{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:00:12Z","timestamp":1787497212818,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","award":["30822"],"award-info":[{"award-number":["30822"]}],"id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Studies that evaluate the effectiveness of concussion laws often use only a single variable (ie, presence of the law), failing to account for law complexity. We examined the association between multiple design elements of state concussion laws and rates of sports-related concussion reporting among US high school athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We derived 3 design elements of concussion laws from the 2009-2017 LawAtlas database: (1) strength of law, (2) number of law revisions, and (3) speed of law adoption. We examined the association between these design elements and rates of new and recurrent sports-related concussion reporting from the 2009-2010 through 2016-2017 academic years in a nationally representative sample of high school athletes participating in High School Report Information Online, an online data collection tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7064 sports-related concussions (6332 [89.6%] new and 732 [10.4%] recurrent concussions) were reported during the study period, with an overall rate of 39.7 sports-related concussions per 100 000 athletic exposures (eg, game or practice). Rates of new concussion reporting were higher among high schools in states with medium- or high-strength concussion laws than in states with low-strength concussion laws and in states with at least 1 concussion law revision than in states with no concussion law revisions. Rates of recurrent concussion reporting were lower among high schools in states with \u22652 concussion law revisions than in states with &lt;2 concussion law revisions. Early law adoption was associated with higher rates of new and recurrent concussion reporting, and late law adoption was associated with lower rates of new and recurrent concussion reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings may help inform legislators of the public health effect of concussion laws.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354920988611","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T18:37:49Z","timestamp":1614191869000},"page":"745-753","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Association Between Design Elements of Concussion Laws and Reporting of Sports-Related Concussions Among US High School Athletes, 2009-2017"],"prefix":"10.1177","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4019-0999","authenticated-orcid":false,"given":"Jingzhen","family":"Yang","sequence":"first","affiliation":[{"name":"Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"},{"name":"Department of Pediatrics, College of Medicine and Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosea H.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Beasley School of Law, Temple University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"},{"name":"Discipline of Children\u2019s Studies, National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Huang","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"},{"name":"Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Dawn Comstock","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"bibr1-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4635"},{"key":"bibr2-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.1082"},{"key":"bibr3-0033354920988611","volume-title":"Sports-Related Concussions in Youth: Improving the Science, Changing the Culture","author":"Graham R.","year":"2014"},{"key":"bibr4-0033354920988611","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301107"},{"issue":"1","key":"bibr5-0033354920988611","first-page":"66","volume":"14","author":"Harvey HH","year":"2014","journal-title":"Yale J Health Policy Law Ethics"},{"key":"bibr6-0033354920988611","unstructured":"State of Washington. House Bill 1824\u2014Zackery Lystedt Law. 61st Legislature (2009)."},{"key":"bibr7-0033354920988611","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.304056"},{"key":"bibr8-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-015-0034-7"},{"key":"bibr9-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.2320"},{"key":"bibr10-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.10.021"},{"key":"bibr11-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000397"},{"key":"bibr12-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2004.09.013"},{"key":"bibr13-0033354920988611","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2008.156224"},{"key":"bibr14-0033354920988611","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.130278"},{"key":"bibr15-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2010.00595.x"},{"key":"bibr16-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2009.00192.x"},{"key":"bibr17-0033354920988611","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-43.2.197"},{"key":"bibr18-0033354920988611","unstructured":"The Datalys Center for Sports Injury Research and Prevention. High School RIO: Reporting Information Online. Accessed November 21, 2020. https:\/\/www.datalyscenter.org\/rio"},{"key":"bibr19-0033354920988611","unstructured":"LawAtlas. The policy surveillance program. Accessed November 21, 2020. http:\/\/lawatlas.org"},{"key":"bibr20-0033354920988611","unstructured":"National Center for Injury Prevention and Control. Implementing Return to Play: Learning From the Experiences of Early Implementers. Centers for Disease Control and Prevention; 2013. Accessed November 21, 2020. https:\/\/www.cdc.gov\/headsup\/pdfs\/policy\/rtp_implementation-a.pdf"},{"key":"bibr21-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511435626"},{"key":"bibr22-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2011-090115"},{"key":"bibr23-0033354920988611","doi-asserted-by":"publisher","DOI":"10.3171\/2012.9.FOCUS12280"},{"key":"bibr24-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1111\/jlme.12146"},{"key":"bibr25-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2151"},{"key":"bibr26-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.07.003"},{"key":"bibr27-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-lawsocsci-102612-134011"},{"key":"bibr28-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1177\/0033354918805741"},{"key":"bibr29-0033354920988611","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032315-021841"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0033354920988611","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0033354920988611","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0033354920988611","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:36:54Z","timestamp":1777628214000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0033354920988611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,24]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1177\/0033354920988611"],"URL":"https:\/\/doi.org\/10.1177\/0033354920988611","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,24]]}}}