Interscholastic Athletics Research Articles

The privilege to play: race, gender, & SES advantages in boys’ high school athletic opportunities

ABSTRACT In this study, with an exploratory sequential mixed-methods design, we considered the components and implications of a habitus that (re)produces racial/ethnic, social class, and gender differences in US interscholastic sport participation. We drew from independently collected qualitative (N = 19 men and 47 total college athletes) and quantitative (N = 4,097 high school boys) data and noted and investigated dynamic links between individual choices; family, community, and school contexts; and power structures that inform interscholastic athletics. Findings positioned sports as offering valuable institutionalized cultural capital but being rife with reproductive struggles. Schools serve as fields that co-construct unequal athletic opportunity structures by nurturing and rewarding a cultivated athletic habitus associated with masculinity, whiteness, and affluent dispositions. These processes situate athletic advantages and successes as purely meritorious but restrict who is most likely to receive the individual and social benefits of high school sports participation.

Coaching Endorsements, Certifications, Policies, and the Need for Reform in Florida School Sports: Why We Need to Lead the Change

The purpose of this article to the editor is to introduce the special issue and highlight some of the challenges that coaches and coach educators face today. Specifically, it provides an example of the current state of the coach certification system within Florida’s public schools. It identifies significant concerns, including outdated certification standards, insufficient training, low coach retention, and poor compensation. Practical suggestions for comprehensive reforms are proposed, including mandatory coach training, updated certification content, professional development, and increased stipends. These solutions aim to break the cycle of inadequacy in Florida’s coach certification system and enhance the quality of interscholastic athletics and the safety and well-being of student-athletes. The article calls for more coaches, athletic directors, and academic educators to take a more active role in policy reform.

Geographic Disparity in Distance to Trauma Care in Secondary Schools Across the United States.

Geographic disparities exist in trauma care (ie, "trauma center desert") within the United States. An athletic trainer (AT) on site at secondary schools (SSs) may help enhance collaboration with emergency medical systems and potentially lead to better outcomes after catastrophic injuries. However, access to AT services relative to the location of level I or II (ie, tertiary) trauma centers remains unknown. To visualize and describe the distance between SSs and trauma centers and compare access to AT services across the United States. Cross-sectional study. Public and private SSs with interscholastic athletics programs in the United States. Survey data obtained through the Athletic Training Locations and Services (ATLAS) project database between September 2019 and April 2023. The minimum distance from each SS to a tertiary trauma center was calculated on Tableau Desktop by geocoding with longitude and latitude. The status and level of AT employment were obtained from the ATLAS project database. The odds and percentages of access to AT services were examined by distance ranges. A total of 18 244 SSs were included in the analyses. Of these, 75% (n = 13 613) were located within 50 miles (81 km) of a tertiary trauma center. The odds of access to AT services were 2.74 (95% CI = 2.56, 2.93) times greater in SSs situated within 50 miles of a tertiary trauma center (P < .001). Additionally, SSs located more than 60 miles (97 km) from a tertiary trauma center had decreased access to AT services (R2 = 0.9192). This study highlighted the geographic disparities in distance to trauma care for SSs in the United States. Those SSs located more than 60 miles from trauma centers had reduced odds of access to AT services. Identification of geographic trends of AT services relative to the location of tertiary trauma centers is a critical first step in preventing fatal consequences of catastrophic injuries.

Inequalities in Girls’ High School Sports Participation: How Social Class, Race/Ethnicity, and Gender Route Opportunities to Play and Persist in Athletics

ABSTRACT High school athletics are understudied sites for social and educational stratification. Participation can offer mental and physical health benefits, improved student retention and graduation rates, the encouragement of pro-social behaviors, resume building, and enhanced social statuses. Despite legal prohibitions against race and gender discrimination in schools, opportunities to play and persist in interscholastic athletics may reflect and amplify existing social and educational stratification processes. Using an exploratory sequential mixed-methods research design, this study centers on girls’ high school sports and considers how gender, race/ethnicity, and social class operate at the individual, interactional, cultural, and institutional levels and encourage proclivities, commitments, and support for participation. We combine qualitative (N = 28 women and 47 total college athletes) and quantitative (N = 4,271 high school students) studies to inquire about how, and to what extent, racial/ethnic and social-class dynamics affect girls playing any and specific high school sports and whether they play persistently. Findings suggest that schools co-construct unequal athletic opportunity structures by nurturing and rewarding a cultivated athletic habitus associated with masculinity, whiteness, and affluent dispositions. These processes disguise athletic advantages and successes as well-earned merit and restrict who is most likely to receive the individual and social benefits of high school sports participation.

