parents and coaches.When providing education or recommendations for concussion education sources to coaches and parents, educational strategies grounded in behavioural change theory that specifically target the motivators of behavioural change should be considered.

Project description:BACKGROUND:The United Nation's Sustainable Development Goals encompass lifelong learning from birth to youth to adulthood (Goal 4) and economic opportunities for young people (Goal 8). The targets include improving access to quality early childhood care and education (ECCE) as well as learning and training opportunities for adolescents and youth. Cross-generational models for young children and youth may offer opportunities to address the interconnections between goals and targets for the next generation. We investigated whether an ECCE programme for young children (3.5-6.5 years) delivered by female youth (18-24 years) in rural Pakistan would be effective on children's school readiness. METHODS:In partnership with the National Commission for Human Development in Pakistan, we implemented the 'Youth Leaders for Early Childhood Assuring Children are Prepared for School' (LEAPS) programme to train female youth to deliver ECCE. The effectiveness of the LEAPS programme on children's school readiness was evaluated in a cluster-randomised controlled trial. We randomly allocated five clusters (villages) to receive the intervention (n = 170 children) and five clusters to control (n = 170 children). Children's school readiness was assessed after nine months of intervention exposure using the International Development and Early Learning Assessment tool. Analyses was by intention-to-treat. The trial is registered with ClinicalTrials.gov, number NCT02645162. FINDINGS:At endline, the intervention group had significantly higher school readiness scores (n = 166, mean percentage score 59.4, 95% CI 52.7 to 66.2) compared with the control group (n = 168, mean percentage score 45.5, 95% CI 38.8 to 52.3). The effect size (Cohen's d) was 0.3. CONCLUSION:Trained female youth delivered an ECCE programme that was effective in benefitting young children's school readiness. The cross-generational model is a promising approach to support early child development; however, further evaluation of the model is needed to assess the specific benefits to youth including their skills and economic development.

Dataset Information

Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial.

Objectives

Methods

Results

Conclusions and relevance

Trial registration number

Publications

Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial.

Similar Datasets

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