Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers.
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ABSTRACT: Background
Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course.Method
Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted.Results
The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test.Conclusion
SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs.
SUBMITTER: Daugherty J
PROVIDER: S-EPMC7644176 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background:Concussions are common among youth athletes. Responsibility for the recognition and management of concussion is often put on coaches. To equip coaches with appropriate knowledge and skills, the US Centers for Disease Control and Prevention (CDC) launched the HEADS UP: Concussion in Youth Sports online training. Objectives:To determine whether HEADS UP coaches' training improves knowledge, attitudes and behavioural intentions. Methods:Knowledge questions were grouped into scales by level of difficulty. Differences between pre-and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score and effect sizes were interpreted. Results:Coaches displayed a high level of knowledge in the pre-test. While lower difficulty questions did not show improvement from pre- to post-test, moderate and high difficulty questions did. Use of the training was associated with improved knowledge about symptom resolution, return-to-play recommendations and under-reporting of incidents of concussion. Coaches demonstrated improvement in five of the seven concussion-related attitude and behavioural intention items post training. Conclusion:HEADS UP training improved coaches' knowledge on select topics and helped them feel more comfortable about responding to concussion among their athletes. This study provides insight into how to better focus future HEADS UP concussion health education efforts to fit coaches' informational needs.
| S-EPMC6747698 | biostudies-literature
Project description:ContextDetermining an athlete's hydration status allows hydration-related concerns to be identified before significant medical or performance concerns arise. Weight charts are an accurate measure of hydration status changes, yet their clinical use by athletic trainers (ATs) is unknown.ObjectiveTo investigate ATs' use of weight charts in athletic settings and describe their subsequent clinical decisions.DesignCross-sectional survey.SettingHigh schools and National Collegiate Athletic Association Divisions I, II, III and National Association Intercollegiate Athletics colleges.Patients or other participantsA total of 354 ATs (men = 162, women = 175; 17 respondents did not answer the demographic questions) responded across athletic settings (Division I [45.7%]; Division II, Division III, National Association Intercollegiate Athletics combined [n = 19.9%]; and high school [34.4%]).Main outcome measure(s)The 26-question online survey was developed by content experts and pilot tested before data collection. Participants answered questions focused on weight-chart use (implementation, timing, and calculations) and clinical decision processes (policies, interventions, and referral). Frequency statistics were calculated.ResultsThe majority of ATs (57.2%) did not use weight charts. Of those who did, most (76.0%) used charts with football, soccer (28%), and wrestling (6%) athletes. They calculated changes as either an absolute (42.2%) or percentage (36.7%) change from prepractice to postpractice; only 11.7% used a baseline weight for calculations. Of those who used the percentage change in body mass, 66.0% selected a threshold of -3% to -4% for an intervention. Most ATs (97.0%) intervened with verbal education, whereas only one-third (37.0%) provided specific fluid amounts based on body mass changes.ConclusionsTypically, ATs in athletic settings did not use weight charts. They considered a body mass change of -3% the indication for intervention but did not specify rehydration amounts for hypohydrated athletes. Educational workshops or technology applications could be developed to encourage ATs to use weight charts and calculate appropriate individual fluid interventions for their athletes.