Spinal Cord Injury Management Policies in High School Sports as Reported by Athletic Administrators

ABSTRACT Introduction/Purpose Athletic administrators (AA) in U.S. high schools are uniquely positioned to provide guidance and endorsement for the prevention and management of common sport-related catastrophic injuries, such as the development of a spinal cord injury management (SCIM) policy. The purpose of this project was to evaluate AA’s knowledge of comprehensive SCIM policies in U.S. high schools. Secondarily, we aimed to investigate the factors, facilitators, and barriers to the development and adoption of comprehensive policies. Methods An online questionnaire was distributed to 6423 AA working in U.S.-based high school athletics, with 366 included in the final data analysis. The questionnaire evaluated AA’s knowledge of comprehensive SCIM policies addressing components of adoption, documentation, and communication. The questionnaire was developed based on the 2002 “National Athletic Trainers’ Association Position Statement: Acute Management of the Cervical Spine-Injured Athlete.” The questionnaire also inquired about facilitators and barriers to developing and adopting comprehensive policies. Proportions were calculated for policy adoption, and independent-samples t-tests evaluated the influence of athletic training services on comprehensive SCIM policies. Results About half of AA (49.2%, n = 180/366) reported having all recommended components of a written SCIM policy. AA who had access to an athletic trainer (yes = 62.9%, no = 18.1%, unknown = 19%) were more likely to have a comprehensive SCIM policy compared with those without access (80.6% vs 19.4%, χ 2 1 = 7.091, P = 0.008, prevalence ratio = 1.24, 95% confidence interval = 1.03–1.50). The most commonly reported facilitator (49.9%) was “having a medical professional at the school,” and the main barrier (30.2%) was “my school would need more information, resources, assistance, etc.” Conclusions The findings identify areas for improvement in supporting the health and safety of children in high school participating in interscholastic athletics. Future dissemination and implementation research should develop strategies tailored to individual school community and need to improve SCIM policy adoption and implementation.

Abstract 12668: Prevalence of Phenotypic Hypertrophic Cardiomyopathy Among Students Referred for Sport Pre-Participation Cardiovascular Screening

Background: Although rare, sudden cardiac death (SCD) is a tragic event for young sports participants and has catastrophic impact on the community. Hypertrophic cardiomyopathy (HCM) is a leading cause of SCD in sports. Comprehensive initial pre-participation physical evaluation (CIPPE) is mandated for middle school, and junior and senior high school students by Pennsylvania Interscholastic Athletic Association (PIAA) primarily for reducing potential sports-related injuries and SCD. Prospective data has been limited in this age group in regard to the prevalence of HCM. Methods: Between 2015 and 2023, we prospectively screened 424 students [age 10-21 (15±2) years, 60% male, 64% Caucasian) referred for cardiovascular disease pre-participation screening based on at least one positive response on the 14-point AHA questionnaire during CIPPE. Evaluation included 12-lead ECG and rhythm strip (100%), transthoracic echo (96.4%), ambulatory heart rhythm monitor (3.8%), treadmill exercise ECG (14.5%), stress echo (2.1%), and cardiac MRI (0.9%). Results: Overall, 1 (0.24%) student was diagnosed with definitive and two were diagnosed with probable HCM [Table-1]. Conclusion: In this prospective cohort of middle school and junior and senior high school students with at least one positive response to the 14-point AHA questionnaire, 1 (0.24%) had definitive and 2 (0.47%) had probable phenotypic HCM.

Abstract 12669: Yield of Systematic Screening for Cardiovascular Disease in Young Sports Participants

