Research SHINEs a light on youth concussion education

Over 200,000 concussions occur in Canada each year, and tens of thousands of those incidents happen to youth. In 2016-2017 alone, 46,000 children aged 5 to 19 were taken to the hospital for concussion.

Along with short-term effects like dizziness, headaches, and issues with concentration and memory, youth who suffer concussion may have an increased risk of long-term neuropsychological impairments and mental health problems. These issues could include depression, anxiety, continued cognitive deficits in memory and attention span, ADHD, and post-concussion syndrome. There is also the risk of second-impact syndrome, a rare but possibly fatal condition in which the brain rapidly swells shortly after someone suffers a second concussion before symptoms from the first have subsided.

“We need to educate youth on the importance of recognizing, responding to, and reporting concussions to avoid these serious outcomes,” says Jamie Morrison.

Jamie and fellow undergraduate student Madison Yanish recently completed a research project with the Christie Lab on the effectiveness of concussion education. The research partners focused their study on Student Head Injury Neuro Education (SHINE), a 45-minute course on the basics of concussion that they created along with their classmates Emma Skaug, Briar Mayoh and Emily Bosdachin. (They created the program in their MEDS 490 – Directed Studies in Medical Sciences – course focused on NeuroEducation.) Together with graduate student mentor Taylor Snowden-Richardson, the class presented SHINE to seven Grade 9 – 12 classrooms in the Greater Victoria School District. They also asked the high school students to complete the same 26-question quiz both before and after each presentation.

“The program was effective,” says Jamie. “We found a significant increase between the pre-session scores [average score of 19/26] and the post-session scores [average score of 22/26].”

Madison and Jamie also looked at classroom demographics to see if there were any variables affecting the youths’ baseline knowledge and learning outcomes. Jamie focused on gender and age, and she found that neither of these factors influenced pre- and post-session scores. “This is both good and bad,” she says, who recently presented her finding at the Jamie Cassels Undergraduate Research Awards. While it again shows SHINE can useful for multiple demographics, it also “really highlights the importance of our program” as students don’t seem to learn more about concussion as they age through high school.

Madison focused on participation in contact sports and history of concussion, and she similarly found that neither of these variables affected pre- or post-session scores. “These results were surprising to me,” she says, adding she particularly thought students who played contact sports and who had a history of concussion would have a higher baseline knowledge due to their exposure to this type of injury. “These results show that there is a lack of concussion education and awareness in these groups, and they promote the importance of providing these groups with information that could help prevent concussions early on and help youth properly recover if they do sustain an injury.”

Of course, this isn’t the first attempt at concussion education for youth. There has been an overall increase in programs like SHINE, but recent studies have shown that it hasn’t led to an increase in concussion reporting.

Jamie says that while educating youth will hopefully lead to self-advocacy, she feels it’s also important to educate coaches, parents, and other authority figures because, as adults, they have such influence over the kids in their care. Drawing from her own soccer experience, she remembers the “you gotta get back into the game” attitude of some coaches and being pressured to head the ball. “I love soccer, but that was kind of concerning,” she says. “Your brain health is more important than a sport’s game and impressing your coach.”

Madison knows this from personal experience. “Due to a lack of proper education and awareness, I did not follow proper return to play protocol after my first concussion in grade 10 and unfortunately received three more between then and my second year of playing collegiate volleyball,” she says. “I am still dealing with some long-term consequences of my concussions, such as exercise-related fatigue, headaches, and possible related anxiety. My personal experiences have led me to be incredibly passionate about doing my best to try and prevent youth in sports from sustaining these injuries and dealing with the short- and long-term consequences like I have.”

The Victoria Brain Injury Society (VBIS), a regular partner of the Christie Lab, has since taken over facilitating SHINE in the Victoria area and has expanded the program to focuses on brain injury in general as opposed to just concussion. Jamie, who is the VBIS volunteer coordinator, says she’ll be looking to recruit youth volunteer facilitators this summer and that she would also like to see the program tailored for presentations to sports teams.

“It’s exciting to see the project to continue and grow,” she says.