| S-EPMC7863603 | biostudies-literature
Project description:BACKGROUND:There is an increasing concern over adolescent concussions in sports due to risks of long-term negative effects. This study analyzed data over three school years on reported concussion incidence rates by season, high school grade levels and gender, and reported symptoms by school nurses versus athletic trainers, from New Jersey student-athlete concussion data available from an online school-based surveillance system. METHODS:School nurses and athletic trainers reported 300 concussions within five days from when each occurred over three school years, 2015-2018, in team sports and physical education in New Jersey high schools. Analysis was further conducted on symptoms and number of symptoms reported by school nurses versus school athletic trainers for each documented student-athlete concussion. Estimated concussion incidence rates were calculated using state agency verified school enrollment data. FINDINGS:Concussions most commonly occurred during fall, followed by spring, then winter. Concussion incidence rates ranged from 6.3/1000 (4.99, 7.55) - 9.1/1000 (7.27, 10.98) students over the three school years of the study. Athletic trainers completed 86% of the reports while nurses completed 11% (position or title of 3%, or n = 7, were not disclosed); the values were similar when considering only fall pre-season and regular season sports (88, 10, 2%, respectively). On average, across the three school years, athletic trainers reported about 3.5 symptoms per report while nurses reported 2.7 (values in fall seasons only were 3.7 and 3.1, respectively.) CONCLUSIONS: Certified athletic trainers, compared to school nurses, more often completed concussion report forms and reported more symptoms per injured student, perhaps due partly to closer contact and immediate care provided after injury. Additionally, this study had a higher concussion incidence rate during fall sports seasons compared to winter and spring. Future research can further improve our understanding of concussions among adolescent student-athletes to better inform concussion identification, management and recovery protocols.
| S-EPMC6956499 | biostudies-literature
Project description:BackgroundCore stability training has grown in popularity over 25 years, initially for back pain prevention or therapy. Subsequently, it developed as a mode of exercise training for health, fitness and sport. The scientific basis for traditional core stability exercise has recently been questioned and challenged, especially in relation to dynamic athletic performance. Reviews have called for clarity on what constitutes anatomy and function of the core, especially in healthy and uninjured people. Clinical research suggests that traditional core stability training is inappropriate for development of fitness for heath and sports performance. However, commonly used methods of measuring core stability in research do not reflect functional nature of core stability in uninjured, healthy and athletic populations. Recent reviews have proposed a more dynamic, whole body approach to training core stabilization, and research has begun to measure and report efficacy of these modes training. The purpose of this study was to assess extent to which these developments have informed people currently working and participating in sport.MethodsAn online survey questionnaire was developed around common themes on core stability training as defined in the current scientific literature and circulated to a sample population of people working and participating in sport. Survey results were assessed against key elements of the current scientific debate.ResultsPerceptions on anatomy and function of the core were gathered from a representative cohort of athletes, coaches, sports science and sports medicine practitioners (n = 241), along with their views on effectiveness of various current and traditional exercise training modes. Most popular method of testing and measuring core function was subjective assessment through observation (43%), while a quarter (22%) believed there was no effective method of measurement. Perceptions of people in sport reflect the scientific debate, and practitioners have adopted a more functional approach to core stability training. There was strong support for loaded, compound exercises performed upright, compared to moderate support for traditional core stability exercises. Half of the participants (50%) in the survey, however, still support a traditional isolation core stability training.ConclusionPerceptions in applied practice on core stability training for dynamic athletic performance are aligned to a large extent to the scientific literature.
| S-EPMC6047949 | biostudies-literature
Project description:Purposein the last two decades, several evidences have been provided to support the relationship between single nucleotide polymorphisms and the susceptibility to develop injuries participating in sport and performance related to sports activity. We report up-to-date review of the genetics factors involved in tendon injuries and athletic performance.Methodswe searched PubMed using the terms "sports injuries", "athletic performance" and "genetics" over the period 1990 to the present day. We also included non-English journals.Resultsmost of the currently established or putative tendinopathy susceptibility loci have been analyzed by candidate gene studies. The genes currently associated with tendon injuries include gene encoding for collagen, matrix metallopeptidase, tenascin and growth factors. Several genes have been related to the physical performance phenotypes affecting endurance capacity and muscle performance. The most studied include ACE and ACTN3 genes.Conclusionsgenetics determines the response of an individual to the surrounding environment. Recently, some of the individual genetic variations contributing to the athletic performance and the onset of musculoskeletal injuries, particularly in tendon and ligament tissues, have been identified. However, the identification of the genetic background related to susceptibility to injuries and physical performance of the athletes is challenging yet and further studies must be performed to establish the specific role of each gene and the potential effect of the interaction of these.
