Objective To 1) identify barriers and facilitators for detection of sport-related concussion; 2) Develop an evidence-based toolkit.

Design Cross-sectional survey.

Setting Sport Organizations and stakeholders in Canada

Participants A survey was completed by 225 stakeholders (131 high performance; 58.2%) involved in the management of concussion in sport [81 (21.4%) sport administrators, 24 (10.7%) parents, 53 (23.6%) coaches, 29 (12.4%) officials, 41 (18.2%) players, 27 (12.0%) health care professionals, 21 (9.3%) other stakeholders].

Interventions N/A

Outcome Measures Participants completed a survey informed by previous Canadian Concussion harmonization processes (meetings, workshops and surveys) and the literature based on the Theoretical Domains Framework. Questions included demographics, awareness of protocols and challenges with implementation of concussion detection by stakeholder type. Both high performance and grass roots stakeholders face validated the questionnaire. A toolkit to address barriers was subsequently developed.

Main Results A total of 21.3% (48/225) of participants did not feel confident using the Concussion Recognition Tool 5 (CRT5). Nine out of twenty-one (42.9%) officials did not feel confident knowing if a player should be removed from the game compared to few parents (1/18; 5.6%), coaches (1/34; 2.9%) and no health care professional. Stakeholders also reported that they wanted additional training beyond written material. To address these challenges, a video with interactive case examples was developed and reviewed by multiple stakeholders.

Conclusions Concussion recognition remains a challenge for some sport stakeholders. Additional supports including training on the CRT5 may assist in improving concussion detection.

recognition remains a challenge for some sport stakeholders. Additional supports including training on the CRT5 may assist in improving concussion detection.