Successful dissemination of guidelines needs to consider the relevant implementation context

But publishing guidelines only in sports medicine journals means they only reach a particular target group, especially if no consideration is given to implementation and dissemination strategies more widely.2 There is no doubt that sports medicine practitioners should be one of the major target groups for this information, but there are many other stakeholder groups (eg, coaches3) that are overlooked with this approach. Ensuring effective and sustained sports safety actions across all levels of sport, such as concussion guideline adoption, requires recognition of the ecological context in which sport is delivered, how participation is undertaken and the range of both professional and volunteers who support them.4 The implementation role of the key stakeholders at each ecological level of concussion guideline implementation is shown in table 1.

The principles behind optimal knowledge transfer for concussion guidelines and education internationally has previously been discussed in the BJSM.5 To our knowledge, the preferred specific information sources for concussion knowledge have not been summarised. We draw on our experiences within a community (or recreational) sport delivery setting that is common in many parts of the world to give suggestions for which organisations and/or professional groups should be the delivery agent/producer of such information.

How do players and parents want to be informed about concussion?

In the setting of community-wide Australian football participation, we have previously reported that both players6 and parents of junior players7 have limited awareness of concussion guidelines and have concerns about their ready application in community sport. These perceptions lead to the natural conclusion that both players and parents need to be better informed and educated about all aspects of concussion guidelines. Importantly, this cannot be achieved through papers published in peer-review journals and specific dissemination strategies would be needed for this. As part of our discussions with both stakeholder groups,6 7 we asked them about their preferred sources of concussion information. As shown in tables 2 and 3, no one said ‘a medical journal’.

How do doctors want to be informed?

Given the importance of doctors, both as the recognised expert responsible for actioning concussion guidelines mentioned in the Consensus Statement1 and as an important and preferred source of information recognised by both players and parents,6 7 we surveyed general practitioners about their concussion knowledge and their preferred sources of information.8 As shown in table 4, none indicated ‘peer-review medical journal’ as a major concussion information source. Moreover, the vast majority of preferred sources were not linked to organisations or professionals most commonly directly associated with sport and its delivery—they wanted to get their information from recognised medical and medical education sources.

Bring in the social marketing experts

A recent study9 has stressed the need to involve stakeholders ‘from the outset to ensure the incorporation of sport-specific contextual influence that will increase the potential for wide-scale adoption and scale-up of preventive research findings’. As our findings show, the avenues for sports injury information dissemination preferred by these stakeholders are quite different to what is of most relevance to sports medicine practitioners; none are publications in peer-reviewed journals. Importantly, communicating with the broader medical community about concussion will require the sports medicine sector to first engage more directly with general medical education and update avenues, as doctors are unlikely to readily recognise new information sources disseminated through sport-specific channels. So while disseminating information about concussion through local/national/international sports bodies might reach players and their parents, it will not reach the general community-based medical profession.

We are fortunate to now have expert-agreed, evidence-based statements to guide the management and detection of concussion.1 But this information will only reach and also be adopted by all stakeholders if targeted disseminated strategies are used and the learnings from  social marketing are now applied.2 New approaches to information dissemination that engage the range of organisations and practitioner groups, including intermediary agencies such as peak agencies10 must be the focus of concussion prevention and management efforts going forward.