Countywide Concussion Program (Miami Concussion Model)

With the national spotlight on concussions sustained in contact sports, this Countywide Concussion Program addresses the unique challenges presented to public and private high schools in order to increase concussion awareness, identification, and management. In order to prevent and reduce the consequences of injuries, the CDC recommends the public health approach; describing the problem, identifying the risk and protective factors, developing and testing preventative interventions and strategies, and ensuring widespread adoption of the interventions and strategies.

This model was used to develop the Miami Concussion Model (MCM), a 3E model that includes components of Education, Execution, and Evaluation. The MCM was developed with a standard protocol that includes: formation of a task force of stakeholders; concussion education and training to coaches, athletic trainers, and athletes; baseline ImPACT testing; the facilitation of ‘return to play’ decisions with effective medical treatment; and the development and implementation of a concussion injury surveillance system.

The MCM was implemented in Miami-Dade County in 2011. This model, or a modified version, can be implemented to centralize concussion management in other counties and communities across the country. There is a unified need in every community for the development of concussion care protocol with the ever-increasing awareness and liability involved in high school sports.

The goals of the MCM are to provide a comprehensive and centralized concussion care program to 1) increase concussion awareness and identification through education and training; 2) facilitate the return to play decision with effective medical treatment, which includes baseline neurocognitive testing; and 3) implement a standardized concussion care protocol and concussion injury surveillance system to assist in the prevention of concussions, improve player safety, and limit school liability.

From the pilot evaluation of the model it was determined that the MCM model or a similarly designed one is effective in increasing the number of concussions identified, reported, and also treated at a clinic.

The MCM outlined this program is designed to be a guideline that can be adapted to the needs of different communities. Data will continue to be collected and analyzed to evaluate the effectiveness of this program. With limited coordination and low cost for baseline testing, it is important to have a concussion management program in place.

This program specifically was successfully implemented in 40 high schools in Miami-Dade County (MDC), with baseline testing of 18,357 student-athletes over two years. The MCM provided training for over 100 coaches and 40 athletic trainers, and also provided concussion education to high school football athletes. Since 2011, the concussion clinic had treated a total of 216 high school athletes and the surveillance system had tracked 198 student athletes.