true+true+final+propsal

Anthony Yung
Rutgers University
8450 BPO Way,
Piscataway, NJ 08854
(732) 789-9358
anthonyyung7@gmail.com
June 26, 2013
Rita M. Olson, Ph. D
Superintendent for the School District of South Milwaukee
South Milwaukee High School
801 Fifteenth Avenue
South Milwaukee, WI 53172
Dear Dr. Olson,
I am writing this letter to express my concern over the increasingly common problem of
concussions among high school football players. As a previous high school athlete, I have
encountered the challenges of recognizing and struggling with concussion. Like many other high
school athletes, I was unaware and uninterested of the long-term consequence of concussion and
avoided facing my health condition. I also refused to confront the problem for fear of being
labeled as “weak”. Fortunately, I did not suffer another concussion during my high school
athletic career. However, after I enrolled in college as a biomedical engineering major, I saw the
negative backlash of my actions. I realized that my decision to cover up my injury was both
immature and irresponsible. This has inspired me to write this proposal to you in order to help
other high school athletes recognize the severity and long-lasting negative effects of concussions.
According to a recent research, 90% of all concussions go undiagnosed and unreported.
Meanwhile, the number of high school athletes suffering concussions is growing. Studies have
shown the mindset that contributed to concussions, such as the fearing of being labeled as
“weak”, can be better managed and prevented through education. As athletes postpone medical
attention and refuse to recognize concussion, the issues of concussion are boost by the anxiety
and embarrassment. Therefore, resolving the mindset associated to concussion is vital for
preventing concussion epidemic among high school athletes.
Although South Milwaukee High School have already implemented a concussion
prevention program, the current policy is ineffective at best. Several high schools have already
developed programs to curb the concussion epidemic including West Roxbury Academy and
Colton High School. Following their lead and creating a local concussion education program as
the model will benefit the athletes of South Milwaukee High School abundantly. Since South
Milwaukee High School has previously funded concussion prevention programs, it may be in
your best interest to consider this proposal.
Lastly, I would like to thank you for taking your time to review my proposal. Should you
have any questions, please feel free to contact me via email or phone. Thank you for your time
and consideration. I look forward to hear from you.
Sincerely,
Anthony Yung

Proposal for Raising Concussion Awareness in South Milwaukee High School
Submitted by:
Anthony Yung
Submitted to:
Rita M. Olson, Ph. D
Superintendent of School District South Milwaukee
South Milwaukee High School
801 Fifteenth Avenue
South Milwaukee, WI 53172
Prepared for:
Scientific and Technical Writing: 355:302:V2
Dr. Peter Sorrell
July 29, 2013

i
Abstract
Concussions traditionally have not had much attention in science or in society. While “head trauma” seems
a simple enough definition, it is difficult to actually diagnose because there are not always exterior signals for a
concussion. Some of the symptoms may not even occur right away, only to appear days, if not weeks, after the
incident. But concussions are attracting more attention as more and more athletes, especially football players, are
reporting physical and psychological symptoms of head trauma. Even some professional athletes from the National
Football League have begun publicize their chronic symptoms due to many years of concussions from heavy tackles.
But the victims most vulnerable to concussions are high school football players; in the middle of their physical and
mental development, any severe concussion can have irreversible detrimental effects, such as recurring headaches
and memory loss. The worst problem of all though, is how little attention and knowledge about concussions in high
school sports: coaches and students alike generally do not know how to recognize a case or its severity, leading to
improper and insufficient treatment.
This proposal uses several models from previous programs to create a cohesive, comprehensive program
that will address most, if not all, the problems regarding concussions. The program hopes address the
misunderstandings and ignorant behavior many students and athletes have regarding concussions in high school
sports. This follows the prevention aspect of concussion control; preventing a disease is much more cost-effective
and less painful than curing the disease. Another aspect of this proposal aspires to create a concussion management
team to bring together different members of the community together to help the athlete in need. Members with
different professional backgrounds can provide their own feedback and unique skills towards creating a caring and
hospitable environment for the student. Through education and attentive care, current concussion cases can be fully
and correctly treated and future cases can be prevented.
Keywords: concussions, high school football players, community, education, management team

