Experience with canada’s first school-based concussion policy, and overall evaluation using a modified delphi methods

Abstract

ObjectiveOntario is the first province in Canada to implement a school-based concussion policy, Policy/Program Memorandum (PPM) 158. It requires all public school boards to develop a concussion strategy. The aim of this research was to conduct a pilot assessment of PPM 158 implementation in one large school board, and then to develop a novel policy evaluation tool to evaluate how well all 72 school board concussion strategies align with best practices identified through a modified Delphi method.DesignDescriptive.SettingOntario public school boards (n=72).Participants and main resultsIn the pilot assessing PPM 158 implementation, there were 39 respondents of 109 high school principals in the Toronto District School Board (TDSB). 92% of schools provided education to students in the TDSB, and fewer educated staff (85%) or parents (43.6%). Most schools had return-to-play protocols (92%) and fewer had return-to-learn protocols (77%).Outcome measuresAs a result of the pilot study, it was decided to develop the following outcome measures: stakeholder concussion education for staff, parents and students; mode of education; and existence of return-to-play and return-to-learn protocols. Policy evaluation will comprise the following: score achieved on the policy evaluation tool to be developed through a modified Delphi method, which reflects how each policy compares with best practices recommendations.ConclusionsSignificant progress has been made in developing school-based concussion in the single board assessed, but there are deficiencies in certain areas of implementation. This research has informed policies that target childhood concussions in Ontario and beyond.Competing interestsNone.