Background: Although rare, sudden cardiac death (SCD) is a tragic event for young athletes. Comprehensive initial pre-participation physical evaluation (CIPPE) is mandated for middle, junior high and senior high school students by Pennsylvania Interscholastic Athletic Association (PIAA) primarily for reducing potential sports injuries and SCD. Those with positive screening for cardiac disease [on 14-element AHA screening questionnaire] are referred for cardiac evaluation. We prospectively evaluated yield of cardiac screening in this age group. Method: From 2015 to 2023, 424 students [age 10-21 (15±2) years, 60% male, 64% Caucasian, 43% overweight) referred for cardiac screening. Evaluation included 12-lead ECG and rhythm strip (100%), transthoracic echo (96.4%), ambulatory monitor (3.8%), exercise ECG (14.5%), stress echo (2.1%), and cardiac MRI (0.9%). Results: Actionable abnormalities were found in 25 (5.9%) and included hypertension (n=8), bicuspid aortic valve (n=4, Figure:A), ascending aortic aneurysm (n=3, Figure:B*), definite or probable hypertrophic cardiomyopathy (n=3, Figure:C), atrial septal defect (n=2), mitral valve prolapse (n=2), aortic insufficiency (n=1), coronary artery anomaly (n=1) and ventricular tachycardia requiring ablation (n=1). Conclusion: Although uncommon, a systematic approach to screening in young sport participants can lead to identification of serious unsuspected cardiovascular disorders in 1 out of 17 students.

Evaluating the Use of Communication and Technology by High School Athletic Directors to Navigate the COVID-19 Pandemic

High school athletics represents a major segment of the sport industry and is regarded as an important component in youth development in the United States. With the rise of the COVID-19 pandemic, challenges emerged that forced athletic directors to provide essential information to key stakeholders, keep people safe, and identify new ways to bring events to fans. To further understand these experiences, this commentary aimed to evaluate the use of communication and technology by high school athletic directors to address challenges, develop new strategies, adapt to day-to-day changes, and manage the long-term impacts of COVID-19 on interscholastic athletics. Through in-depth interviews with athletic directors, responses demonstrated how enhanced communication with key stakeholders (i.e., athletic programs and fellow athletic directors) and a reliance on technologies (i.e., digital ticketing and online live streaming) helped these leaders successfully navigate the pandemic and develop new strategies that will persist into the future.

The Sports Revolution: How Texas Changed the Culture of American Athletics by Frank Andre Guridy

Reviewed by: The Sports Revolution: How Texas Changed the Culture of American Athleticsby Frank Andre Guridy David K. Wiggins The Sports Revolution: How Texas Changed the Culture of American Athletics. By Frank Andre Guridy. Texas Bookshelf. ( Austin: University of Texas Press, 2021. Pp. x, 418. $29.95, ISBN 978-1-4773-2183-6.) I like this book very much. Frank Andre Guridy, utilizing a nice combination of secondary and primary source material, provides a very interesting and insightful analysis of sports in Texas and, by extension, in American culture more generally. Although some might be overwhelmed by its 353 pages of text and disappointed by its limited coverage of interscholastic athletics, the book provides important and detailed information largely about the role and [End Page 590]changing pattern of college and professional sports in the Lone Star State from the end of the Jim Crow era to the 1980s. I have no doubt readers of The Sports Revolution: How Texas Changed the Culture of American Athleticswill gain a better appreciation of the large number of outstanding athletes and culturally significant sporting events that took place in Texas during a rapidly changing and tumultuous period in American history. Guridy covers some frequently told stories such as the integration of football at Southern Methodist University and the subsequent scandal that rocked its gridiron program, the well-known Battle of the Sexes tennis match between Billie Jean King and Bobby Riggs at the Houston Astrodome, the enormous success of the University of Houston's basketball program popularly referred to as Phi Slama Jama, the football dominance of the University of Texas Longhorns, and the emergence and ultimate success of the San Antonio Spurs professional basketball team. He also examines some stories not as well known, including perhaps most important the origin and cultural significance of the Dallas Cowboys cheerleaders. In the process, Guridy provides interesting details on the athletes, coaches, owners, and support personnel who contributed to the vibrant and nationally prominent sports programs in Texas. He furnishes significant details and background information, for example, on perhaps the greatest woman athlete of all time, Mildred Ella "Babe" Didrikson; the University of Texas's great running back Earl Campbell; Jerry LeVias, who integrated the Southern Methodist University football program; coach Guy Lewis, who masterminded the University of Houston's highly successful basketball team; oil tycoon Lamar Hunt, who co-founded the American Football League (AFL); Gussie Nell Davis, who led the highly skilled Kilgore Rangerettes drill team; tennis legends Rosemary "Rosie" Casals and Gladys Medalie Heldman; the Dallas Cowboys' famous coach Tom Landry; Texas Rangers owner Robert E. Short; and University of Houston football coach Bill Yeoman. Adding immeasurably to the effectiveness of the book is the fact that Guridy places sports in Texas in proper historical context and consistently draws connections to what was taking place in the industry on a national scale and how sport in the state both impacted and was impacted by larger societal changes and movements. Virtually every page of the book is filled with engaging details about the business side of athletics and how smart, wealthy, and imaginative entrepreneurs transformed how sports were organized, viewed, and financed. Guridy effectively connects sports in the Lone Star State to the larger civil rights struggle and explains how Black athletes increasingly found their way into intercollegiate and professional sports while still suffering the pangs of racial discrimination and being viewed as commodities in institutions still controlled largely by white men. Guridy also effectively connects sports in Texas to the second-wave feminist movement and illuminates how women athletes negotiated for better treatment while at once struggling to overcome the sexist views and gender stereotypes so rampant in a culture that continued to trivialize their efforts at bodily excellence and skill development. In all, there is much to recommend about Frank Guridy's The Sports Revolution. It is a nicely written, compelling, and thoughtful book that provides an awareness of and appreciation for the changing nature of sports in [End Page 591]Texas specifically and American culture more broadly. I expect it to have a long shelf life and to be of interest to those who want to learn more...

