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Introduction: Current research recommends that students returning to school after a concussion should receive a return to school plan that is tailored to their individual symptoms. School professionals play important roles in designing and implementing the supports outlined in return to school plans. Methods: This qualitative study explored middle and high school professionals' experiences with concussion, particularly their knowledge and perceptions of the injury and their experience with supporting students with concussion. Six focus groups were conducted with two to four school professionals per group, including two groups of teachers, two groups of school psychologists and counselors, and two groups of school nurses. Findings were coded into four categories: (a) challenges with identifying a concussion; (b) strategies for communicating with students about concussion; (c) barriers to implementing return to learn plans; and (d) establishing a collaborative school support team. Results: School professionals who participated in the focus groups were knowledgeable about concussion and the importance of helping their student recover. Participants also understood the importance of recognizing the signs and symptoms of concussion and communicating with students and parents about this injury. However, the study participants reported various challenges related to concussion identification and management, including the perceived validity of concussion symptom reporting by students. A team-based approach was mentioned across all groups as the preferred method for school-based concussion management for students. Conclusion: School professionals in this study were eager to address concussion in their schools, but desire guidance on how to overcome social norms around concussion identification and reporting. In addition, there is a need for consistent use of written instructions from healthcare providers to help guide return to learn (RTL) accommodations.

Background: Concussion, a commonly reported injury among young athletes, can lead to short-and long-term physical, cognitive, emotional, and sleep-related symptoms. Parents are in a unique position to help identify a possible concussion and to support an athlete's recovery. Methods: This qualitative study used a focus group methodology to explore five research questions focused on two main topics: (1) parents' perception of concussion and (2) parent-athlete communication. Two authors independently reviewed notes from each of the focus groups and then generated a list of emerging themes related to five research questions. Results: Parents in this study valued and were interested in discussing concussion with their athletes. However, parents were uncertain about their role in promoting concussion safety and often rely on coaches to communicate with athletes about concussion reporting and recovery. Participants described barriers their athletes may face in concussion reporting and suggested strategies to improve communication about both reporting and recovery. Conclusion: Concussion education efforts may benefit from promoting specific actions parents can take to prevent concussion and how to communicate effectively with their child about reporting a possible concussion.

Background: For 15 years, the US Centers for Disease Control and Prevention’s (CDC) HEADS UP education campaign has focused on increasing awareness of concussion among children to reduce adverse outcomes from this injury. Objective: To keep pace with the rapid expansion in media coverage, research, state laws and education efforts on concussion, the CDC embarked on a comprehensive evaluation effort to assess the campaign’s brand. Method: The CDC conducted a multi-step process to evaluate HEADS UP. This included surveying partner organisations and focus groups targeting key audiences. Results: The analysis demonstrated that most (70%) partner organisations have used the materials for 4 years or longer, and more than half (51%) found the materials very useful or extremely useful. Focus groups with the campaign’s target audiences yielded insights and opportunities to refresh the CDC HEADS UP brand. The need for more compelling images, prevention facts and use of eye-catching colours was signalled by all the campaign’s target audiences. Updates focused on the use of data visualisation, more emotionally compelling images and more engaging colours. The CDC also created a new tagline to focus on concussion prevention that encourages children and young people to think about protecting their brains from concussion so that they can have a safer future. Conclusion: This paper describes the process used to update the branding of an educational health promotion campaign in order to meet the needs of key audiences. Findings can help others working to keep their educational campaigns relevant and aligned with expanding and changing public health problems.

To identify opportunities to improve coach-athlete communication, this study examined young athletes' perceptions and concerns about concussion, as well as their information needs. A qualitative data collection approach, based on the grounded theory methodology, was utilized. Six virtual focus groups were conducted with 17 male and female athletes’ ages 12 to 18 years. Results indicated that athletes were concerned about the potential long-term effects of a concussion. Athletes described multiple barriers that interfere with concussion reporting, including: being unfamiliar with concussion signs and symptoms, perceived pressure from teammates, concerns of interference that concussion reporting can have on gameplay, and a lack of focus on concussion during play. To help address these, participants expressed an interest in hearing frequently and directly, such as during a pre-game or practice huddle, from coaches about concussion and how to prevent this injury. The results demonstrate that concussion education programs can consider promoting messages for coaches to deliver to athletes about concussion prevention strategies and the benefits of concussion reporting on an athlete’s long-term health.