Researchers Put Youth Sports Safety and Concussion Awareness Ahead of the Game With Novel Program

Seattle Children’s researchers consulted with the Northwest Junior Football League before moving ahead with a CDC-funded program addressing safety and concussion awareness in youth sports. Photo courtesy of Brian Bodine Photography/NJFL

Seattle Children’s researchers will launch an innovative program in early 2018 aimed at shifting the culture of safety in youth sports and building concussion awareness during competitive play.

The program, called One Team, emphasizes community engagement in conducting brief pre-game safety huddles involving coaches, officials, parents and athletes, with a goal of addressing both sportsmanship and the importance of removing an athlete from play if they potentially have a concussion.

Dr. Sara Chrisman and Dr. Emily Kroshus, both members of the Seattle Pediatric Concussion Research Collaborative and Seattle Children’s Center for Childhood Health, Behavior and Development, designed the program.

“We want to change how children, parents and coaches relate to injuries, and reinforce a line in athlete safety that shouldn’t be crossed, even in a competitive atmosphere,” Chrisman said.

A $1.6 million grant from the Centers for Disease Control and Prevention will fund development and implementation of One Team among children ages 9 to 13 in youth football and soccer leagues in the Puget Sound region and southern Georgia. The first year of One Team will focus on refining the program, followed by a year-long randomized controlled trial evaluating outcomes in sportsmanship and playing with concussive symptoms.

Huddling up for safety

The One Team program will target 9- to 13-year-olds in soccer and football leagues in the Puget Sound and southern Georgia.

Many hospitals use daily safety huddles to raise awareness of risks, highlight safety tools, decrease medical errors and establish a culture of patient and provider safety.

Chrisman and Kroshus thought a pre-game safety huddle could be impactful in addressing youth sports concussions, which affect an estimated 1.1 to 1.9 million children in the United States each year.

“A key focus of One Team is changing concussion reporting and removing the fear that a player will have a diminished role on their team when they return to play after a concussion,” Kroshus said.

The researchers also hope One Team emulates hospital safety huddles in encouraging those who aren’t at the top of the workplace hierarchy to comfortably voice concerns on safety issues.

“We know from prior studies that pressure from parents and coaches can influence the extent to which youth sports referees enforce rules, and that affects game safety,” Kroshus said. “It’s much easier to speak up if the community supports a culture of safety.”

Current efforts to prevent concussions in youth sports are primarily focused around rule changes to minimize forceful collisions affecting the head and neck area, and improving concussion identification to mitigate further damage with continued play.

Engaging the community to turn theory into reality

Chrisman and Kroshus turned to community members to see if the safety-huddle approach of One Team would be embraced by youth sports leagues.

“We thought we had a good theory but we knew that if the change came from within the community, it would be more effective,” Chrisman said.

Dr. Frederick Rivara, who leads the Collaborative, suggested Chrisman and Kroshus connect with officials from the Northwest Junior Football League. Rivara was already working with NJFL President Mike Shigley and NJFL Safety Director Rob Laris on a landmark longitudinal study of concussions.

Shigley and Laris have been instrumental in helping the NJFL develop a concussion awareness program, enforce rule changes, issue players with better-fitting better equipment, institute player sportsmanship pledges and emphasize less tackling in practices.

“We’ve tried to take steps to help prevent that first concussion from even happening,” Laris said.

Kindred spirits of safety

Seattle Children’s researchers Drs. Emily Kroshus (left) and Sara Chrisman designed and will lead the development of the One Team program.

Seeking to encourage high standards of conduct, Shigley and Laris incorporated pre-game sportsmanship huddles and post-game sportsmanship awards at NJFL contests near the end of the 2016 season. They thought having officials and coaches deliver sportsmanship messages to both teams before games could positively influenced the behaviors of players and parents.

While conduct did improve, in discussions with Chrisman and Kroshus, Shigley and Laris also realized player safety was impacted.

“Our pre-game huddles were primarily to improve conduct and behavior,” Shigley said. “We saw fewer injuries after the pre-game huddles were instituted. We didn’t really make the connection between safety and conduct until we started talking with Dr. Chrisman and Dr. Kroshus.”

Shigley and Laris are both eager to embrace One Team as it develops.

“The safety huddle brings all of the game’s stakeholders together,” Shigley said. “It’s challenging to get everyone on the same page, but we really think it has a lot of potential.”

Chrisman and Kroshus are currently speaking with other youth sports leagues in the Puget Sound to develop partnerships in implementing One Team.

“We’re excited to get started,” Chrisman said.

Chrisman and Kroshus have also involved other collaborators, including Dr. Tamerah Hunt at Georgia Southern University, U.S. Soccer Chief Medical Officer Dr. George Chiampas, and Dr. Ann Glang at the University of Oregon.


Seattle Pediatric Concussion Research Collaborative

Seattle Children’s Research Institute Center for Child Health, Behavior and Development

Northwest Junior Football League

Football study to focus on head injuries in players ages 6-14 – UW Medicine

Sports- and Recreation-Related Concussions in US Youth – Pediatrics