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Sport-related head injuries place a significant burden on the health service delivery systems needed to treat and assess them; the sport delivery systems responsible for providing safe sporting opportunities; and personally on the individuals who sustain them. The number of head injury occurrences, the anecdotally high levels of public concern about the risk of head injury in sport and the fact that there is so much public misinformation about their assessment, management and prevention1–3 make the prevention of sport-related head injury a health priority. The most recent international consensus statement on the management of concussion in sport stated that there is a need to develop guidelines, education resources and other health promotion approaches for the prevention of head injury and its adverse outcomes across all sports with a risk of serious head injury.4 However, while there is evidence that some educational resources and guidelines have been developed, these have had varying success because they have not incorporated social marketing approaches.2 ,3 ,5
The content of concussion prevention
Three meetings have developed international consensus and furthered the evidence base about the understanding and management of concussion in sport.4 ,6 ,7 The 2001 meeting defined concussion and recommended that management strategies be based on individualised clinical and cognitive recovery assessment post-injury.7 The 2004 meeting produced a standardised concussion assessment tool (the SCAT) to help medical personnel diagnose, assess and manage concussions; the concept of a concussion ‘rehabilitation’ protocol was introduced to facilitate a step-wise graded return-to-play programme.6 In 2008,4 the SCAT was modified to include an assessment of balance and more detailed screening of brain function (the SCAT2) and a brief sideline version was developed to help identify concussions on-site (PocketSCAT2). Management of concussion in specific subpopulations (eg, children) was also considered, with agreement that these …