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Project description:Natural Horsemanship is popular among many amateur and professional trainers and as such, has been the subject of recent scientific enquiry. One method commonly adopted by Natural Horsemanship (NH) trainers is that of round pen training (RPT). RPT sessions are usually split into a series of bouts; each including two phases: chasing/flight and chasing offset/flight offset. However, NH training styles are heterogeneous. This study investigated online videos of RPT to explore the characteristics of RPT sessions and test for differences in techniques and outcomes between amateurs and professionals (the latter being defined as those with accompanying online materials that promote clinics, merchandise or a service to the public). From more than 300 candidate videos, we selected sample files for individual amateur (n = 24) and professional (n = 21) trainers. Inclusion criteria were: training at liberty in a Round Pen; more than one bout and good quality video. Sessions or portions of sessions were excluded if the trainer attached equipment, such as a lunge line, directly to the horse or the horse was saddled, mounted or ridden. The number of bouts and duration of each chasing and non-chasing phase were recorded, and the duration of each RPT session was calculated. General weighted regression analysis revealed that, when compared with amateurs, professionals showed fewer arm movements per bout (p<0.05). Poisson regression analysis showed that professionals spent more time looking up at their horses, when transitioning between gaits, than amateurs did (p<0.05). The probability of horses following the trainer was not significantly associated with amount of chasing, regardless of category. Given that, according to some practitioners, the following response is a goal of RPT, this result may prompt caution in those inclined to give chase. The horses handled by professionals showed fewer conflict behaviours (e.g. kicking, biting, stomping, head-tossing, defecating, bucking and attempting to escape), and fewer oral and head movements (e.g. head-lowering, licking and chewing) than those horses handled by amateurs Overall, these findings highlight the need for selectivity when using the internet as an educational source and the importance of trainer skill and excellent timing when using negative reinforcement in horse training.
| S-EPMC5602637 | biostudies-literature
Project description:ContextHiring athletic trainers (ATs) in high schools may lower medical payments by third-party payers such as Medicaid or commercial insurers by reducing injury risks or may increase medical payments due to more referrals to other health care providers. To date, evidence is lacking on the actual financial effect of high school ATs based on an analysis of medical claims.ObjectiveTo assess the overall cost-benefit of hiring ATs in Oregon high schools based on medical claims data across years.DesignCost-benefit study.SettingOregon public high schools.Patients or other participantsPatients aged 14 to 18 years old.Main outcome measure(s)We analyzed the 2011-2014 limited dataset from the Oregon Health Authority's All Payer All Claims database. Paired t tests were used to compare claims payments at the zip code level between periods of having and not having ATs in Oregon high schools. We also used the percentage of AT effort to adjust for AT investment. The main outcome measure was the return on investment associated with hiring ATs in high schools.ResultsThe presence of ATs in Oregon high schools may have had different effects on medical payments for Medicaid and commercial insurance. With every dollar invested in hiring ATs in Oregon public high schools from 2011 to 2014, Medicaid payments increased by 24 cents per month at the zip code level, while commercial insurance payments decreased by 24 cents, although the changes were not statistically significant.ConclusionsHiring ATs in an outreach model for high schools may not necessarily generate medical savings for Medicaid or commercial insurers. Further research is needed to determine if the lack of cost savings in our study was a factor of the employment model, resulted from increased health care utilization, or reflected the need for ATs to deliver more on-site AT services.
