Academic Review Article: Essay

Educating Coaches About Concussion in Sports: Evaluation of the CDC’s
”Heads Up: Concussion in Youth Sports” Initiative
Written By
Tyrell Thomas Tarboro
Vanguard Univerity
April 07, 2017
Article: Educating Coaches About Concussion in Sports: Evaluation of the
CDC’s ”Heads Up: Concussion in Youth Sports” Initiative by Tracey
Covassin, PhD, ATC; R. J. Elbin, PhD; Kelly Sarmiento, MPH
Publication: The Journal of School Health [J Sch Health] 2012 May; Vol. 82
(5), pp. 233-8
Educating Coaches About Concussion in Sports: Evaluation of the CDC’s
”Heads Up: Concussion in Youth Sports” simply evaluates the effectiveness
of the Heads Up Initiative and the difference in youth coaches education
and readiness such as preventing, recognizing, and responding to
concussions. Also, the article states, “it is important that individuals
involved in youth sports, coaches in particular, be aware of the signs and
symptoms of concussion and know how to respond if a concussion is
suspected.” According to Valovich-McLeod, “only 61% of youth coaches could
correctly identify the symptoms of a concussion pre-and-post mortem” (P.

234). The creator of the Heads Up program created a questionnaire composed
by a panel of specialist that range from physicians to youth coaches to
gauge the knowledge of the youth coaches on concussions. The objective of
this research was to see if the tools from the Heads Up education program
provided youth coaches with a better understanding on how to prevent,
recognize, and respond to concussion. Their research found that coaches who
possessed the Heads Up information six months prior to the questionnaire,
felt that this information was helpful to them in their coaching and
education of concussions. Even though this survey was limited to a small
sample size and the knowledge of the youth coach’s previous knowledge on
concussions prior to the survey was unknown, the consensus on the CDC’s
assessment of the Heads Up program is that this material taught coaches
either something new about concussions or provided them with the
information to teach the kids, coaches, and parents about concussions. This
article concluded that all school officials involved in athletics and
coaches should implement a pre-season, mid-season, and post-season
checklist to include training on concussions to maintain the education and
knowledge to prevent the mishandling of this serious injury.

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Research Problem
Concussions are defined as temporary unconsciousness or confusion due to an
injury to the head. Concussions have become an increasing problem for
athletes playing sports, primarily in youth because the symptoms are not
always present immediately as with adults causing long term effects of the
brain to go unnoticed and untreated. With concussions increasing every year
and becoming more publicized, the attention has been placed on educating
coaches, players and parents on how to prevent, recognize, and respond to
concussion in a timely manner to prevent long term diseases form developing
in the brain. The articles hypothesis states, “it is important that
individuals involved in youth sports, coaches in particular, be aware of
the signs and symptoms of concussion and know how to respond if a
concussion is suspected.” The objective of this research was to see how
educated youth coaches were on concussions after receiving the Heads Up
material and if they were teaching they were properly preventing,
recognizing and responding to concussions in their athletes.

Research Design and Procedures
A 22-question survey was sent out to a small sample size of 1,000 coaches
to gauge their knowledge and understanding of concussions and the
effectiveness of the Heads up educational material. The survey was sent out
to coaches who had been given the Heads Up material 6 months prior to the
survey. The survey questions varied from demographic to their awareness of
the Head Up material they received and what they knew of the program, and
also what was their general knowledge of concussions. The coaches were
asked their opinion on how serious they thought concussions were and what
materials from the Heads Up program they thought were most helpful when
educating other about concussions. The survey did not specify if the
questions were open-ended or closed-ended, nor did the article specify how
the survey was administered.

Findings and Data Analysis
Of the 336 coaches who completed the survey, 77% of the coaches stated that
they could better identify the signs of a concussion., with 50% stating
that they found out something new about concussions. All of the coaches
agreed that having the Heads Up educational material help them to be able
to prevent, recognize, and respond to a concussion. Also the coaches stated
that they were going to pass the material along and educate other coaches
and parents on the seriousness of concussions.

I do not find that the data 100% supports the hypothesis because the
research was done to see the significance of the Heads Up material and how
much it helped the coaches, however, it was never stated the experience of
the coaches nor was there a controlled group of coaches that were
interviewed. With the experience level not being a requirement to answer
the survey, how truthful are the facts that 50% of the coaches stated that
learned something new. It favors the finding to assure that the
information. The article broke down the sports in which the coaches who
took the survey were a part of, and not all of the sports have the same
concussion rate. If a person is coaching youth golf, it is most likely not
going to have the same concussion rates as football or soccer, so of
course a coach’s answers are going to skew the results because his or her
experience may not be the same. This goes in line with the result of 23.2%
(78/336) of the coaches not believing concussions are serious injuries,
because that injury may not be a factor in the sport they coach.

