Evaluation of Spot Light: A Concussion Injury Management App for Youth Sports
Condition: TBI
Study type: Interventional

Summary: 
      Sports-related traumatic brain injuries (TBIs), including mTBIs-commonly referred to as
      concussions-are a serious public health concern. Diagnostic criteria and consensus return to
      play (RTP) guidelines exist, but clinicians have varying approaches to the diagnosis and
      management of sports-related concussion as these guidelines are almost completely unsupported
      by an evidence base. It is well known that by increasing awareness of concussion signs and
      symptoms as well as the importance of addressing this injury, improving coaching on proper
      sports activity techniques and good sportsmanship, providing appropriate protective
      equipment, and quickly responding to injuries, the incidence, severity, and long-term
      negative health effects of sports-related concussion among children and adolescents can be
      reduced. The overall objective of this application, which is the first step toward attainment
      of our long-term goal, is to evaluate the effectiveness of Spot Light (a concussion injury
      management application [app] that coordinates diagnosis, management, and RTP procedures from
      injury to safe return to sport) when utilized by youth football teams. Our central hypothesis
      is that youth football teams randomized to receive SpotLight will report increased rates of
      concussion, increased referrals to physicians for care, and increased athlete compliance with
      RTP guidelines. The rationale that underlies the proposed research is that providing an easy
      to-use app has a high probability of effectively helping people involved with youth sports
      better recognize, respond to, and ensure athletes are fully recovered from sports-related
      concussion. We will test our hypothesis by pursuing the following aims: 1: Evaluate whether
      Spot Light will increase reported rates of sports-related concussion; Aim 2: Evaluate whether
      Spot Light increases referrals to physicians following concussion; Aim 3: Evaluate whether
      Spot Light improves the management of sports-related concussion. We expect to determine
      whether there is increased reporting, referrals to physicians, and athlete compliance with
      RTP guidelines. This contribution will be significant because it will allow physicians,
      athletic trainers (ATs), coaches, and parents to collaboratively track concussions from
      injury through safe RTP thereby lessening the chances of long-term negative outcomes as well
      as acute catastrophic outcomes.
    

Detailed description: 
      Sports-related traumatic brain injuries (TBIs), including mTBIs - commonly referred to as
      concussions - are a serious public health concern. During the last decade, emergency
      department visits for sports and recreation related TBIs among youth, including concussions,
      increased by 62%.[1] Concussion rates among high school athletes have significantly increased
      over the past decade.[2] Although most sports-related concussions are mild injuries where the
      athlete fully recovers from symptoms within a week, [3-5] each year TBIs contribute to a
      substantial number of deaths and cases of permanent disability. While contact sports such as
      football have the highest incidence and rates of concussion, these injuries occur across a
      wide range of sports.[5] Diagnostic criteria and consensus return to play (RTP) guidelines
      exist, but clinicians have varying approaches to the diagnosis and management of
      sports-related concussions as these guidelines are almost completely unsupported by an
      evidence base. Increasing awareness of concussion signs and symptoms, improving sport
      specific coaching techniques, promoting good sportsmanship, providing appropriate protective
      equipment and responding quickly to injuries reduces the incidence, severity and long-term
      negative health effects of sports related concussions among children and adolescents.[1] Thus
      there is a critical need for the development of tools for prevention. Our long-term goal is
      to reduce the negative consequences of sports-related concussions, specifically in youth
      sports. The overall objective of this application, which is the first step toward attainment
      of our long-term goal, is to evaluate the effectiveness of Spot Light (a concussion injury
      management application [app] that organizes and coordinates diagnosis, management, and RTP
      procedures from injury to safe return to sport) (Appendix 1) when utilized by middle and high
      school football teams. Our central hypothesis is that middle and high school football teams
      randomized to receive Spot Light will report increased rates of concussion; increased
      referrals to physicians for care, and increased athlete compliance with RTP guidelines. The
      rationale that underlies the proposed research is that providing an easy-to-use app for
      sports-related concussions has a high probability of effectively helping people involved with
      youth sports better recognize, respond to, and ensure that athletes are fully recovered from
      sports-related concussion.

      We plan to test our central hypothesis and, thereby, attain the objective of this application
      by pursuing the following specific aims: Aim 1. Evaluate whether or not Spot Light increases
      reported rates of sports-related concussions.

      Working Hypothesis-teams using Spot Light will report a higher rate of concussion than teams
      without Spot Light.

      Aim 2. Evaluate whether or not Spot Light increases referrals to physicians for patient care
      following a sports-related concussion. Working Hypothesis-teams using Spot Light will refer
      more concussed athletes for treatment by a physician than teams without Spot Light.

      Aim 3. Evaluate whether or not Spot Light improves management of sports-related concussions.

      Working Hypothesis-injured athletes on teams utilizing Spot Light will exhibit higher
      compliance with RTP guidelines, than teams without Spot Light.

      It is anticipated that these aims will yield the following expected outcomes. We expect to
      determine whether there is increased reporting of concussion, referrals to physicians, and
      athlete compliance with RTP guidelines. We also expect to learn whether the app is adopted
      and utilized similarly when distributed to different levels of youth sports (middle vs. high
      school age) and different types of "reporters" (coaches vs. certified athletic trainers). We
      expect widespread effectiveness across age groups and types of reporters; these results would
      suggest that Spot Light is suitable for widespread distribution across a variety of youth
      sports and settings. These outcomes are expected to have an important positive impact because
      timely and proper diagnosis, management, and coordination of care and RTP decisions will
      ultimately reduce the negative consequences and impact of sports-related concussions, as will
      now be detailed in the next section.
    

Intervention name(s): Spot Light Concussion App
Intervention type(s): Other
Intervention description(s): Certified Athletic Trainers will report football injuries using High School RIO and will report possible concussions using the Spot Light concussion app.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Spot Light; High School RIO; Concussion; Injury Prevention; Football; Pop Warner; High School; Middle School