| S-EPMC6464301 | biostudies-literature
Project description:ContextAs the demand for athletic training services has grown, the per diem athletic training setting has expanded to fulfill this need. Per diem services are provided by athletic trainers (ATs) who are hired as independent contractors for short time periods. These service opportunities help to increase access to care for medically underserved populations; however, due to the transient nature of the work, the quality of care may be compromised.ObjectiveTo examine current practices in per diem services and evaluate ATs' accessibility to resources.DesignCross-sectional study.SettingOnline survey.Patients or other participantsA total of 448 participants responded (access rate = 9.57%), of whom 210 were ineligible (46.9%). Of those who were eligible, 192 participants completed the entire tool (completion rate = 80.7%, age = 38 ± 12 years, years certified = 14 ± 11, years providing per diem services = 8 ± 8).Main outcome measure(s)The survey comprised 3 sections: (1) demographics, (2) accessibility to resources and influence on patient care, and (3) domains of athletic training while providing per diem services. Resources assessed included those that are relevant to ATs practicing in accordance with the Board of Certification "Standards of Professional Practice." The final instrument included approximately 30 questions (depending on display logic) and took an average of 12 minutes to complete.ResultsOf the 11 primary resources assessed, participants had limited accessibility to 6. Critical resources related to informatics, legalities, and health care delivery were often not available, were seen as unimportant to providing medical services, or both.ConclusionsParticipants indicated varied perceptions about the need for and access to these resources. Yet such resources contribute to the creation of a safe infrastructure for providing medical services and should be part of the routine dialogue regarding independent contracting.
| S-EPMC7863608 | biostudies-literature
Project description:ContextIn December 2019, severe acute respiratory syndrome coronavirus 2, also known as the novel coronavirus disease 2019 (COVID-19), became a global public health crisis. Government officials in the United States subsequently responded by issuing lockdown orders that closed schools, terminated sports, and resulted in many people transitioning to working from home, immediately affecting the ability of athletic trainers (ATs) to practice clinically.ObjectiveTo describe the job status, job duties, telemedicine use, and resiliency of ATs during the COVID-19 pandemic.DesignCross-sectional study.SettingMixed-methods survey.Patients or other participantsA total of 611 ATs (age = 32 ± 13 years).Main outcome measure(s)The survey consisted of 6 demographic questions, a job status assessment (3 questions, 1 open-ended prompt), a telemedicine use assessment (5 questions, 2 open-ended prompts), and the 6-item Brief Resilience Scale. Qualitative analyses were completed using Text iQ technology and descriptive statistics, and cross-tabulations were conducted using follow-up χ2 comparisons of resiliency with job setting and telemedicine use.ResultsMost ATs continued to work in some capacity throughout the COVID-19 pandemic and expressed optimism about the likelihood that their job status and setting would return. However, participants shared financial and mental health concerns because of reduced pay, stress, and uncertainty about the future. We also identified versatility within the profession, as ATs were serving in new roles related to COVID-19 or adopting telemedicine (n = 251, 41.1%). Athletic trainers were implementing all domains of clinical practice using telemedicine, yet most did not consult legal counsel on or have formal training in the delivery method before implementation. Finally, most ATs exhibited normal resilience that was not affected by job setting (χ2 = 26.901, P = .68) or the use of virtual health care (χ2 = 2.597, P = .27).ConclusionsThe COVID-19 pandemic has affected ATs' jobs, and in many cases, the ATs have demonstrated adaptability and value in assuming various roles in the larger health care system.
| S-EPMC7863602 | biostudies-literature
Project description:The Internet offers low-cost ways to participate in political life, which reduces the motivation required to participate and thus potentially reduces inequalities in participation. I examine online and offline contacting of elected officials using original survey data from Canada, France, the United Kingdom, and the United States collected in 2019 and 2021. Education is a consistent positive predictor of contacting in all countries as well as both modes of contact (online and offline). Income differences are small. Younger people are more likely to contact officials, online and offline, compared to older people. Females are less likely to contact officials, online and offline, compared to males. While political interest, efficacy, online information consumption, and online group ties are believed to lead to more equity in online communication, I do not see strong differences in these variables for online and offline contacting. I conclude by discussing the implications of exclusively online contacting of officials when this form of contact is devalued by elected officials, as well as the implications of participatory inequalities with respect to influencing public policy and access to government services.
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