An Implementation-Effectiveness Study of an Evidence-Based Intervention to Improve Head Impact Safety in Youth Football

项目总结 由于其潜在的关联性，接触性运动中反复的头部撞击是一个重大的公共卫生问题 有短期和长期的神经缺陷。在研究人员中，有争议的是 暴露可能导致神经认知改变；一些研究人员已经证明这些改变 可能发生在一个赛季的时间跨度。青少年足球运动员占参赛运动员总数的70% 运动和在练习中经历了超过一半的头部撞击--一个可以干预的环境。 目前的一项研究(1K25HD101686-01A1)将开发一种旨在减少头部的循证干预 使用社区参与的方法，在实践中影响暴露。这项建议加强了这项家长研究 通过结合临床结果评估和让足球运动员参与干预的评估 程序。这项执行成效研究的目的是评估 减少实践中暴露的干预计划及其对减轻临床变化的影响 在监测执行进程的同时，监测结果。在目标1中，神经认知测量、姿势 对照和前庭/眼运动症状将由参加对照和训练的运动员评估 在赛季前和赛季后的时间点干预青少年足球队以及非接触性运动队。 生物力学数据将用来测量赛季中命中的频率和严重程度 定制仪表式吹嘴。干预措施在减少头部撞击暴露和 将对临床结果的缓解变化进行评估。在目标2中， 将评估干预计划的实施策略，以告知干预计划的结果。 参加高中和大学级别的前青少年足球运动员将被聘请来评估 干预方案的可行性和可接受性。这项研究的结果将提供重要的试点数据 关于减少暴露对临床结果的影响，同时告知干预计划如何运作和 为未来干预的大规模测试提供了有价值的见解。博士后候选人将 通过伤害生物力学、公共卫生、 实施科学、神经心理学和运动医学。这一奖学金机会也将提供 创伤性脑损伤的健壮传授训练和经验学习，生物力学数据方法 收集和实施科学、生物统计学、临床试验设计、神经认知测试管理和 口译和专业发展。本次博士后研究和培训计划将 将成功的候选人定位为一位富有成效的独立研究科学家，并将其技能组合在一起 伤害生物力学和公共卫生评估伤害预防策略。

PROJECT SUMMARY Repetitive head impacts in contact sports are a significant public health concern due to their potential association with short- and long-term neurological deficits. There is debate amongst researchers as to the amount of exposure that may lead to neurocognitive changes; some researchers have demonstrated that these alterations could occur over the span of one season. Youth football players represent 70% of all athletes participating in the sport and experience over half of their head impacts during practice - an environment amendable to intervention. A current study (1K25HD101686-01A1) will develop an evidence-based intervention aimed to reduce head impact exposure in practices, using a community-engaged approach. This proposal enhances this parent study by incorporating clinical outcome assessments and engaging football athletes in the evaluation of the intervention program. The objective of this implementation-effectiveness study is to evaluate the effectiveness of the intervention program on reducing exposure in practices and its effect on mitigating changes in clinical outcomes, while monitoring the implementation process. In Aim 1, measures of neurocognition, postural control, and vestibular/ocular motor symptoms will be evaluated from athletes participating on control and intervention youth football teams as well as non-contact sports teams at pre- and post-season time points. Biomechanical data informing the frequency and severity of hits during the season will be measured using a custom instrumented mouthpiece. The effectiveness of the intervention at reducing head impact exposure and mitigating changes in clinical outcomes will be evaluated. In Aim 2, the feasibility and potential utility of the implementation strategy of the intervention program will be assessed to inform intervention program outcomes. Former youth football players participating at the high school and collegiate level will be engaged to evaluate the feasibility and acceptability of the intervention program. The results of this study will provide important pilot data on the effect of reducing exposure on clinical outcomes, while informing how the intervention program works and providing valuable insight into future large-scale testing of the intervention. The predoctoral Candidate will achieve the study aims through cross-disciplinary mentorship in injury biomechanics, public health, implementation science, neuropsychology, and sports medicine. This fellowship opportunity will also provide robust didactic training and experiential learning in traumatic brain injury, methods of biomechanical data collection and implementation science, biostatistics, clinical trials design, neurocognitive test administration and interpretation, and professional development. The research and training plan of this Predoctoral Fellowship will position the Candidate for success as a productive independent research scientist with a skillset to combine injury biomechanics and public health to assess injury prevention strategies.