ii
Table of Contents
Abstract i
Table of Contents ii-iii
Table of Figures iv-v
Introduction 1
Concussion Epidemic 1
Concussion Epidemic in Sports 1
World 2
United States 3
Midwest Region 3
Wisconsin 4
Milwaukee 4
South Milwaukee High School 4
Conclusion 5
Literature Review 6
Why do concussions go unreported? 6
Why do concussions more prevalent in Midwest? 7
What makes younger football athletes more vulnerable? 8
What makes young male more vulnerable than young female? 8
Knowledge Transfer 9
Successful Model of Knowledge Transfer 10
Mentorship 11
Successful Model of Mentorship 11
Community of Purpose 12
Successful Model of Community of Purpose 12
Successful Model of ImPACT Baseline Testing 13
Successful Model of Social Media 13
Current Effort in South Milwaukee High School 14
Conclusion 14
Plan 16
Literature Overview 16
Phase I: Educate and Raise Awareness (ERA) among Community 16
Phase II: Advanced Concussion Training (ACT) for Community 18
Phase III: Established and Utilized Concussion Management Team (CMT) 18
Phase IV: Preseason Baseline Testing & Post-Injury Testing 19

iii
Phase V: Utilizing Social Media to Convey Concussion Information 20
Plan 20
Dr. Olson, Superintendent for the School District of South Milwaukee 21
Conclusion 21
Budget 22
Cost Breakdown 22
Justification 23
Discussion 24
Reference 25
Appendix 30
Appendix A: Concussion Educational Seminar Flyer 30
Appendix B: Flyer for Adult Concussion Seminar 30
Appendix C: Volunteer Flyer 31
Appendix D: Advanced Concussion Training (ACT) Curriculum 31
Appendix E: Responsibilities Flyer of CMT 32
Appendix F: ImPACT Testing Day Flyer 33
Appendix G: Facebook Concussion Blog 33
Appendix H: Office Depot Price of 1 Letter sized Page 34
Appendix I: Domino Pizza Menu 34
Appendix J: One pack of 24 cans of Pepsi price 35
Appendix K: Volunteer T-Shirt Price 35
Appendix L: ImPACT Baseline Test Package 36
Appendix M: Sponsorship of Brain Injury Alliance of Wisconsin 36
Appendix N: Sponsorship of BrainSTEPS 37
Appendix O: Sponsorship from Sports Legacy Institute 37

iv
Table of Figures
Figure 1
Compare incidence of TBI with other major epidemic 1
Figure 2
Cause of TBI 1
Figure 3
TBI incidences in the past 12 years 2
Figure 4
TBI prevalence by age 3
Figure 5
ED visit for mild TBI in 1998-2000 by region 3
Figure 6
Sports Medicine Concussion Volume in Wisconsin 4
Figure 7
Reasons Why Concussion not Reported 4
Figure 8
Incidence of Concussion in South Milwaukee High School 4
Figure 9
Frequency of Cerebral Concussion from 1865 to 2009 7
Figure 10
Theory of reasoned action 7
Figure 11
Comparison of High School and College Concussion rate 8
Figure 12
Age and Gender Demographic of Concussion 9
Figure 13
Knowledge to Action framework (KTA) flow chart for Concussion 9
Figure 14
Pre-presentation and Post-presentation passing rate 10
Figure 15
Mentorship Model 11

v
Figure 16
Pre-test and Post-test on ACT 11
Figure 17
Community of Purpose Pyramid 12
Figure 18
The ImPACT Concussion Management Model 13
Table 1
Models integrated into the Plan 16
Figure 19
Two Leader Mode of CMT 19
Table 2
Plan of Action 20
Table 3
Budget Details Breakdown 23

