Parent-Child communication about concussion: what role can the Centers for Disease Control and Prevention's HEADS UP concussion in youth sports handouts play?

Only 94 parents completed both surveys, so the primary analysis compared different parents at different time points rather than tracking the same people. The authors describe this as a cross-sectional approach. Estimated response rate was about 15% of 9,464 eligible parents. Respondents were likely more interested in concussion safety than non-respondents. All sites were YMCA branches. Parents were predominantly female, white, and held undergraduate or graduate degrees, limiting generalizability to other settings and demographics. The intervention was a single handout distribution with a request to discuss it. The authors call this a low-dose intervention and note that more intensive approaches might produce larger effects. The study measured only whether parents talked to their child about concussion. It did not measure whether the child's actual behavior (reporting symptoms, leaving play) changed. The YMCA setting and the specific coach-to-parent-to-child chain of dissemination may not replicate in other youth sports organizations.

No conflicts of interest declared. Funded by NIH (intramural and extramural). Conducted as part of a larger evaluation of CDC HEADS UP materials, approved by the FHI 360 Institutional Review Board. The CDC is the agency whose handouts are being evaluated.

The 33% increase is a within-group change from pre to post season, not a head-to-head treatment effect between the two arms. Only 94 parents completed both surveys, so the primary analysis compared different parents at different time points. The sample was about 15% of an estimated 9,464 eligible parents, mostly white and highly educated, in YMCA settings. This does not show that the conversation changed what the child actually did after a suspected concussion.