Mahi Tahi (Working Together) and the Lessons Learned From Implementating a Concussion Management Pathway for Community Rugby in New Zealand: Haerenga (Our Journey)
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Salmon, Danielle M
Badenhorst, Marelise
Kerr, Zachary Yukio
Whatman, Chris
Brown, James
Romanchuk, Janelle
Register-Mihalik, Johna
Walters, Simon
Sole, Gisela
Murphy, Ian
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Elsevier BV
Abstract
Concussion guidelines are widely available, but implementing them consistently in community sport remains difficult. Common barriers include limited access to medical care, reliance on volunteers, fragmented communication, and sporting cultures that may discourage reporting. In response, New Zealand Rugby developed and refined over multiple seasons, a community Concussion Management Pathway (CMP), to operationalise World Rugby's principles of ‘Recognise and Remove’ in real-world community settings.
This editorial reflects on lessons learned from the design, implementation, and iterative refinement of the CMP over multiple seasons. Rather than evaluating effectiveness, we focus on the practical realities of implementation within a complex community sport system. Key lessons learned include the importance of co-design with stakeholders, adapting elite-derived processes to community capacity, balancing standardisation with flexibility, and recognising the complexity associated with baseline testing, technology use, and navigating primary healthcare pathways. The role of education, role clarity, and systems-level communication in shaping concussion reporting and management behaviours are also explored.
Our experiences highlight that in community sport concussion interventions must be treated as living systems, requiring ongoing adaptation to local context, resources, and cultures. The lessons outlined provide transferable insights for researchers, sporting organisations, and policy-makers seeking to design, implement, or scale concussion prevention and management initiatives across community sport.
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Implementation science, Systems thinking, Knowledge translation, Intervention adaptation
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JSAMS Plus, ISSN: 2772-6967 (Print), Elsevier BV, 8, 100156-100156. doi: 10.1016/j.jsampl.2026.100156
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Except where otherwise noted, this item's license is described as Creative Commons Attribution License