1
Introduction
Historically, concussions have received relatively little attention in the United States. The
symptoms are ambiguous and not always present, and other more popular diseases and disorders
such as cardiovascular disease and diabetes overshadow the concussion epidemic. But gradually,
concussion awareness has increased due to the increasing number of athletes, especially high
school football athletes, reporting similar symptoms from years of hard tackling. Due to lack of
knowledge regarding concussions, most athletes do not even know if they have had a concussion.
Even if the concussion is severe enough to bench the athlete, coaches and athletes often
downplay its severity, resulting in athletes returning to the field before they have sufficiently
recovered. The extreme popularity of football in the Midwest results in it becoming the region
with the highest concussion rate in the US, with Milwaukee, Wisconsin, among one of the cities
with the highest rate.
Concussion Epidemic
The concussion epidemic affects more
than just high schools communities. In past
years, as more research focused on the long-
term effect of concussions, society has finally
begun to realize the hidden threats of
concussions. Figure 1 show that concussions
are indeed more prevalent than more
publicized disease such as breast cancer,
HIV/AIDS, and multiple sclerosis. In fact,
breast cancer finished a distant second, with
only 176,300 incidents per year compared
traumatic brain injuries‟ 1,500,000. This data
suggest that society has have been overlooking
the concussion epidemic for years since few people even
know of its existence. A concussion is defined as a
traumatic brain injury due to violent impact directly to the
head. However, unlike other traumatic injuries, concussions do not always present with
symptoms that can be readily observed, which makes them even more difficult to diagnose.
Perhaps due to the complexity in diagnosing the injury, concussions may be more prevalent in
America than was once thought.
Concussion Epidemic in Sports
Sports are prevalent, if not essential,
form of interaction between individuals
throughout the human history. Appropriate
interplay can quickly create bonds between
two strangers– whether through respect,
competition, victory, rivalry, or any other
aspect of sports. Participation often is a
gateway to developing peer relationships and
establishes individual physical fitness as a
Figure 1: Compare incidence of TBI with other major
epidemic (University of Pennsylvania, 2013)
Figure 2: Cause of TBI (Fortune & Wen, 1999)

2
habit in juveniles. In addition, sports can build a proper attitude through sportsmanship and fair
play. As a result, youth sports have become prevalent and popular in the United States.
Although sports have numerous
physical and social benefits for players,
sports bring along the potential for
injury. Figure 2 shows that sports-
induced concussions make up a
significant proportion of the overall
concussion population. In fact, the data
suggest sports concussion is the second
leading cause. Annually, emergency
rooms have admitted approximately 2.7
million children under the age of
nineteen for sports-related injuries,
according to the Center for Disease
Control. Of those, 173,285 were
concussion injuries (CDC, 2011). In addition, 71% of
those were male athlete. This data suggests that young
male athletes have a much higher risk for concussions. In fact, some studies have shown that
concussions account for as much as 3.8 million or 13.2% of all sport-related injuries (Halstead,
2010). Also, the high school football concussion rate has increased at about an eight percent
rate annually over an eleven-year period from 2000 to 2011 (Figure 3). This data suggests that
concussions are on the rise. This epidemic needs to be address immediately.
The associated symptoms of a concussion and susceptibility to future recurrences are
severe. After an athlete‟s first concussion, the chances of a second one increases 3 to 6 times.
Athletes who experience three or more concussions are 8 times more likely to lose
consciousness, 5.5 times more likely to experience post-traumatic amnesia (decreased ability to
form new memories after a brain injury), and 5.1 times more likely to experience confusion after
a future concussion (Meehan, 2011). Just these symptoms alone are serious enough to call for
state, if not federal, action. But the increased susceptibility to future concussions due to the initial
injury is even more alarming. As statistically shown, children who are sent to the emergency
room for a head injury have more than double the risk of sustaining a similar head injury in the
future within a year (Meehan, 2011). The symptoms and problems associated with concussions
call for immediate and strong measures to treat and prevent concussions.
World
Concussions are one of the most problematic epidemics in the world. Despite recognize
its existence for hundreds of years, concussions currently do not have a single, universally-
accepted, formal definition. During the first International Concussion Symposium, scientists
only defined a concussion as “a complex pathophysiological process affecting the brain, induced
by traumatic biomechanical forces” (Aubury et al, 2001). Due to the lack of a consistent
definition, concussion research is often interrupted and stalled by misunderstanding and
confusion. Today, 10 million people worldwide suffer concussions annually. In fact,
concussions are so common that it will “become the third leading cause of death and disability in
Figure 4: TBI incidence in the past 12 years
(CDC, 2012)
Figure 3: TBI incidence in the past 12 years
(Lincoln et. al, 2011)

