One Team: Changing the culture of youth sport

项目总结/摘要 青年运动相关脑震荡越来越被认为是一个公共卫生问题。降低 脑震荡的健康负担需要（a）减少脑震荡发生的次数， 减少危险碰撞（初级预防）和（B）确保年轻人不玩 脑震荡症状，从而导致更大的风险（二级预防）。规则是一种有希望的手段 为实现这些变化（即，取缔长矛，要求运动员从比赛中删除，如果 但如果我们不改变青少年体育文化，改变规则是无效的 关于安全。加强不惜一切代价获胜价值观的体育文化引导运动员，教练和父母 无视旨在保障运动员安全的规则裁判，其中许多人往往是未成年人 在这种环境中，他们自己也面临着执行规则的挑战。改变体育文化需要 我们如何看待干预的范式转变。先前为降低脑震荡发生率所做的努力， 减少年轻人玩脑震荡症状的比例效果有限，因为他们确实 不要在系统层面进行干预。改变体育文化需要与多个利益攸关方进行干预 （裁判员、教练员、运动员、家长）并强调遵守规则的价值观 与脑震荡安全有关。我们提出了一个名为“一个团队”的干预措施， 来改变青少年体育文化。蜷缩最初是在足球中发展起来的，但它已经被 医疗系统采用的一种方式，使关键利益相关者参与，以提高安全性。一个团队 干预措施将使用赛前安全会议，将教练、运动员、家长和裁判聚集在一起， 申明：（a）体育价值观（即不参与危险和非法碰撞）和（B）共享 没有运动员在脑震荡时打球。与足球和足球教练合作， 运动员，家长和裁判员在西雅图西澳大利亚州和斯泰茨伯勒GA使用社区参与的过程中，我们将 完善“一个团队”的干预措施，并对实施情况和效力进行试点评估。我们还将 与我们的国家合作伙伴（疾病控制和预防中心，美国足球和美国足球）合作 在整个研究过程中，确保我们开发的产品符合他们的组织需求， 传播平台和渠道。在这项研究完成后，我们将进行干预， 转变青年体育中的安全文化，并使其能够触及所有青年体育利益攸关方，包括低收入者， 资源社区。

PROJECT SUMMARY/ABSTRACT Sports-related concussion in youth is increasingly being recognized as a public health concern. Decreasing the health burden of concussion requires both (a) decreasing the number of concussions that occur by decreasing dangerous collisions (primary prevention) and (b) ensuring that youth are not playing with concussive symptoms and thereby incurring greater risk (secondary prevention). Rules are a promising means for effecting such changes (i.e, outlawing spearing, requiring that athletes be removed from play if a concussion is suspected), but changing rules is not effective if we do not also shift the culture of youth sport regarding safety. Sport cultures that reinforce values of winning-at-all-costs lead athletes, coaches and parents to disregard the rules that are intended to keep athletes safe. Referees, many of whom are often minors themselves, face challenges enforcing rules in such environments. Changing the culture of sport requires a paradigm shift in how we think about intervention. Prior efforts to decrease the incidence of concussion and decrease the rate of youth playing with concussive symptoms have had limited effectiveness because they did not intervene at a systems-level. Changing sport culture requires intervening with multiple stakeholders (referees, coaches, athletes, parents) and addressing the values that underlie a commitment to following rules related to concussion safety. We propose an intervention called “One Team” that will utilize safety huddles to shift the culture of youth sport. The huddle was originally developed in football, but it has been adopted by the medical system as a way to engage key stakeholders to improve safety. The One Team intervention will use pre-game safety huddles to bring together coaches, athletes, parents and referees to affirm: (a) values of sportsmanship (i.e, not engaging in dangerous and illegal collisions) and (b) shared responsibility that no athlete play while concussed. Working in partnership with football and soccer coaches, athletes, parents and referees in Seattle WA and Statesboro GA using a community-engaged process, we will refine the One Team intervention and conduct pilot evaluations of implementation and efficacy. We will also work with our national partners (Centers for Disease Control and Prevention, US Soccer and USA Football) throughout this research to ensure that the product we develop will align with their organizational needs, dissemination platforms and channels. At the completion of this research we will have an intervention that will shift the culture of safety in youth sport and that can reach all youth sport stakeholders, including those in low resource communities.