Table.

Strategies for Athletic Trainers (AT) to Address Concussion Prevention and Education at Each Level of the Socioecological Framework

Framework Level	Strategies	Example
Society and policy	Understand state law and work to educate other stakeholders about the law27 Understand state interscholastic association or National Collegiate Athletic Association policy and work with administrators to ensure their policy meets any requirements34 Develop good relationship and sound concussion policy with directing physician72 Communicate regularly with directing physician Support and conduct research on policy effectiveness	AT works with directing physician, school administrators, and risk-management personnel to develop concussion plan based on best practices, taking into account any specifics from interscholastic association policy and state law to ensure compliance AT educates appropriate stakeholders about policy and law to meet any requirements for education and informed consent
Community	Ensure AT and medical-provider presence at games and practices54,55 Implement and practice organization's concussion safety and policy measures72 Promote communication about concussion and positive messaging to other stakeholders63,78 Facilitate use of appropriate equipment and playing surfaces57	AT works with other health care providers and school administrators to determine event coverage, practice of emergency action plan, equipment fitting, etc
Interpersonal	Educate coaches and parents63,89 on appropriate recognition and response to concussion Help foster supportive communication between coaches and athletes about concussion safety63,78 Encourage teammates in concussion safety and concussion disclosure83	During preseason, AT holds parent-team meetings to educate about concussion, review appropriate policies, and discuss postinjury management scenarios AT provides postinjury anticipatory guidance to patients and families throughout recovery course
Intrapersonal	Educate athletes and provide opportunities for experiential and observational learning93 Address attitudes about concussion disclosure13,89 Encourage and support concussion disclosure63 Correct misperceived concussion-related norms79,80 Educate athletes about appropriate sport skills aimed at keeping head out of play and following rules43	Ensure that concussion education being provided to athletes has been evaluated and demonstrated effectiveness in changing at least knowledge but ideally other relevant factors (eg, attitudes, norms, and reporting intention) Remind athletes about importance of concussion safety throughout season