|Keywords:||Health Sciences, Public Health; Health Sciences, Mental Health; Health Sciences, Recreation; Sports Concussions; Health Policy; Mixed Methods; Diffusion of Innovations; Youth Athletes; Implementation Science; Evidence Based Practices|
|Full text PDF:||http://pid.emory.edu/ark:/25593/q4g54|
Introduction: Over 3.8 million sports concussions occur every year in the United States. Youth athletes are particularly at risk because they participate in sports at a high rate. With over 40 million youth athletes and nearly 8 million high school athletes, as many as 400,000 athletes per year report experiencing a concussion. Concussions have immediate impacts on sports performance and health; however, most concerning are the long-term mental-behavioral health consequences of repeated concussions such as depression, dementia, and suicidality. Prior sports concussion research has lacked well-designed applications of multiple-level theory and mixed and qualitative methods to understanding concussion laws, guidelines, and policies for youth athletes. Objectives: To explore: 1) how decision-makers influence creating, adopting, and implementing sports concussion policies in Georgia high schools and youth sports; 2) how decision-makers perceive prominent sports concussion guidelines; 3) how decision-makers' perceptions of prominent sports concussion guidelines influences concussion policy adoption decisions. Methods: The investigator applied a mixed methods design of in-depth-interviews and quantitative surveys informed by Diffusion of Innovations theory and analyzed using a grounded theory approach. Telephone and e-mail recruitment yielded thirteen interviews and seven surveys. Primary analyses involved inductive, thematic analysis and concept mapping of interviews and descriptive statistics, frequency counts, and free lists of survey data. Results: Thirteen key themes and 58 sub-codes emerged from interviews, culminating in a concept map of 22 key themes and sub-codes. Variation in communication, resources, and knowledge regarding sports concussions was pervasive at the school and community levels, influencing sports concussion policy roles, creation, and implementation. Participants viewed prominent concussion guidelines favorably citing general use in providing concussion care but minimal influence on creating sports concussion legislation and policies in Georgia. Conclusion: Resource variability in schools and communities influences how they create and implement sports concussion policies and thus the extent that they can adhere to Georgia's concussion law. The diffusion of this law and concussion guidelines appears incomplete, potentially leaving athletes at risk. Solutions to resource and knowledge gaps are available but require greater leadership, communication, and collaboration to address this public health issue. N/A Advisors/Committee Members: Elifson, Kirk (Committee Member), Thompson, Nancy J (Thesis Advisor).