Concussions in sports have received much focus recently; however, the consequences of non-concussive head impacts, more common and thus potentially more important, may have a greater influence on brain health in youth athletes. With ~ 3.5 million football players between ages 6 and 13 each year, there is a critical need to reduce head impact exposure, thereby improving safety of youth football. Several youth football organizations have implemented regulations to reduce contact and concussion risk; but we lack biomechanical evidence in youth football to inform policies on reducing head impact exposure. Football practices are controlled environments amenable to intervention; however, the most effective targets for intervention or how best to design and implement effective interventions in this context is unknown. In other areas of research, engaging community members has repeatedly been shown as essential for successful development, implementation, and sustenance of viable interventions. The objective is to develop and pilot test an evidence-based intervention to reduce head impact exposure in youth football, using a community-engaged approach. A comprehensive mentored training program has been planned, closely aligned with the following research aims.
In Aim 1, 30 youth football players participating on two teams at the middle school level (ages 12-14) will be fitted with mouthpiece-based head impact sensors. Biomechanical data will be collected and quantified during team activities which will be used to inform discussions with stakeholders (coaches, parents, league officials). Using an audit and feedback approach, sharing biomechanical data with stakeholders, and an anonymous survey, we will assess awareness and receptivity to change.
In Aim 2, mixed methods will be used to integrate data identified from literature and Aim 1. Stakeholders will be engaged to identify, develop, and refine evidence-based strategies to reduce head impact exposure at each level of the social ecological model. Outcomes will include defined objectives, guidelines, resources, and a timeline for implementation of an intervention.
In Aim 3, two new youth football teams at the middle school level (ages 12-14) will be recruited to pilot-test the intervention developed in Aim 2. Head impact exposure will be measured from 30 athletes participating on the 2 teams using head impact sensors and the effectiveness of the intervention at reducing head impact exposure as well as the feasibility, acceptability, and fidelity of the intervention will be evaluated. The implementation process will be monitored and findings will be disseminated to the youth football league. The skills gained, data gathered, and methods developed in this K25 Award will position the Candidate for success as an independent investigator combining public health science and injury biomechanics to develop, test, and improve injury prevention strategies.
Head impact exposure in contact sports such as football is a rising concern, since it appears that exposure to repetitive head impacts, even if a concussion is not suspected, may be linked to brain disease later in life and changes in the brain over a single season. This K25 Mentored Quantitative Research Development Award will develop and pilot test an evidence-based intervention to reduce head impact exposure in youth football, involving coaches and parents in the development of the intervention. Formal training in organizational systems theory, intervention planning and evaluation, community engagement, and implementation monitoring will prepare the applicant to lead future studies combining public health sciences and injury biomechanics to develop, test, and improve injury prevention strategies among youth athletes.
