Table 1

The ecological context (and hierarchical levels) of implementation of concussion guidelines in community, or recreational, sport*

Ecological (or hierarchical) level of sports safety implementationImplementation role
Players and parents of playersTarget end users and beneficiaries of concussion education, guidelines and prevention; actions would be at both the individual and whole-of-team level
Coaches and sports trainersKey community sports personnel to initially recognise a potential concussion has occurred, initiate local actions in response to the suspected/actual concussion, support and monitor the adoption of guidelines and support players diagnosed with concussion return to play
General practitioners (doctors)Key role in diagnosing concussion and providing medical management of concussion. (In most community sport settings, it would not be common for sports physicians or sports physiotherapists to be associated with teams, so access to general medical personnel is necessary.)
Sports bodies (regional, national and/or international) and peak sports medicine/health promotion agenciesSetting of rule, preparation and dissemination of guideline information and other resources, supporting community sport infrastructure, education
International expert opinionDetermining, summarising, publishing and disseminating the scientific and medical content of concussion guidelines
  • *This table describes the situation for countries where most sporting participation opportunities are provided through community-based or recreational sporting organisations. It is acknowledged that some countries, like the USA, have sports delivery systems that are more likely to be linked to high schools or university colleges and so some of the opportunities for intervention may be different. In particular, US-based sports have certified athletic trainers who would be a key conduit of concussion knowledge and action.