Online Program

Promoting and inhibiting factors in implementing state youth sports concussion laws: Results of a survey of state implementers

Monday, November 4, 2013 : 11:30 a.m. - 11:45 a.m.

Kerri McGowan Lowrey, JD, MPH, Network for Public Health Law--Eastern Region, University of Maryland Francis King Carey School of Law, Baltimore, MD
Stephanie Morain, MPH, Interfaculty Initiative in Health Policy, Harvard University: Health Policy, Cambridge, MA
As of 12/31/2012, youth sports concussion legislation was effective in 42 states and the District of Columbia, all passed since 2009. While the laws contain very similar provisions aimed at secondary prevention (e.g., secondary impact syndrome, early-onset dementia, suicide), little is known about how they are being implemented or what factors promote or inhibit implementation. We conducted a qualitative interview study to explore states' experiences with implementing concussion laws, conducting key-informant interviews over 5 months with individuals from state agencies/organizations charged with implementation. As of 2/1/2013, with a response rate of 74% (32 interviews, 31 of 43 states represented), findings suggest considerable heterogeneity. Respondents report that factors facilitating implementation include involvement of the implementing agency/organization in the lawmaking process, prior state-level activity, preexisting resources and partnerships, and “lead time” before the law's effective date. Factors impeding implementation include vague/imprecise statutory terminology, geographic access to trained medical professionals, and decentralized nature of recreational sports. Respondents reported a desire for requirements not included in their state laws, including “return to learn” guidance and training for additional groups. Enforcement mechanisms are minimal-to-nonexistent, and we identified almost universal belief that education and awareness resulting from the law will have the greatest impact on reducing negative outcomes. States' ability to collect data for policy evaluation seems to be tied to existing partnerships (e.g., with academic medical centers). Our research provides an important first step in evaluating the effectiveness of youth sports concussion laws, as well as information to guide lawmakers in drafting public health legislation.

Learning Areas:

Administration, management, leadership
Other professions or practice related to public health
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe the legal/policy landscape related to state youth sports concussion laws and the rapid pace of enactment since 2009. Discuss possible reasons for rapid enactment and implications for future public health policymaking. Identify challenges or inhibiting factors related to implementation of state sports concussion laws reported in interviews with officials charged with implementation. Identify promoting factors, best practices, and strategies for overcoming challenges to implementing youth concussion laws. Discuss next steps in evaluating effectiveness of youth sports concussion laws.

Keyword(s): Injury Prevention, Law

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Deputy Director of the Network for Public Health Law's Eastern Region and a public health lawyer with 13 years of experience conducting legal, legislative, and policy research on a variety of public health topics, including injury prevention policy issues such as graduated drivers licensing, safe routes to school laws, and youth sports concussion laws.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.