{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T10:23:53Z","timestamp":1773570233687,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess statewide prevalence of medical access, concussion reporting, and concussion clearance rates of high school athletic departments in Massachusetts after the implementation of state\u2010wide concussion legislation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A random sample of 50 athletic directors (ADs) from Massachusetts high schools with an enrollment of &gt;150 students was selected. A 10\u2010minute electronic survey about access to athletic trainers and physicians, and concussion reporting and clearance practices was administered. Responses were anonymous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The response rate was 80% (n\u00a0= 40). In total, 90% of respondents were male. Median age and experience of respondents was 52 years old and 10 years, respectively. The median school size was 637 students, represented from all Massachusetts geographic athletic districts. ADs disclosed that on average, 12% (95% confidence interval 7%\u201020%) of concussions go unreported at their schools. In total, 16% of respondents reported that at least 1 in 4 of concussed athletes at their school returned to play without appropriate medical clearance, and 5% of ADs reported that not all of their coaches had undergone any form of concussion training. Overall, 55% of high schools do not have access to a full\u2010time athletic trainer and 50% do not have a team physician; 20% have affiliations with an orthopaedic surgeon and 8% with a neurologist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite new regulations in Massachusetts, high school ADs report concussion reporting and clearance that are less than 100%. Less than one half of all Massachusetts high schools report access to a full\u2010time athletic trainer or formal relationship with a school physician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Investigating compliance with Massachusetts school athletics safety regulations could help identify a need for reform of policies designed to help schools keep student athletes safer in situations where a concussion may have occurred.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2020.07.002","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T03:05:35Z","timestamp":1600743935000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["High School Athletic Directors Report Poor Compliance With Concussion Reporting and Medical Clearance in Massachusetts"],"prefix":"10.1002","volume":"2","author":[{"given":"Joseph B.","family":"Kahan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Salzler","sequence":"additional","affiliation":[{"name":"Tufts Medical Center Department of Orthopaedic Surgery Boston Massachusetts U.S.A."},{"name":"Tufts University School of Medicine Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"DiCenzo","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Zink","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Radford","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Tybor","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2011.08.010"},{"issue":"11","key":"e_1_2_2_3_2","first-page":"1","article-title":"Comparative analysis of state\u2010level concussion legislation and review of current practices in concussion","volume":"33","author":"Tomei K.L.","year":"2012","journal-title":"Neurosurg Focus"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510376737"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2010.08.006"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2016.05.009"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.04.035"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.8334"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(02)00095-9"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6552a2"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100007046"},{"key":"e_1_2_2_12_2","unstructured":"Massachusetts Risk Behavior Survey and Massachusetts Youth Health Survey. Health and Risk Behaviors of Massachusetts Youth Executive Summary. Department of Public Health. 017 Reporthttp:\/\/www.doe.mass.edu\/sfs\/yrbs\/2017exec\u2010summary.pdf Accessed June 1 2018"},{"key":"e_1_2_2_13_2","first-page":"87","article-title":"Continued play following sport\u2010related concussion in United States youth soccer","volume":"13","author":"Zynda A.J.","year":"2020","journal-title":"Int J Exerc Sci"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-44.4.400"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.06.018"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301107"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1073110516667946"},{"key":"e_1_2_2_18_2","volume-title":"Internet, phone, mail, and mixed\u2010mode surveys","author":"Smith J.D.","year":"2014"},{"key":"e_1_2_2_19_2","unstructured":"Massachusetts Department of Public Health.Statewide sports concussion initiative: MA law and Department of Public Health regulationshttps:\/\/malegislature.gov\/Laws\/SessionLaws\/Acts\/2010\/Chapter166. 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}]}}