3
the world by the year 2020”. In additional, The World Health Organization has noted that
concussion is the “No. 1 cause of morbidity and mortality for children and young adults” (Gean
et al., 2010).
United States
In America, concussions have always been a severe and complex problem. The number
of Americans affected is one of the highest
in the world. Currently, concussions have
caused five million Americans to live with
disability. Every year, 1.5 million
Americans will suffer a concussion (Center
for Disease Control [CDC], 2011). Of
those, 230,000 will be hospitalized and
survive. Unfortunately, 50,000 will die
and 90,000 will suffer long term disability
(CDC, 2011). More importantly,
concussions negatively affect the economy.
Because of the large population of patients,
America loses those patients‟ potential
productivity due to the direct and indirect
cost of concussion. In 2000, the total loss
of productivity was estimated at $76.5 billion in the United States (Finkelstein et al, 2006).
According to Center for Diseases Control and Prevention, concussions have been rising amongst
all age group since the 1970s. In fact, the greatest increase has been observed in young adults in
high school ages (Figure 5).
Midwest Region
One of the most at-risk regions for concussion in America is the Midwest. Citizens in the
Midwest have a higher risk of suffering concussion than those in any other region of the United
States (Bazarian 2005). The data in Figure 1 shows that the Midwest has the highest rate of
concussion incidence per one hundred thousand people than other regions in United States.
Thus, states located within this region, such as Wisconsin, are likely to have higher incidence of
concussion.
Figure 5: ED visit for mild TBI 1998-2000, by region (Bazarian 2005)
Figure 4: TBI prevalence by age (CDC, 2012)

4
Figure 7: Reasons Why Concussion not Reported (McCrea, 2004)
Wisconsin
In fact, Wisconsin has spent
approximately $16.2 million on long-term care
for brain injuries in 2008 (Wisconsin Department
of Health Service, 2008). Within the state, one of
the most members of the population exposed to
concussions is male teens (Tieves, 2005). As a
general trend, the overall rate of sports-induced
concussions in Wisconsin has been rising. In the
Children‟s Hospital of Wisconsin, the number of
visits involving sports-induced concussions has
increased dramatically. In the year of 2008, there
were only around 100 visits per year. However,
the volume of concussions has been increasing
consistently for the past three years, with the most
recent 2011 report showing a 1200% increase overall.
This data validates the fact that there is a highly-
growing concussion epidemic in Wisconsin.
Milwaukee
Milwaukee possesses an abnormally high
rate of concussion. As a matter of fact, 30% of
high school football athletes there have sustained
a concussion. Compared to the national average
rate (only 5.6% of high school football athletes
have sustained a concussion), the Milwaukee
concussion epidemic is one of the most severe in
the nation (Guskiewicz, 2000). Of those, only
47.3% reported their injuries, which mean less
than half of all injuries are recorded. The
general reason for not reporting concussion
included “a player not thinking the injury was
serious enough to warrant medical attention,
motivation not to be withheld from competition, and lack of awareness of probable concussion”
(Figure 2).
South Milwaukee High
School
According to a
phone interview with Coach
John Galewski, the head
coach of South Milwaukee
High School football team,
the number of concussions
has been a major concern in
Figure 6: Sports Medicine Concussion Volume in Wisconsin
(Children‟s Hospital of Wisconsin, 2011)
Figure 8: Incidence of Concussion in South Milwaukee High School
(Galewsk, personal communication, July 20, 2013)
0
2
4
6
8
10
2009-2010 2010-2011 2011-2012 2012-2013
AmountofConcussion
Amount of Concussion in South
Milwuakee High School Football Team

5
recent years. In figure 8, the number of concussion reported to the Athletic Department has
continuously increased for the past four years. The number of reported concussions and its high
growth rate are shocking considering the number of players in the team roster. SMHS‟ football
team consist roughly 50 players in each of the past four years. This make the concussion rate for
SMHS football team around 18% in the 2012-13 year alone.
Unfortunately, one concussion incident has sparked significant media attention. Last
season, South Milwaukee High School (SMHS) finished at the top of their conference, winning
five of their last six regular season games, and qualified for the Wisconsin state playoff.
However during the first game of the playoff, all-regional and conference junior Zach Simuncak
aggressively ran head first in an effort to stop the opposing running back from advancing. After
landing the heavy tackle, Simuncak went unconscious and motionless for ninety seconds on the
field (Cohen, 2012). He felt no sensation in his lower extremities and was immediately rushed to
the nearby hospital. Unfortunately, with the loss of its star player, South Milwaukee High
became demoralized and did not win that game, losing a chance to run for its first state title.
Another team, Bookfield Central, went on to win the title 33-8. Fortunately, Simuncak was able
to recover from the head trauma. However, this unfortunate incident attracted much negative
media attention and damaged the school‟s reputation as a football powerhouse. The undermining
problems of concussions should not be neglected and ignored. More importantly, concussions
have long been a problem among high school football player in the Milwaukee area. Preventing
concussion from happening should be a top priority for SMHS.
Conclusion
Concussions have severe consequences, but especially so during the crucial
developmental stage of adolescence. Adolescent concussions produce long-term health
consequences which have few or no effective treatments or cures, such as memory loss. In
severe cases, adolescent concussion can lead to permanent disability or, even worse, death.
While the symptoms alone sound severe, the more discouraging fact is that concussion cases are
increasing at a consistent rate with no sign of slowing down. The Midwest has the highest
percentage of concussion patients in the nation. The concussion cases in Wisconsin alone
increased 120 times in the three year span between 2008 and 2011. Lastly, South Milwaukee
High School has also had a consistent increase of cases while having the same number of
members on the team. Considering the risks and severity of concussions in high school sports, it
is absolutely necessary to take initiative in adopting concussion prevention strategies to curb this
ever-growing epidemic.

