title: Statewide assessment of the Rhode Island School and Youth Programs Concussion Act.
abstract: BACKGROUND
  Sport-related concussion among youth athletes has become an area of increasing concern. Rhode Island passed the School and Youth Programs Concussion Act (SYPCA) in July 2010. The law contains both mandatory and recommended provisions outlining management of youth with a suspected concussion. Only Rhode Island Interscholastic League (RIIL) member schools are bound by this legislation. The purpose of this study was to assess compliance with the law.
  
  
  METHODS
  We designed a 29-question survey to assess compliance with the SYPCA. The survey was e-mailed to athletic directors of all RIIL member high schools, nonmember high schools, and selected community sports organizations.
  
  
  RESULTS
  Surveys were e-mailed to 65 athletic directors. Seven were returned as undeliverable. Forty-two individuals (71%) responded, and 38 (65%) submitted a completed survey. Among the RIIL schools that completed the survey, 100% stated that they require students and parents to sign preseason concussion information sheets. All reported that athletes with a suspected concussion are immediately removed from play, and 93% (29 of 31) stated that athletes must receive written clearance from a licensed physician before being able to return to play. All require annual concussion training for coaches, and 29 (93%) require annual training for volunteers. Only six RIIL schools require all student athletes to complete preseason neurocognitive testing. Approximately half of the RIIL respondents (17 of 31) stated that their school has a written return-to-play protocol. Compliance with all provisions of the law was lower among the non-RIIL schools and organizations.
  
  
  CONCLUSIONS
  Compliance with mandated elements of the SYPCA is close to universal; however, compliance with recommended elements is limited. To best protect Rhode Island youth athletes, all recommendations in the law should be mandatory, and non-RIIL schools and organizations should be required to comply.
authors.affiliation: From the Injury Prevention Center at Rhode Island Hospital (D.M., M.M.); Division of Sports Medicine (N.P.R.), Department of Emergency Medicine, The Warren Alpert Medical School of Brown University (D.M., M.M.); CAQ Primary Care Sports Medicine (N.P.R.); and Rhode Island Department of Health (J.A.-K.), Providence, Rhode Island.
authors.forename: Dina
authors.initials: D
authors.lastname: Morrissey
authors.forename: Neha P
authors.initials: NP
authors.lastname: Raukar
authors.forename: Jennifer
authors.initials: J
authors.lastname: Andrade-Koziol
authors.forename: Michael
authors.initials: M
authors.lastname: Mello
mesh_terms: D001265:Athletic Injuries / Q000628:therapy*; D001924:Brain Concussion / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D007883:Legislation, Medical; D012237:Rhode Island