Youth Tackle Football Head Impact Estimation by Players and Parents: Is the Perception the Reality?

Abstract

ABSTRACT Context: With growing concerns surrounding exposure to head impacts in youth tackle football, it is essential that parents and players understand the exposure level when consenting/assenting to participate. Objective: We aimed to determine whether youth football parents and players could estimate on-field head impact frequency, severity, and location. Design: Prospective Cohort Study Setting: On-field Patients or Other Participants: We administered a 10-question head impact estimation tool to parents (N=23; 36.5, 95% CI: 31.7, 37.3) and players (N=16; Age: 11.1, 95%CI: 10.3,11.8). Main Outcome Measures: Player on-field head impact exposure was captured using the Triax SIM-G system. We determined the accuracy between parent and players estimates relative to on-field head impact exposures using kappa and weighted kappa values. Results: Youth tackle football parents and players do not accurately estimate on-field head impact frequency (kappa range:−0.09–0.40), severity (kappa range: −0.05–0.34), or location (kappa range: −0.30–0.09). Parents and players overestimated head impact frequency in practices, but underestimated the frequency in games. Parents and players overestimated head impact severity, particularly in games. Most parents and players underestimated the number of head impacts to the top of the head, particularly during practices. Conclusions: Underestimations in head impact frequency in games and to the top of the head suggest that informed consent processes aimed at educating parents and players should be improved. Overestimations in head impact frequency in practices and severity may explain declining rates of youth tackle football participation.