6
Literature Review
The historical trend in players and coaches‟ ignorance and victims‟ refusal to seek help is
severe. Due to these reasons, concussions have become widespread while receiving minimal
attention for years. The increase in concussion among high school football players has only
recently caught national attention. Improving concussion prevention and management in high
schools has become a top national priority due to the media attention and publicizing of
impairments in football players. The inefficacies of current common policies have pushed many
high schools to readjust their current management plans and prevention methods or create new
ones. One of the newer initiatives is establishing education programs to teach members of
involved in the team about concussion prevention and mitigation. By empowering the athletes,
the main victims, with knowledge, they can serve as the front line in preventing concussions by
playing more safely and reporting injuries immediately. These new education programs can help
reduce the incidence and severity of current and future head injuries caused by sports.
Why do concussions go unreported?
Americans‟ love and passion for football is difficult for foreigners to fathom; football
seems violent and barbarian. However, football is deeply ingrained in American culture.
Throughout history, no matter how severely divided by ethnic and class differences, football can
always unify passionate fan across the nation to cheer for their favorite teams and players on a
Sunday night. It is precisely due to the violence of the sport that the players who sacrifice their
own well-being for the sake of receiving the game-winning touchdown become the heroes that
American citizens look up to. Because of this significance, football has bypassed baseball in
popularity and become the “American Sport”, a symbol of American Romanticism. As the
national sport, football attracts many youngsters who dream of becoming professional players.
However, the risk of traumatic brain injury cannot be overlooked. High school football has the
highest rate of concussion of all sports, 6.4 concussions per 10,000 athletes. Annually, 67,000
concussions are diagnosed (Broglio, 2009) and 90% of concussions goes unreported and
undiagnosed (Daneshvar, 2011).
The lack of education on concussion and refusal of athletes to report themselves are well
documented. The deficiency of basic knowledge regarding concussions is problematic even at
the professional level. During one season in the Canadian football league, 44.8% of players
struggled with concussion symptoms. However, only 18.8% of those fully realized that they
have suffered a concussion (Delaney, 2000). If even professionals are not sure as to whether
they have suffered concussions, then how does one expect relatively untrained teenage athletes to
know?
Not only are most athletes ignorant as to whether they have been afflicted, many refuse to
report the injury even if they do know. Athletes usually cover up injuries “because their identity
is strongly tied to their athletic ability” (Banks, 2011). If the injury is relatively unnoticeable,
such as a minor headache or muscle pain, it is “manlier” to bear the pain alone. This behavior is
further perpetrated by the “American hero” mentality in American football; players who can
fight through injury and win are often praise as “hero” and tough, while resting players are labels
as “weak” and traitors to the team. While hiding their injuries will help them look brave in
stadiums and glamorous in advertisements, this behavior is detrimental in the long run.