Flaws in Procedural Design
This survey was issued out without knowing the extent of what these youth
coaches knew about concussions. The coaches were only limited to the
questions on the survey, leaving no room for them to inform the interviewer
of the survey what they really knew. Meaning, a coach’s knowledge of
concussions could have been really high and the results of this survey
would have been a little bias because he assumption of the survey was that
the material provided by Heads Up gave the coaches more than what they
knew. The survey was sent out to 1,000 coaches but there was only a
response of 340 coaches, which is a 34% response rate. This small sample
size can have bias results because the overall findings were that over 50%
of the coaches reported learning something new, but the average years
coached from all of the coaches was 7.8 years. Numbers like these can bias
if you have 160 coaches who have coached for 2 years but the remaining
coaches have coached for 20+ years your numbers are going to be off.

Considering the different styles in coaching and how they change over the
years, an older coach’s stance on players with concussion may differ from a
coach who is brought up in the age of advanced medicine and concussions.

This can affect numbers like: percentages of coaches who learned something
new, if a coach feels it’s his duty to educate parents on concussion,
whether a coach will put a plyer back in after receiving a concussion, or
if concussions are a serious problem. I have played for older coaches and
newer coaches and there is a significant difference in how they approach a
concussion. Some of my older coached have told me that if I wasn’t
unconscious then I didn’t have a concussion, and with the coaches of the
newer generation that I have played for they have advanced techniques for
determining if a player has a concussion.

Even though the article stated that the demographic was taken into
account when administering this survey, only 340 coaches replied. There is
really no way to know how many youth sports programs there are in the U.S.,
and for a sample size this small 340 coaches can’t speak for the masses.

The survey wasn’t broken down to be sport specific, gender specific, or
surrounding environment specific, which all of these attributes can affect
how a coach may answer these questions. The future studies recommended to
focus study on the policies laws being passed and the awareness of coaches
on concussions, and doing this with controlled focus groups. I think for
this to be extremely successful and accurate a survey from every sport,
every gender, and every state should be done, and even though a project
like this can take a long time and be costly the overall result of the
survey would be more accurate.

Research Conclusions and Recommendations
The author’s state that with the help of the Heads Up educational material
77% of the youth coaches said that they were able to identify concussions
with more ese after possessing the material. 50% of the coaches said that
they learned something new, concluding that the Heads Up program was a
success on a small scale. The CDC believes that making this material
accessible to more youth coaches it will help with the implementation of
future concussion laws and policies. Any school or parental official
working with youth athletic associations should prepare for concussion
before athletes take the field. A pre, mid, and post season checklist can
be accessed on, to help coaches and parents prepare
athletes for their upcoming season and keep them updated on concussion
material throughout their season. As a high school football coach, I make
it a priority to keep my athletes educated on the proper techniques to keep
themselves safe from concussion, it is the due diligence of a coach to put
safety before winning or pride.

Researcher’s Reputation
Tracey Covassin, PhD a graduate of Temple University, is an associate
professor in the kinesiology department and a certified athletic trainer in
the Sports Medicine Program for the Department of Athletics at Michigan
State University. Tracey Covassin’s area of expertise is kinesiology and
she currently has an active grant with the Joe D. Pentecost Foundation: A
Prospective Examination of Neurocognitive Function, Balance, and Symptom
Reporting in Youth and High School Athletes with Sport-Related Concussions.

R. J. Elbin, PhD is an assistant professor in Exercise Science at the
University of Arkansas, and Director of Office for Sports Concussion
Research. Dr. Elbin’s research focuses on developing best practice for
concussion education; identifying factors that contribute to concussion
risk and prolonged recovery; and documenting the persistent effects of
concussion on neurocognitive, psychosocial, and vestibular/oculomotor
functioning in youth and adolescent athletes.

Dr. Elbin has also given over 100 lectures on sports related concussions
and has published over 60 peer-reviewed publications for journals.

Kelly Sarmiento, MPH expertise are in the “Heads Up” program and concussion
where she serves a Health Communications Specialist for the Division of
Unintentional Injury Prevention’s Home and Recreation Team. Kelly leads the
“Heads Up” program which is intended to educate all who have a common
objective to prevent, recognize and respond to concussions in children.

Kelly obtained her Bachelor’s degree from University of California, Santa
Barbra and her Master’s degree from Yale University School of Epidemiology
and Public Health. Her innovations have led to her being awarded within the
public health and health communication fields.

Tracey Covassin – Directory – College of Education – Michigan State
University. N.p., n.d. Web. 05 Apr. 2017.

Dr. R. J. Elbin Bio. N.p., n.d. Web.
content/uploads/2016/09/Elbin_Bio.pdf. A brief bio of Dr. Elbin and his

“Executive Leadership and Expert Bios.” Centers for Disease Control and
Prevention. Centers for Disease Control and Prevention, 31 Mar. 2016. Web.

05 Apr. 2017.

Covassin, T., Elbin, R. J., & Sarmiento, K. (2012). Educating coaches about
concussion in sports: evaluation of the CDC’s “Heads Up: concussion in
youth sports” initiative. The Journal of School Health, 82(5), 233-238.



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