1. Outcomes and applications from CDC's educational concussion tool kit for high school athletic coaches
Kelly Sarmiento, MPH
Health Communications Specialist
Centers for Disease Control and Prevention

2. CDC’s Activities Children’s Health Act of 2000
Implement a public information and education program for the prevention of traumatic brain injury (TBI) and for broadening the awareness of the public concerning the public health consequences of TBI.

3. Background: Concussion
As many 3.8 million sports- and
recreation-related concussions occur in the United States each year
Concussions are caused by a bump or blow to the head or body that causes the brain to move rapidly inside the skull
Repeat concussions can result in brain swelling, permanent brain damage, and even death

4. “Heads Up: Concussion in High School Sports”

5. Goals of the Tool Kit
Raise awareness among high school coaches about sports-related concussion
Help coaches educate others about concussion
Provide high school coaches with tools that will help them prevent concussion and take appropriate action if a concussion occurs

6. Contents The tool kit contains: 16-page guide for coaches Wallet card
Clipboard sticker
Fact sheets for parents and athletes
Posters
Video/DVD

7. National Launch Launched nationally: September, 2005
Over 6 million media impressions
Newspaper, magazine, radio, television exposure
20,000 Web hits
Disseminated over 40,000 copies of the tool kit

8. Evaluation One-year follow-up study: Study participants:
Survey of coaches who ordered the tool kit online from CDC’s website between September 2005 and July 2006
Study participants:
Self-identified as coaches of high school-aged athletes and reported that they received the “Heads Up” tool kit
Purpose was to assess:
Coaches’ use of the tool kit materials
Changes in coaches’ knowledge, attitudes, and behaviors towards concussion

9. Methods Two-pronged mixed-method evaluation:
Mail survey (both multiple choice and open-ended formats)
Focus groups with coaches of high and low-impact sports
Research questions focused on environment, materials, knowledge, attitude, behavior, and skills

10. Results 333 eligible participants (45% response rate) Demographics:
Were male (78%)
Had more than 10 years experience (53%)
Coached athletes with middle-income parents (63%)
Were situated in suburban (43%) or rural settings (38%)
Worked at a public school (78%) with fewer than 1,000 students (50%)

11. Use of Tool Kit Materials

12. Materials “Everything was right there, so it really came in handy.”
“The thing we found the most useful was the quick snapshot signs and symptoms [wallet] card and we had that photocopied and put into everybody’s med kit of all the coaches, every sport, every level.”

13. Changes in Knowledge
34% of coaches reported that the tool kit had taught them something new.
“[I learned] what kinds of things to look for to determine if an athlete has a concussion and when to allow them back into a game or practice.”
“I thought symptoms would be more severe and the athlete would not be able to continue, but I was surprised that many times coaches and athletes would continue having the injured play.”

14. Changes in Attitudes
50% of coaches reported that the tool kit changed how they viewed the seriousness of concussions.
“[Concussions are] more serious and more prevalent than I ever thought.”
“[I learned] not to take unnecessary chances. Better safe than sorry.”
“I was guilty of thinking, ‘Oh, he got his bell rung.’ That type of thing. Thinking that some of that stuff was just part of the competition and not taking it quite as seriously as I should have.”

15. Changes in Behavior
68% of coaches reported that they have educated others about preventing or managing concussions since receiving the tool kit.
“It is much easier when I can hand the parent the fact sheet. They seem to take things more seriously.”
“What’s happened is that we’ve at least elevated [concussions] to an upfront discussion. And it enables us to get through the season with everybody understanding that if [a concussion] happens, this is what we’re going to do…”

16. Changes in Behavior (2)
Over a third of coaches (38%) reported making changes in the way they prevented or managed concussions after reviewing the tool kit.
“Anytime that I suspect [a concussion], I first go through the checklist from the ‘Heads Up’ packet.”
“I spend more time talking about proper tackling and take down techniques and talk about properly fitted equipment, helmets, and head gear.”

17. Conclusion
Tool kit had a positive impact on coaches’ knowledge, attitudes, behavior, and skills related to concussion prevention and management
Majority of coaches found the materials to be useful and relevant and used the materials to educate others

18. Conclusion (2)
Over a third reported they learned something new about concussion
Many coaches reported placing more emphasis on training techniques and safety equipment to prevent and minimize risk of concussion
High school coaches’ tool kit initiative expanded to target coaches and administrators of youth sports

19. Authors Centers for Disease Control and Prevention Constella Group
Jane Mitchko, MEd, CHES
Kelly Sarmiento, MPH
Constella Group
Sharon Wong, MPH
Cynthia Klein, PhD