“If I can help somebody”: The civic-oriented thought and practices of Black male teacher-coaches

ABSTRACT Fostering a sense of civic engagement is considered an essential purpose of social studies education. However, given the ways in which formal civic curricula and standards decenter the impact of racial membership on civic status, Black teachers are turning to alternative, out-of-school sites to enact critical approaches to teaching civics. Interscholastic athletics serves as one locale for such revisionist practices. This multiple case study troubles the centrality of Whiteness and deficit notions within the teacher-coach discourse by explicating the civic practices of five Black male teacher-coaches who served in schools that were not predominantly Black. Drawing on a conceptual framework rooted in Black critical theories, their civic mindedness of coaching ideologies and civic-oriented activities fostered a sense of liberatory fantasy while immersed within an anti-Black milieu.

A Mixed-Methods Approach to Identifying Ethical Issues Pertinent in Interscholastic Athletics

The purpose of this study was to investigate three research questions: (a) What are the ethical issues most pertinent to interscholastic sport today, as well as in the next 5 years? (b) How important are those ethical issues to interscholastic athletic administrators? (c) What are the potential implications of those pertinent ethical issues to practicing interscholastic athletic administrators? For the first inquiry, the Minnesota State High School League (MSHSL) provided 14 contemporary ethical issues that were most pertinent to interscholastic sport today, as well as in the next 5 years: behavioral issues, competing club sports, competitive balance, emphasis on winning, health concerns, nontraditional sports, outside sport organizations, participation for all, pay-to-play organizations, promises by camp organizers, scholarship myth, sportsmanship, too much structure, and win at all costs. For the second proposition, a national study was conducted with athletic directors from the National Interscholastic Athletic Administrators Association (n = 170) annual conference. Following a survey in which participants ranked issues according to importance, a one-tailed analysis of variance determined significant differences among the 14 ethical issues identified by the MSHSL. Four issues exhibited significant differences based on region: behavioral issues, promises by camp organizers, scholarship myth, and win at all costs. A Games-Howell post hoc determined significant differences across geographical regions of the United States for these four ethical issues. For the third research question, semistructured interviews provided insight on the implications for practicing athletic administrators. Athletic administrators generally emphasized the importance of the issues identified in this study.

Tinkering With Policies in the Digital Age: How Interscholastic Athletic Directors Address Social Media Use by Student-Athletes

Social media use by student-athletes has become a topic of concern for interscholastic athletic directors. The recent Mahanoy Area School District v. B.L. Supreme Court case highlighted how student speech has evolved in the digital age. This study explored how Texas interscholastic athletic directors view social media policy implementation and the effect it has on student-athlete behavior. Semistructured interviews were conducted with 13 athletic directors across all six University Interscholastic League enrollment classifications. Analysis revealed that athletic directors do have legal concerns when restricting online off-campus speech but see a need for promoting positive social media use by their student-athletes. The results suggest high school athletic departments must update their policies frequently to ensure that the information relayed to student-athletes is current, relevant, and based on recent case law.

