title: Experience with Canada's First Policy on Concussion Education and Management in Schools.
abstract: BACKGROUND
  In response to the rising incidence of concussions among children and adolescents, the province of Ontario recently introduced the Ontario Policy/Program Memorandum on Concussions (PPM No. 158) requiring school boards to develop a concussion protocol. As this is the first policy of its kind in Canada, the impact of the PPM is not yet known.
  
  
  METHODS
  An electronic survey was sent to all high school principals in the Toronto District School Board 1 year after announcement of the PPM. Questions covered extent of student, parent, and staff concussion education along with concussion management protocols.
  
  
  RESULTS
  Of 109 high school principals contacted, 39 responded (36%). Almost all schools provided concussion education to students (92%), with most education delivered through physical education classes. Nearly all schools had return to play (92%) and return to learn (77%) protocols. Although 85% of schools educated staff on concussions, training was aimed at individuals involved in sports/physical education. Only 43.6% of schools delivered concussion education to parents, and many principals requested additional resources in this area.
  
  
  CONCLUSIONS
  One year after announcement of the PPM, high schools in the Toronto District School Board implemented significant student concussion education programs and management protocols. Staff training and parent education required further development. A series of recommendations are provided to aid in future concussion policy development.
authors.affiliation: 1Canadian Concussion Centre,Toronto Western Hospital,University Health Network,Toronto,ON,Canada.
authors.forename: Laureen D
authors.initials: LD
authors.lastname: Hachem
authors.affiliation: 3Department of Health and Physical Education,Toronto District School Board,Toronto,ON,Canada.
authors.forename: George
authors.initials: G
authors.lastname: Kourtis
authors.affiliation: 2Faculty of Medicine,University of Toronto,Toronto,ON,Canada.
authors.forename: Swapna
authors.initials: S
authors.lastname: Mylabathula
authors.affiliation: 1Canadian Concussion Centre,Toronto Western Hospital,University Health Network,Toronto,ON,Canada.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tator
mesh_terms: D001924:Brain Concussion / Q000534:rehabilitation*; D002170:Canada; D019468:Disease Management; D004521:Educational Measurement; D005178:Faculty / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012572:School Health Services / Q000706:statistics & numerical data; D012574:Schools; D011795:Surveys and Questionnaires
keywords: Brain injury; Brain injury - traumatic; Education; Head trauma