Managing Concussion in the Real World: Stakeholder Perspectives of New Zealand Rugby’s Concussion Management Pathway

Date
2023-12-28
Authors
Salmon, Danielle
Walters, Simon
Brown, James
Kerr, Zachary
Clacy, Amanda
Keung, Sierra
Sullivan, S John
Mihalik, Johna Register
Whatman, Chris
Sole, Gisela
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
SAGE Publications
Abstract

The potential adverse consequences associated with poor concussion management highlights the need to improve the translation of concussion guidelines into consistent use in real-world sport settings. To facilitate this process, New Zealand Rugby developed a community concussion management pathway to support concussion recognition, diagnosis, and management. This study adopted a pragmatic, descriptive qualitative approach to explore key stakeholders’ perceptions of the concussion management pathway, with the aim to inform policy and practice. Interviews were conducted with 123 participants, including players, parents, coaches, healthcare professionals, and school and provincial union representatives. The framework method was used to analyze data. Themes were organized according to the principles of realist process evaluation that considers contextual factors and mechanisms influencing a program's operation to produce specific outcomes. Contextual factors influencing the concussion management pathway's implementation included governing bodies’ support, existing local resources, general concussion attitudes, or concussion severity. The optimal functioning of the concussion management pathway (mechanism) was influenced by (i) pathway resources, (ii) roles and relationships, (iii) buy-in and support towards the concussion management pathway, and (iv) diligence and communication. Outcomes identified included (i) hitting the target (optimally managed and enhanced awareness) or (ii) missing the mark (dissatisfaction or management gaps). Overall, participants found the concussion management pathway valuable. However, the acceptability of certain policy-related aspects and the underlying attitudes associated with these perceptions, are some areas requiring further investigation and support. Tailoring programs according to end-users’ perceptions is crucial in developing context-sensitive interventions appropriate for a specific setting. These findings may act as a foundation for investigations of concussion management in other settings.

Description
Keywords
11 Medical and Health Sciences , 17 Psychology and Cognitive Sciences , 32 Biomedical and clinical sciences , 42 Health sciences , 52 Psychology
Source
International Journal of Sports Science and Coaching, ISSN: 1747-9541 (Print); 2048-397X (Online), SAGE Publications. doi: 10.1177/17479541231218518
Rights statement
© The Author(s) 2023. Creative Commons License (CC BY 4.0). This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).