Managing Concussions in New Zealand Secondary Schools: Let's Take It Seriously

Abstract

INTRODUCTION: Concussion can cause lasting cognitive, physical, and emotional challenges, impacting academic performance. New Zealand secondary schools lack sufficient knowledge and resources to support affected students. We co-designed and implemented the Framework for Management of Concussion in New Zealand Secondary Schools (FRANCS).

AIM: To explore experiences and perceptions of school stakeholders during 2 years of FRANCS implementation.

METHODS: Sixty-nine participants from 12 schools (students, parents, staff, and healthcare providers) took part in semi-structured interviews or focus groups. Data were analyzed using framework analysis to identify themes.

RESULTS: Four themes were developed: (1) Flexibility of implementation - friend or foe; (2) Owning the process; (3) The process is too onerous; and (4) External context and confounders.

CONCLUSION: FRANCS' flexibility enabled some schools to adapt and integrate it into existing communication pathways, supporting students' return-to-learn. Others faced challenges, resource limitations, and low engagement. Effective implementation requires initial external support to tailor FRANCS to school contexts, establish communication and monitoring systems, and embed return-to-learn processes.