Working with Sports Coaches on Athlete Safety and Injury Prevention

Background:  In the United States, there are over 6.5 million youth sports coaches (the majority of whom are volunteers) and an estimated 1 million high school coaches. Whether in the youth sport or high school setting, coaching is often a demanding and highly influential job. Coaches play a significant role in shaping a young athlete’s overall sports experience. Young athletes look to their coach to understand the culture of sport and expectations of safe play. Coaches also play an important role in concussion prevention, identification, response, and recovery for young athletes. Coaches are present at every practice, every game, and every tournament. They are often the first adult a young athlete approaches to report a possible concussion and they make decisions about sitting an athlete out or letting them continue playing. Young athletes also look to their coach to learn about concussion and understand expectations around concussion reporting and safe play. 

Program background:  Over the past ten years, CDC has conducted formative testing with youth and high school sports coaches about their concussion knowledge, attitudes and behaviors for the HEADS UP Initiative. This included focus groups, in-depth-interviews, and/or surveys with coaches, in addition to research and informal conversations with coaching and sporting organizations. 

Evaluation Methods and Results:  As part of a larger project that reviewed 105 primary research studies about key audiences addressing concussion, including parents, athletes, health care providers and school professionals, CDC recently conducted a literature review covering coaches’ knowledge, attitudes, and behaviors regarding concussion, as well as existing concussion educational efforts. Thirty-six primary research studies about coaches were reviewed. Coaches are well positioned to promote concussion-symptom reporting among their teams. Coaches often feel a sense of pride in seeing their sport or leadership organization affiliated with prevention and safety efforts. By educating their athletes about concussion and praising symptom-reporting behaviors, coaches can encourage a culture of safe and fair play. The majority of youth sports coaches are volunteers who have limited time and resources to take trainings or learn about new health topics. Yet, if engaged properly, coaches can facilitate educating others about concussion and help begin to change social norms around injury reporting.

Conclusions:  Youth and high school sports coaches play an invaluable role in concussion prevention. Research on coaches’ knowledge, attitudes, and behaviors has informed the development and approach of CDC’s HEADS UP Initiative. This approach has helped CDC gain a rich understanding of coaches’ learning needs and preferences in order to more effectively engage coaches and enhance the HEADS UP Initiative. Coaches are community leaders and role models to both athletes and their parents and can be effective agents for bringing health information home to families. 

Implications for research and/or practice:  There are opportunities to engage youth and high school sports coaches to foster a sports culture that supports concussion safety. Close collaboration and input from coaches and the organizations that serve them can maximize the impact of their involvement and the success of the effort.