Quest for clarity: investigating concussion-related responsibilities across the New Zealand Rugby Community System

Danielle M Salmon; Jason Chua; James C Brown; Amanda Clacy; Zachary Yukio Kerr; Simon Walters; Sierra Keung; S John Sullivan; Johna Register-Mihalik; Chris Whatman; Gisela Sole; Marelise Badenhorst

doi:10.1136/bmjsem-2023-001722

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Quest for clarity: investigating concussion-related responsibilities across the New Zealand Rugby Community System

Journal article

Open access

Peer reviewed

Quest for clarity: investigating concussion-related responsibilities across the New Zealand Rugby Community System

Danielle M Salmon, Jason Chua, James C Brown, Amanda Clacy, Zachary Yukio Kerr, Simon Walters, Sierra Keung, S John Sullivan, Johna Register-Mihalik, Chris Whatman, …

BMJ Open Sport & Exercise Medicine, Vol.9(4), pp.1-15

2023

DOI: https://doi.org/10.1136/bmjsem-2023-001722

PMCID: PMC10582854

PMID: 37860152

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Abstract

There is a growing concern around concussions in rugby union, at all levels of the game. These concerns highlight the need to better manage and care for players. However, consistency around concussion-related responsibilities of stakeholders across the community rugby system remains challenging. Taking a systems thinking approach, this pragmatic, qualitative descriptive study explored key stakeholder groups within New Zealand’s community rugby system’s perceptions of their own and others’ concussion-related responsibilities. Participants included players from schools and clubs, coaches, parents, team leads and representatives from four provincial unions. A total of 155 participants (67 females and 88 males) were included in the study. Focus groups and individual interviews were conducted. Thematic content analysis was used to analyse data. Thirty concussion-related responsibilities were identified. These responsibilities were contained within four themes: (1) policies and support (responsibilities which influence policy, infrastructure, human or financial resources); (2) rugby culture and general management (responsibilities impacting players’ welfare and safety, attitudes and behaviour, including education, injury reporting and communication); (3) individual capabilities (responsibilities demonstrating knowledge and confidence managing concussion, leadership or role/task shifting) and (4) intervention following a suspected concussion (immediate responsibilities as a consequence of a suspected concussion). The need for role clarity was a prominent finding across themes. Additionally, injury management initiatives should prioritise communication between stakeholders and consider task-shifting opportunities for stakeholders with multiple responsibilities. How concussions will realistically be managed in a real-world sports setting and by whom needs to be clearly defined and accepted by each stakeholder group. A ‘framework of responsibilities’ may act as a starting point for discussion within different individual community rugby contexts on how these responsibilities translate to their context and how these responsibilities can be approached and assigned among available stakeholders.

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Title: Quest for clarity: investigating concussion-related responsibilities across the New Zealand Rugby Community System
Authors: Danielle M Salmon (Author) - Auckland University of Technology
Jason Chua (Author) - Auckland University of Technology
James C Brown (Author) - Stellenbosch University
Amanda Clacy (Author) - University of the Sunshine Coast, Queensland, School of Law and Society
Zachary Yukio Kerr (Author) - University of North Carolina at Chapel Hill
Simon Walters (Author) - Auckland University of Technology
Sierra Keung (Author) - Auckland University of Technology
S John Sullivan (Author) - Education New Zealand
Johna Register-Mihalik (Author) - University of North Carolina at Chapel Hill
Chris Whatman (Author) - Auckland University of Technology
Gisela Sole (Author) - University of Otago
Marelise Badenhorst (Author) - Auckland University of Technology
Publication details: BMJ Open Sport & Exercise Medicine, Vol.9(4), pp.1-15
Publisher: BMJ Group
Date published: 2023
DOI: 10.1136/bmjsem-2023-001722
ISSN: 2055-7647
PMID: 37860152; PMC10582854
Copyright note: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
Data Availability: Data are available on reasonable request. Data are in the form of digital voice recording, which have been transcribed verbatim. Voice recordings contain identifiable data and will not be made available. Deidentified transcriptions may be made available on reasonable request.
Grant note: World Rugby New Zealand Rugby Foundation and the Accident Compensation Corporation
Organisation Unit: Centre for Human Factors and Systems Science; University of the Sunshine Coast, Queensland; Thompson Institute; School of Law and Society
Language: English
Record Identifier: 99971188702621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Sport Sciences

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