A mixed-methods approach to identifying participation issues pertinent in interscholastic sports

ABSTRACT The purpose of this mixed-methods study was to investigate three propositions: (a) What are the participation issues most pertinent to interscholastic athletic administrators? (b) What is the perceived level of importance of these participation issues to athletic administrators? and (c) What are the potential implications of those pertinent participation issues to practicing athletic administrators? A national study was conducted with athletic directors (n = 170) from the National Interscholastic Athletic Administrators Association annual conference. Athletic directors completed a survey to identify and then rank in terms of importance issues that they face on a daily basis. The 14 issues identified as most important were framed within five categories: Education Base Athletic Programs, Recruitment, Specialization, and Student-Athletes. A one-tailed ANOVA was executed to determine significant differences based on geographical region among these participation issues. Following the quantitative survey, follow-up qualitative interviews were conducted to further delve into the most important issues. The results offer insight from which further investigations could be conducted to continue building on policies that influence interscholastic administrators’ day-to-day accountability when overseeing their programs.

Servant Leadership: Navigating the Ethical Challenges in Athletics

The purpose of this article is to explore principles of servant leadership as a solution to the ethical improprieties mounting in the world of intercollegiate and interscholastic athletics. This article will provide a synthesis of servant leadership literature that highlights the importance of behavioral integrity and its role in building trust and strengthening interpersonal relationships. This specific case of servant leadership will provide a model for fostering an ethical climate in sport and expose current leadership practices in intercollegiate athletics that place organization needs ahead of player development and support the need for ethical reform in intercollegiate athletics.

Indiana Public High School Parents’ Perceptions of Interscholastic Competitive Balance

As part of the educational mission of interscholastic athletics, ensuring competitive balance is a priority of state athletic associations nationwide. Specifically, teams playing within a postseason championship tournament should have a fair and equitable chance to win. Private high schools, in particular, have been the focus of competitive balance scrutiny from public high school stakeholders due to disproportionately high success in many states. Despite much anecdotal scrutiny from public stakeholders, it is not clear how much they know about interscholastic policy or private school characteristics. Therefore, this study set to explore Indiana public high school parents’ perceptions of interscholastic competitive balance through qualitative interview data. Using thematic analysis, five themes emerged from the data influential to competitive balance (location, policy, sport culture, financial resources, and education). Each of these themes was influenced by an omnipresent private school impact, which reinforced a need for additional education of policy and private school characteristics.

Unpacking educational athletics: An exploratory study of high school athletic directors' critical praxis

ObjectivesGiven the salience and popularity of interscholastic athletics, whether high school sport serves as a site for inclusive, empowering experiences for youth participants has significant implications. This study examined how U.S. high school athletic directors think about and navigate (i.e., praxis) broader social issues in their work with student-athletes and coaches to promote youth development. DesignA cultural praxis framework informed qualitative study design consisting of semi-structured interviews with 16 athletic directors from various high school community contexts within one Midwestern state. MethodReflexive thematic analysis of interviews with high school athletic directors employed a semantic (explicit, surface level) and latent (implicit, interpretative) focus (Braun & Clarke, 2019; Braun, Clarke, & Weate, 2016). ResultsSemantic analyses indicated that athletic directors used various strategies to navigate matters that arose in their work with student-athletes and coaches. Relevant issues were contextually situated and emerged as (in)congruent with their context. Latent analyses shed light on assumptions that ADs made about student-athlete development and demonstrated that sport leaders' critical praxis varied along a continuum. ConclusionFuture research is needed to more systematically examine how athletic directors engage in a (critical) praxis; student-athletes’ perspectives on the relevance of certain social issues and efficacy of administrators' praxis; and, developmental initiatives to empower youth and adult leaders in athletics.

What Teens Need From Sport Programs: Educational Athletics by Transformational Coaches

Traditional conceptions of interscholastic athletics describe an “extended classroom” environment in which students develop positive psycho-social skills within a supportive team culture and positive learning climate. However, as the “professionalized model” of youth sport has become more prevalent, with its “win-at-all-cost” mentality, some school leaders have begun to question the educational value of interscholastic sport participation. The authors assert that education-based athletic programs are what teens need from schools and can still result in positive outcomes.

The Chance to Be Champions: Discrediting the Myth That Transgender Athletes Are Not Damaging to Women’s Sports

