Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio (Drs Sullivan, Smith, and Yang); formerly Beasley School of Law, Temple University, Philadelphia, Pennsylvania (Dr Harvey); and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio (Drs Smith and Yang).
J Public Health Manag Pract. 2020 Mar/Apr;26 Suppl 2, Advancing Legal Epidemiology:S84-S92. doi: 10.1097/PHH.0000000000001128.
Each year, approximately 2 million US children 18 years or younger sustain a concussion, a type of mild traumatic brain injury (TBI). Concussions can have detrimental effects on physical, cognitive, emotional, or sleep health.
Between 2009 and 2014, all 50 US states and Washington, District of Columbia, enacted state concussion laws aimed to increase awareness about concussion and reduce the prevalence and severity of this injury. Most state laws include the following core tenets: (1) immediate removal from play after an actual or suspected concussion; (2) medical clearance before an athlete can return to play (RTP); and (3) concussion education for athletes, parents, and coaches.
State concussion laws allow for substantial interpretation at the school level, resulting in considerable variation in the content of school written concussion policies and the level of implementation of state law requirements at the school level.
We assessed the degree of high school written concussion policy compliance with the respective state law and examined the relationship between concussion policy compliance and school-level implementation of concussion laws. Seventy-one school officials completed a semistructured telephone interview and submitted their school's written concussion policy. Of the 71 policies analyzed, most complied with the removal-from-play, RTP, and concussion education tenets (90.1%, 97.2%, and 76.1%, respectively). The majority of participants reported that their school implemented the removal-from-play (91.5%), RTP (93.0%), and concussion education (80.6%) tenets well or very well. No significant relationships were found between researcher-rated school policy compliance and school-reported implementation of state law requirements at the school level.
Our findings suggest that most participating schools complied with their state concussion law and implemented law requirements well or very well. Future studies should identify facilitators and barriers to the implementation of state concussion laws at the school level.
每年，约有 200 万 18 岁以下的美国儿童遭受脑震荡，这是一种轻度创伤性脑损伤（TBI）。脑震荡会对身体、认知、情绪或睡眠健康产生不利影响。
2009 年至 2014 年间，美国所有 50 个州和哥伦比亚特区都颁布了州脑震荡法，旨在提高对脑震荡的认识，减少这种伤害的发生率和严重程度。大多数州的法律都包含以下核心原则：（1）在实际或疑似脑震荡后立即从比赛中退出；（2）在运动员重返比赛（RTP）前获得医疗许可；（3）对运动员、家长和教练进行脑震荡教育。
州脑震荡法允许在学校层面进行大量解释，导致学校书面脑震荡政策的内容和学校层面实施州法律要求的程度存在很大差异。
我们评估了高中书面脑震荡政策遵守各自州法律的程度，并研究了脑震荡政策遵守情况与学校层面脑震荡法律实施情况之间的关系。71 名学校官员完成了半结构化电话访谈，并提交了他们学校的书面脑震荡政策。在分析的 71 项政策中，大多数都符合停赛、RTP 和脑震荡教育原则（分别为 90.1%、97.2%和 76.1%）。大多数参与者报告说，他们的学校很好或非常好地执行了停赛（91.5%）、RTP（93.0%）和脑震荡教育（80.6%）原则。研究人员评定的学校政策遵守情况与学校报告的学校层面州法律要求的实施情况之间没有显著关系。
我们的研究结果表明，大多数参与学校都遵守了其州脑震荡法，并很好或非常好地执行了法律要求。未来的研究应确定学校层面实施州脑震荡法的促进因素和障碍。
