{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T05:19:43Z","timestamp":1777180783495,"version":"3.51.4"},"reference-count":52,"publisher":"National Athletic Trainers' Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"\n Context<\/jats:title>\n State laws provide general guidelines for sport-related concussion (SRC) management but do not comprehensively address the multiple layers of management for this complex injury. Although high schools are encouraged to develop SRC protocols that include both state law tenets and additional management practices, the execution of these protocols warrants examination.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate state law compliance and practice components included in high school SRC protocols and determine whether the degree of sports medicine coverage influenced protocol quality.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Qualitative document analysis.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n High school athletics.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n In total, 184 Pennsylvania high schools (24.3% of schools statewide; full-time athletic trainers [ATs] = 149, part-time ATs = 13, missing = 22) voluntarily provided copies of their protocols from the 2018\u20132019 academic year.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n Four ATs conducted document analyses using a 67-item component analysis guide. Frequencies were computed for included protocol components related to the state law, preparticipation and prevention, recognition and assessment, and management. The difference in the total number of included components (maximum = 60) by sports medicine coverage was assessed using a Mann-Whitney U test.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Heterogeneity existed in the components included in the submitted protocols. Only 23.4% included all mandatory state law tenets. Immediate removal from play was noted in 67.4% of protocols, whereas only 1.6% contained prevention strategies. Return to play was addressed more frequently than return to learn (74.5% versus 32.6%). The sample had a mean of 15.5 \u00b1 9.7 total components per protocol. Schools with full-time sports medicine coverage had more protocol components than those with part-time ATs (15 [interquartile range = 8.5\u201322.5] versus 6 [3\u201310.5] median components; U = 377.5, P &lt; .001).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n School-level written SRC protocols were often missing components of the state law and additional best-practice recommendations. Full-time sports medicine coverage in high schools is recommended to increase SRC protocol and health care quality.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0505.20","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T19:31:07Z","timestamp":1623785467000},"page":"32-43","source":"Crossref","is-referenced-by-count":7,"title":["Going Beyond the State Law: Investigating High School Sport-Related Concussion Protocols"],"prefix":"10.4085","volume":"57","author":[{"given":"Erica","family":"Beidler","sequence":"first","affiliation":[{"name":"Department of Athletic Training, Duquesne University, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cailee E.","family":"Welch Bacon","sequence":"additional","affiliation":[{"name":"Athletic Training Programs and School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Hattrup","sequence":"additional","affiliation":[{"name":"Boston University Athletic Training Services, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassidy","family":"Powers","sequence":"additional","affiliation":[{"name":"Department of Athletic Training, Duquesne University, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilly","family":"Saitz","sequence":"additional","affiliation":[{"name":"Department of Environmental Studies, Mount Holyoke College, South Hadley, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara C.","family":"Valovich McLeod","sequence":"additional","affiliation":[{"name":"Athletic Training Programs and School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","published-online":{"date-parts":[[2020,6,18]]},"reference":[{"key":"2022011815572984400_i1938-162X-57-1-32-b01","doi-asserted-by":"crossref","unstructured":"McCrory\n P,\n \n \n Meeuwisse\n W,\n \n \n Dvo\u0159\u00e1k\n J,\n \n et al.\n \n Consensus statement on concussion in sport\u2014the 5th international conference on concussion in sport held in Berlin, October 2016.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t51(11):\n\t\t\t\t\t838\u2013\n\t\t\t\t\t847.