Understanding Concussion Knowledge in Urban Community Settings: Perspectives of School Nurses and Youth Athletic Program Leaders

This study explored concussion knowledge, education, and organizational policies among school nurses (n = 12) and youth athletic program leaders (n = 14) in the Philadelphia area from June-September 2023. Using semi structured interviews, questionnaires, and thematic analysis, three themes emerged: (1) School nurses and youth athletic program leaders know their roles in concussion management but welcomed more education. (2) System-level gaps in concussion oversight beyond organized sports exist for younger children, those injured via non-sport related mechanisms, in recreational settings, or during free play. (3) Challenges in concussion care exist including lack of concussion awareness, parental engagement, language barriers, and access to health care. Although both school nurses and athletic leaders generally possess baseline concussion knowledge, they identified missed cases, particularly non sport related injuries, and insufficient return to play or return to learn procedures in recreational environments. Findings highlight the need for targeted, community specific concussion education to address disparities in youth concussion management.