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Pictured from left: Mary Wilstrup, a pediatric nurse at USA Children's & Women's Hospital; Dr. Anthony Martino, professor and chair of neurosurgery at USA; and Dr. Ashley Marass, assistant professor in the USA College of Nursing. The three are working together to shape a culture of concussion education and awareness in our region.
In 2014, the NCAA and the U.S. Department of Defense began accepting proposals for the Mind Matters Challenge, an educational challenge aimed at changing concussion safety behaviors.
The initiative included grants up to $400,000 for scientific research to improve understanding of how to affect cultural change regarding concussions and awards up to $100,000 for an educational programs challenge to identify entities that create materials in the area of concussion education aimed at at-risk populations.
Last July, a team at the University of South Alabama found out that their proposal was chosen as one of the top six in the country – out of hundreds – for a novel approach to educating athletes about concussions. As one of the six education challenge winners, the team was awarded a $25,000 cash prize and a $75,000 production budget to develop their project. The USA team – consisting of Dr. Anthony Martino, professor and chair of neurosurgery at USA; Mary Wilstrup, a pediatric nurse at USA Children’s & Women’s Hospital; and Dr. Ashley Marass, assistant professor in the USA College of Nursing -- developed an enhanced Concussion Awareness Program (CAP) that fulfills the needs of a school for a complete concussion awareness and management package.
“With the award, our team created a novel, web-based module in which education on concussions is provided to any athletic stakeholder via an engaging, interactive platform,” Wilstrup said.
The entire program is housed on a webpage, which can be accessed via computer, tablet or smart phone. The multi-tiered program includes education on concussions, a pre- and post-test, neurocognitive testing, on-field assessment, and referral to a specialized concussion clinic. Unique account profiles exist for athletes, parents and coaches so content is tailored to each individual.
Mis-diagnosis, underreporting and the stigma and implications of concussive injury are major issues, particularly in our region. According to Dr. Martino, student-athletes often fail to report head injuries and return to play before sufficiently recovering from a concussion – behaviors with significant short- and long-term consequences.
“Concussion education is critical now, particularly as we’re finding more and more that concussions have long-standing effects and that they need to be managed appropriately at a young age,” Dr. Martino said. “The premise behind this project was to use peer-to-peer education to give a better understanding of the symptoms.”
According to Dr. Martino, sometimes student-athletes fail to report head injuries because they may not be aware of all the symptoms, and some of the symptoms are subtle – they may feel dizzy or just a little stunned. Often, that’s a critical sign in concussion. They also want to keep playing and not lose their position on the team.
The education portion of the CAP module is accomplished with a captivating video, according to Dr. Marass. “Our video utilizes a peer-to-peer educational approach,” she said. “Having young athletes and coaches describe their experience with concussions and explain the importance of reporting concussion symptoms creates an environment for the learners to feel the relevance and seriousness of the issue. Also, highlighting athletes from a variety of contact sports reminds viewers that the burden of concussive injuries potentially occurs in all athletic activities.”
Housing other necessary tools in one location increases the module’s accessibility and functionality. “The CAP web tool allows us to assess an athlete’s knowledge and ability to recognize concussion symptoms,” Wilstrup said. “With this approach we empower athletes directly.”
Spreading the word about head injuries is nothing new for the USA team. Since 2005, USA Children’s & Women’s Hospital has been the site for a local chapter of ThinkFirst, a national head and spinal cord injury prevention program taught to children and young adults. Dr. Martino is the sponsoring physician for ThinkFirst Mobile, and Wilstrup acts as chapter director.
USA has also been providing concussion awareness education – in the form of the original CAP project – for high contact sport student athletes for close to five years. The original content included written material and lectures. The work of ThinkFirst and the original CAP initiative already complimented one another, and Dr. Martino, Dr. Marass, and Wilstrup supported the efforts of each other’s work prior to their collaboration on the Mind Matters Challenge.
“With the work being performed via ThinkFirst and CAP, we felt that our efforts met many of the qualifications for this new challenge,” Wilstrup said.
“I think the combination of neurosurgery with nursing really shows that our institution is caring for the people in this region that could potentially have concussions,” Dr. Martino added. “We really want to stress concussion education, especially in this region in particular where it’s a football-rich community.”
The USA concussion team believes CAP is a novel tool that will shape a culture of concussion education and awareness in the south Alabama region and beyond. Their efforts have already proven successful – all athletic teams at USA will use CAP by Fall Semester 2016, and the program was implemented in all Mobile County high schools earlier this year. The team is currently working to expand to surrounding counties. “With this dramatic increase in numbers, we will be able to assess the effectiveness of the program,” Dr. Marass said. “As we start presenting our project with results, we hope to take the program nation-wide.”
“We feel – and our initial results have demonstrated – that this program has had an effect on behavior,” Dr. Martino added. “We hope that there will be easier recognition of symptoms and that athletes will take care of themselves and their teammates.”
To view CAP, visit www.concussionawarenessprogram.org. A demonstration option exists by logging in with the following information: Username: firstname.lastname@example.org ; Password: ncaapass.
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