Have you ever stopped to consider whether unfair competition in sports can be a form of discrimination? The federal case Soule v. Connecticut Association of Schools grapples with this very question. This case tells the story of three high school track and field athletes – Selina Soule, Alanna Smith, and Chelsea Mitchell – whose journeys to becoming champions were cut short when the Connecticut Interscholastic Athletic Conference (CIAC) allowed transgender female athletes to run in the girl’s events and dominate the competition. On May 15, 2020, the Civil Rights Office of the U.S. Department of Education determined that the CIAC’s policy discriminated against women and violated Title IX, a federal law designed to provide equal opportunity for girls and women in federally funded educational institutions. While this decision is a small victory for female athletes in Connecticut, across the country the transgender athlete controversy is far from over. The question remains whether it is possible to provide gender inclusion while maintaining a level playing field for cisgender athletes in sports. There is a significant amount of research to suggest that transgender athletes competing according to their gender identity threaten to dissolve women’s sports as we know it. Both history and traditional values illustrate that the word “sex” means a person’s biological makeup as male or female, and redefining its meaning to be gender inclusive opens the door for case law and politics to manipulate the legal protections afforded female athletes. Science and psychology provide clear evidence that men and women have biological distinctions that keep individuals from ever fully changing their birth sex and that transgender female athletes put the most elite cisgender female athletes at a big disadvantage. Ultimately, the goal of this article is to explain how protections for transgender female athletes in the name of “equality” actually set back the women’s rights movement and could permanently eliminate the social and economic benefits that women receive when participating in competitive sports.

Interscholastic Athletics and Bone Strength: The Iowa Bone Development Study.

Pashkova, A, Hartman, JM, Letuchy, EM, and Janz, KF. Interscholastic athletics and bone strength: the Iowa bone development study. J Strength Cond Res 36(5): 1271-1276, 2022-The objective of this study was to determine the relationship between adolescents' participation in various interscholastic sports and differences in bone strength outcomes. Subjects (N = 380) were recruited from the Iowa Bone Development Study and categorized based on sport participation into 3 power groups: no-power, low-power, and high-power. Sports such as basketball, cheerleading/poms, gymnastics, volleyball, track, football, tennis, and soccer were considered high-power. Peripheral quantitative computed tomography (pQCT) was used to determine bone measures of polar stress-strain index (measure of torsion strength), cortical content (measure of cortical bone size and area at the 66% tibia site), and bone strength index (measure of compression strength based on total bone density and area at the 4% tibia site). Adjusted pairwise comparison for group least squares means high-power sport participation compared with no-power sport participation showed significant differences in all bone strength outcomes for both men and women (p value < 0.01). There was a significant difference in all bone strength measures between low-power and no-power groups for men (p value < 0.05), but not women. Because of decreasing levels of physical activity in late adolescence, the promotion of high-power sports may be particularly important for optimal bone development in the final years before peak bone mass.

Perceptions of implementation of Massachusetts sports concussion regulations: results of a survey of athletic directors

BackgroundIn 2011 the Massachusetts Department of Public Health issued regulations pursuant to 2010 Massachusetts youth sports concussion legislation that provided policies and procedures for persons engaged in the prevention, training, management, and return-to-activity for students who sustain head injury during interscholastic athletics, including Athletic Directors (ADs).MethodsA survey instrument was developed with participation from injury prevention experts at the Boston University School of Medicine, the Massachusetts Department of Public Health, and ADs. An electronic survey was sent to all AD members of the Massachusetts Interscholastic Athletic Association to assess their perceptions of implementation of the sports concussion law.ResultsResponse rate was 75% (260/346). The mean rating on a 0–10 scale (10 being “very important”) on importance of the law for student safety was 9.24, and the mean rating of the law’s impact on workload was 5.54. Perceived impact on workload varied as a function of whether or not the school also employed an athletic trainer (t = 2.24, p = 0.03). Most respondents (88%) reported that their school had a concussion management team, and 74% reported that they were informed “always” (31%) or “often” (43%) when a student-athlete experienced a head injury in a venue other than extracurricular sports. Most respondents (95%) endorsed that “all” or “most” school nurses were “very knowledgeable” about the law and regulations. Approximately half of all respondents endorsed that “all” or “most” teachers and guidance counselors were “very knowledgeable” about the law and regulations; 76% endorsed that “all” or “most” of students’ physicians were “very knowledgeable” about the law and regulations; 59% endorsed that “all” or “most” parents were “very knowledgeable” about the law and regulations. Sixty-six percent endorsed that student-athletes with concussion “often” (10%) or “sometimes” (56%) misrepresent their symptoms to accelerate return-to-play; and, 70% perceived that student-athletes with concussion “often” (15%) or “sometimes” (55%) misrepresent their symptoms to avoid academics.ConclusionsADs perceive the sports concussion legislation as very important to student safety and positively assess implementation of the law and associated regulations. More effort is needed to increase understanding of the law among stakeholders including teachers, parents, and physicians.