Search

Background Many youth in the USA have access to a loaded and unlocked firearm in their home. Discussions between adult family members have the potential to positively influence firearm storage. Purpose Work with firearm-owning parents to develop and obtain preliminary data about the efficacy of a family-centered decision support tool about firearm storage. Methods We adapted the Ottawa Personal Decision Guide for Two to the issue of firearm storage, producing the Family Safety Check-In. Subsequently, we evaluated its acceptability and impact on intentions to make a plan with their partner (or other adult sharing parental duties) about safer firearm storage. Participants were parents/guardians of at least one school-aged child, had firearms in their home, and resided in the USA (n = 402). They completed a web-based pre-test survey, were randomized to the Family Safety Check-In or an American Academy of Pediatrics (AAP) informational resource about firearm storage for families, and then completed a post-test survey. Results The Family Safety Check-In had higher ratings for acceptability (B = 1.24, 95% CI = 0.58–1.90) and appropriateness (B = 1.46, 95% CI = 0.72–2.19) than the AAP resource. Participants in the Family Safety Check-In condition also had greater intentions to make a plan with their partner about storing firearms more safely (OR = 1.90, 95% CI = 1.26–2.87). Conclusions The Family Safety Check-In is a promising direction for harm reduction that warrants further evaluation. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS CONCLUSIONS Youth who have experienced trauma or other adverse childhood events have the potential to uniquely benefit from physical activity (PA). However, how PA is administered in schools can be re‐traumatizing and fail to create positive experiences through movement. We sought to develop role‐specific training to help increase the implementation of trauma‐informed PA.Guided by intervention mapping methodology, we developed “Move & Thrive”—a brief web‐based training about trauma‐informed PA. We then conducted a pilot evaluation of this training using a pre‐posttest design with no control group in a sample of youth sport coaches, parents of school‐aged children, and teachers (n = 150) recruited from an online opt‐in non‐probability panel.Mixed methods feedback found that “Move & Thrive” was highly acceptable. Across all roles (coaches, teachers, and parents/guardians) there were statistically significant increases in all targeted implementation determinants (knowledge, attitudes, self‐efficacy, and perceived resources/support), with moderate to large effect sizes.These results provide the foundation for a larger, adequately powered trial with randomization and follow‐up to assess the implementation of trauma‐informed PA. [ABSTRACT FROM AUTHOR]

Objective: Describe how sports medicine clinicians support decision making about sport participation after concussion recovery with adolescent patients and their parents. Specific areas of inquiry related to how clinicians framed the decision, what factors they considered in how they approached the decision process, and how they navigated discordance within families., Design: Qualitative study., Setting: Tertiary care sports medicine clinics at 4 children's hospitals in the United States., Participants: Individual interviews were conducted with 17 clinicians practicing in sports medicine settings., Interventions: N/A., Main Outcome Measures: Semi-structured interviews explored clinician approaches to supporting decision making, with the question guide informed by components of the Ottawa Decision Support Framework., Results: Clinicians routinely incorporated aspects of shared decision making (SDM) into their conversations with families. This included ensuring all parties were informed about risk and aligned behind a shared value of adolescent well-being. Mediation strategies were used to manage discordance between adolescents and their parents, and between parents. These strategies aimed to facilitate a decision that was adolescent centered. When clinicians believed that there was a medical benefit to modifying the adolescent's sport participation practices, or when they did not believe the athlete was psychologically ready to return to the sport in which they were injured, they initiated conversations about alternative activities. In such situations, they used persuasive communication practices to encourage families to strongly consider this option., Conclusion: The strengths and strategies used by sports medicine clinicians in this study provide a foundation for guidance or intervention development aimed at supporting SDM after concussion with adolescents and their families., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Determine whether Pre-Game Safety Huddles, a novel and low-resource approach to concussion education, increase the expected likelihood of concussion reporting for youth athletes., Methods: A cluster-randomised trial compared Safety Huddles to usual care. Safety Huddles bring together athletes and coaches from both teams before the start of each game for coaches to briefly affirm the importance of speaking up if a concussion is suspected. Participants were athletes from 22 competitive community-based American football and girls and boys soccer teams (ages 9-14), and randomisation into intervention or control occurred at the level of the bracket (group of teams that compete against each other during the regular season). The primary outcome was expected likelihood of reporting concussion symptoms to the coach, measured via validated athlete survey at the beginning and end of the season., Results: Of 343 eligible participants, 339 (99%) completed baseline surveys and 303 (88%) completed surveys at season end. The mean (SD) age was 11.4 (1.1) years, 26% were female soccer athletes, 27% were male soccer athletes and 47% were football athletes. In adjusted analyses accounting for baseline values and clustering by sport and team via random effects, expected likelihood of concussion reporting at the end of the season was significantly higher in the intervention group compared to controls (mean difference=0.49, 95% CI 0.11 to 0.88; Cohen's d=0.35)., Conclusions and Relevance: Pre-Game Safety Huddles increased the expected likelihood of athletes reporting concussion symptoms. While further study is warranted, sport organisations should consider this approach a promising low-resource option for improving concussion safety in their setting., Trial Registration Number: NCT04099329., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)