Injury Prevention, volume 29, issue 1, pages ip-2022-044665

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

Emily Kroshus 1, 2, 3, 4
Sara P. D. Chrisman 1, 2, 3, 4
Ann Glang 5, 6
Tamerah Hunt 7, 8
Rachel Hays 3, 4
Sarah Lowry 3, 4
Alexis B. Peterson 9, 10
Kimberly Garrett 3, 4
Dane Ramshaw 5, 6
Kiana Hafferty 3, 4
Erin Kinney 11
Maria Manzueta 3, 4
Mary Kathleen Steiner 3, 4
Beth J Bollinger 3, 4
George Chiampas 12
Frederick P. Rivara 1, 2, 3, 4
Show full list: 16 authors
1
 
Department of Pediatrics
3
 
Center for Child Health, Behavior and Development
5
 
Center of Brain Injury, Research and Training
6
 
University Of Oregon
7
 
Department of Health Sciences and Kinesiology
9
 
National Center for Injury Prevention and Control
12
 
United States Soccer Federation
Publication typeJournal Article
Publication date2022-09-16
BMJ
BMJ
scimago Q1
SJR0.898
CiteScore5.3
Impact factor2.5
ISSN13538047, 14755785
Public Health, Environmental and Occupational Health
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.

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