{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:57:29Z","timestamp":1790337449594,"version":"4.1.0"},"reference-count":38,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T00:00:00Z","timestamp":1697328000000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007598","name":"Accident Compensation Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007598","id-type":"DOI","asserted-by":"publisher"}]},{"name":"New Zealand Rugby Foundation"},{"name":"World Rugby"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2023,9,25]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>There is a growing concern around concussions in rugby union, at all levels of the game. These concerns highlight the need to better manage and care for players. However, consistency around concussion-related responsibilities of stakeholders across the community rugby system remains challenging. Taking a systems thinking approach, this pragmatic, qualitative descriptive study explored key stakeholder groups within New Zealand\u2019s community rugby system\u2019s perceptions of their own and others\u2019 concussion-related responsibilities. Participants included players from schools and clubs, coaches, parents, team leads and representatives from four provincial unions. A total of 155 participants (67 females and 88 males) were included in the study. Focus groups and individual interviews were conducted. Thematic content analysis was used to analyse data. Thirty concussion-related responsibilities were identified. These responsibilities were contained within four themes: (1) policies and support (responsibilities which influence policy, infrastructure, human or financial resources); (2) rugby culture and general management (responsibilities impacting players\u2019 welfare and safety, attitudes and behaviour, including education, injury reporting and communication); (3) individual capabilities (responsibilities demonstrating knowledge and confidence managing concussion, leadership or role\/task shifting) and (4) intervention following a suspected concussion (immediate responsibilities as a consequence of a suspected concussion). The need for role clarity was a prominent finding across themes. Additionally, injury management initiatives should prioritise communication between stakeholders and consider task-shifting opportunities for stakeholders with multiple responsibilities. How concussions will realistically be managed in a real-world sports setting and by whom needs to be clearly defined and accepted by each stakeholder group. A \u2018framework of responsibilities\u2019 may act as a starting point for discussion within different individual community rugby contexts on how these responsibilities translate to their context and how these responsibilities can be approached and assigned among available stakeholders.<\/jats:p>","DOI":"10.1136\/bmjsem-2023-001722","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T06:20:58Z","timestamp":1697437258000},"page":"e001722","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Quest for clarity: investigating concussion-related responsibilities across the New Zealand Rugby Community System"],"prefix":"10.1136","volume":"9","author":[{"given":"Danielle M","family":"Salmon","sequence":"first","affiliation":[{"name":"Safety and Welfare, New Zealand Rugby, Wellington, New Zealand"},{"name":"Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Chua","sequence":"additional","affiliation":[{"name":"Safety and Welfare, New Zealand Rugby, Wellington, New Zealand"},{"name":"Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7778-7783","authenticated-orcid":false,"given":"James C","family":"Brown","sequence":"additional","affiliation":[{"name":"Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK"},{"name":"Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Clacy","sequence":"additional","affiliation":[{"name":"School of Law & Society, University of the Sunshine Coast, Maroochydore, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary Yukio","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6467-4982","authenticated-orcid":false,"given":"Simon","family":"Walters","sequence":"additional","affiliation":[{"name":"Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sierra","family":"Keung","sequence":"additional","affiliation":[{"name":"Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S John","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Safety and Welfare, New Zealand Rugby, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johna","family":"Register-Mihalik","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Whatman","sequence":"additional","affiliation":[{"name":"Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela","family":"Sole","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, University of Otago - Dunedin Campus, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-9173","authenticated-orcid":false,"given":"Marelise","family":"Badenhorst","sequence":"additional","affiliation":[{"name":"Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"key":"2025083111221569000_9.4.e001722.1","unstructured":"ACC Analytics & Reporting . 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