Objective Ontario 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.

Design Descriptive.

Setting Ontario public school boards (n=72).

Participants and main results In 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 measures As 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.

Conclusions Significant 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 interests None.