\n\t\t\t\t\tdoi:10.1136\/bjsports-2017-097699","DOI":"10.1136\/bjsports-2017-097699"},{"key":"2022011815572984400_i1938-162X-57-1-32-b02","doi-asserted-by":"crossref","unstructured":"Broglio\n SP,\n \n \n Cantu\n RC,\n \n \n Gioia\n GA,\n \n et al.\n \n National Athletic Trainers' Association position statement: management of sport concussion.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2014;\n\t\t\t\t\t49(2):\n\t\t\t\t\t245\u2013\n\t\t\t\t\t265.\n\t\t\t\t\tdoi:10.4085\/1062-6050-49.1.07","DOI":"10.4085\/1062-6050-49.1.07"},{"key":"#cr-split#-2022011815572984400_i1938-162X-57-1-32-b03.1","doi-asserted-by":"crossref","unstructured":"Rosenthal JA, Foraker RE, Collins CL, Comstock RD. 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Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t47(10):\n\t\t\t\t\t2294\u2013\n\t\t\t\t\t2299.\n\t\t\t\t\tdoi:10.1177\/0363546519860120","DOI":"10.1177\/0363546519860120"},{"key":"2022011815572984400_i1938-162X-57-1-32-b34","doi-asserted-by":"crossref","unstructured":"Broglio\n SP,\n \n \n Williams\n RM,\n \n \n O'Connor\n KL,\n \n \n Goldstick\n J.\n \n \n Football players' head-impact exposure after limiting of full-contact practices.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2016;\n\t\t\t\t\t51(7):\n\t\t\t\t\t511\u2013\n\t\t\t\t\t518.\n\t\t\t\t\tdoi:10.4085\/1062-6050-51.7.04","DOI":"10.4085\/1062-6050-51.7.04"},{"key":"2022011815572984400_i1938-162X-57-1-32-b35","doi-asserted-by":"crossref","unstructured":"Yang\n YT,\n \n \n Baugh\n CM.\n \n \n US youth soccer concussion policy: heading in the right direction.\n\t\t\t\t\tJAMA Pediatr2016;\n\t\t\t\t\t170(5):\n\t\t\t\t\t413\u2013\n\t\t\t\t\t414.\n\t\t\t\t\tdoi:10.1001\/jamapediatrics.2016.0338","DOI":"10.1001\/jamapediatrics.2016.0338"},{"key":"2022011815572984400_i1938-162X-57-1-32-b36","doi-asserted-by":"crossref","unstructured":"Black\n AM,\n \n \n Macpherson\n AK,\n \n \n Hagel\n BE,\n \n et al.\n \n Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction in injury and concussion risk in 11- and 12-year-old players.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t50(1):\n\t\t\t\t\t55\u2013\n\t\t\t\t\t61.\n\t\t\t\t\tdoi:10.1136\/bjsports-2015-095103","DOI":"10.1136\/bjsports-2015-095103"},{"key":"2022011815572984400_i1938-162X-57-1-32-b37","doi-asserted-by":"crossref","unstructured":"Harmon\n KG,\n \n \n Clugston\n JR,\n \n \n Dec\n K,\n \n et al.\n \n American Medical Society for Sports Medicine position statement on concussion in sport.\n\t\t\t\t\tBr J Sports 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Sci.\n\t\t\t\t\t2017;\n\t\t\t\t\t94(1):\n\t\t\t\t\t96\u2013\n\t\t\t\t\t100.\n\t\t\t\t\tdoi:10.1097\/OPX.0000000000000910","DOI":"10.1097\/OPX.0000000000000910"},{"key":"2022011815572984400_i1938-162X-57-1-32-b40","doi-asserted-by":"crossref","unstructured":"Master\n CL,\n \n \n Master\n SR,\n \n \n Wiebe\n DJ,\n \n et al.\n \n Vision and vestibular system dysfunction predicts prolonged concussion recovery in children.\n\t\t\t\t\tClin J Sport Med.\n\t\t\t\t\t2018;\n\t\t\t\t\t28(2):\n\t\t\t\t\t139\u2013\n\t\t\t\t\t145.\n\t\t\t\t\tdoi:10.1097\/JSM.0000000000000507","DOI":"10.1097\/JSM.0000000000000507"},{"key":"2022011815572984400_i1938-162X-57-1-32-b41","doi-asserted-by":"crossref","unstructured":"McAvoy\n K,\n \n \n Eagan-Johnson\n B,\n \n \n Halstead\n M.\n \n \n Return to learn: transitioning to school and through ascending levels of academic support for students following a 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Health.\n\t\t\t\t\t2017;\n\t\t\t\t\t9(2):\n\t\t\t\t\t181\u2013\n\t\t\t\t\t184.\n\t\t\t\t\tdoi:10.1177\/1941738116686782","DOI":"10.1177\/1941738116686782"},{"key":"2022011815572984400_i1938-162X-57-1-32-b46","doi-asserted-by":"crossref","unstructured":"McGuine\n TA,\n \n \n Pfaller\n AY,\n \n \n Post\n EG,\n \n \n Hetzel\n SJ,\n \n \n Brooks\n A,\n \n \n Broglio\n SP.\n \n \n The influence of athletic trainers on the incidence and management of concussions in high school athletes.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2018;\n\t\t\t\t\t53(11):\n\t\t\t\t\t1017\u2013\n\t\t\t\t\t1024.\n\t\t\t\t\tdoi:10.4085\/1062-6050-209-18","DOI":"10.4085\/1062-6050-209-18"},{"key":"2022011815572984400_i1938-162X-57-1-32-b47","doi-asserted-by":"crossref","unstructured":"Davies\n S,\n \n \n Coxe\n K,\n \n \n Harvey\n HH,\n \n \n Singichetti\n B,\n \n \n Guo\n J,\n \n \n Yang\n J.\n \n \n Qualitative evaluation of high school implementation strategies for youth sports concussion laws.\n\t\t\t\t\tJ Athl 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