7
According to case studies, “athletes deliberately hide symptoms for fear of being removed from
the game or letting their teammates down” (Grady, 2010). Since most, if not all, teenage football
players are males who seek to emulate those professional role models who “never” show pain,
the number of cases currently reported is definitely underestimated.
Another flaw of the “hero” icon is that even if injured players receive treatment, they will
downplay their injuries in hopes of returning to the field earlier and further highlight their
“manliness”. If players return to the field prematurely, the chances of repetitive concussion
increase dramatically. In another study from 1997 to 2008, 11% of concussions in high school
sports were repeat concussions (Meehan, 2011). This extremely high rate of repeat concussions,
new cases aside, can be attributed to students receiving insufficient treatment. Insufficient
treatment alone is detrimental to the players‟ health, but going back to the rough activities of
American football while still injured will only exacerbate the problem.
Why are concussions more prevalent in Midwest?
Historically, the Midwest region has steadily
produced high sports-induced concussion cases and
rates (Figure 5). This consequence is led by many
cultural factors. The football athletes of the
Midwest region are at risk of concussions due to the
overbearing influence of the football culture in the
area. Some of the biggest rivalries in college
football history are actually between pairs of
Midwest colleges, many of which last for over one
hundred years and counting. For example, the
rivalries between Michigan and Ohio State,
Michigan and Notre Dame, Minnesota and
Wisconsin can be traced back to the late 19th
century. In additional, the Midwest has the most
NFL teams (9) out of any other region in the US.
Growing up in this culture, the great importance
placed in football plays a significant role in the
development of young football athletes‟ mindsets.
There is a great emphasis on the idea “playing
through the pain” and “winning at all costs” in this
culture, and “athletes deliberately hide symptoms for
fear of being removed from the game or letting their
teammates down” (Grady, 2010). Football athletes
are more likely to get involved into a concussion
due to the nature of football. Athletes are also less
likely to reported suspected concussion because they
might feel that doing so signifies that they are weak
and unskilled.
The Theory of Reasoned Action serves as a
good model for explaining why these athletes
behave the way they do. As a social animal, humans
Figure 9: Frequency of Cerebral Concussion from 1865 to 2009
(The Research Foundation of State Univeristy of New York, 2009)
Figure 5: Theory of reasoned action (Ajzen, I, 1980)

8
Figure 11: Comparison of High School and
College Concussion rate (Gessel, 2007)
are inclined to follow the norms established by the majority even if they do not believe them to
be correct. While one‟s beliefs and evaluations create one‟s attitude, normative beliefs (what
society perceives to be normal) and the person‟s motivation to comply create a subjective norm
that usually surpasses one‟s attitude. Not only that, societal factors can influence a person‟s
beliefs, eventually causing his or her beliefs to match the normative beliefs. Even if the person is
not easily swayed, he or she may behave according to the subjective norms anyways except with
a contradictory attitude. In the end, societal standards exert a strong influence on people‟s
behavior. (Aizen 1980) It is no wonder that the heavy emphasis placed on football in the
Midwest has caused the region to have one of the highest concussion rates in the United States.
What makes younger football athletes more vulnerable?
In general, football athletes have the
highest incidence of concussion injuries of
any sport. Among all level of football, high
school players have a far higher rate of
occurrence than collegiate and professional
players (Gessel, 2007). There are different
contributing factors to the higher rate of
concussion. One factor is the biological
anatomy of young athletes‟ brain. The brain
does not fully develop anatomically until one
reaches the age of 25. Because the brain is
still developing, young athletes‟ brains cannot
bear as much physical force in comparison
with older athletes (Lincoln et al., 2011).
Therefore, younger athletes are more prone to concussion.
Inadequate coaching is also a contribute factor to higher
concussion rates among young players. In general, most
youth-level coaches are parent volunteers untrained in the
topic of concussion (Shaughnessy, 2009). Although all state legislations realize the importance
of concussion education for coaches, only 48% require formal concussion education for coaches
(Tomei et al, 2012). With this inadequate coaching, even if a player is correctly removed from
the field, the coach may not know the procedures for treating concussions and that the player
needs proper rest. If the player is a star member of the team, the coach may even disregard the
recommended treatments and rush him back onto the field to win for the team. If a coach does
not know that concussion patients need a lot of rest, then he will obviously try to bring the player
back early. The innate biology of the young brain and coaches‟ ignorance regarding concussions
work together to cause such high concussion rates in young players.
What makes young male more vulnerable than young female?
As a general trend, male athletes tend to have a higher rate of concussion. Annually,
emergency rooms have admitted approximately 2.7 million children under the age of nineteen for
sports-related injuries, according to the Center for Disease Control. Of those, 173,285 were
concussion injuries (CDC, 2011). In addition, 71% of those were male athlete. This data
suggests that male athletes have a much higher risk for concussions. However, during

9
adolescence, the gap between male and female
cases widens significantly. This result is directly
cause by gender differences. During adolescence,
males are considerably exposed to head injuries,
intentional or not, due to their venturous demeanor
(Huizinga, 2000). On the other hand, female have
been observed to more likely think ahead before
springing into action. Moreover, male teens who
engage in high school sports are much more likely
to sustain injuries (Powell, 1999). This is in fact
due to the more aggressive nature of play in male
sports and greater athletic capabilities (greater muscle
mass leads to increased strength and speed) that result in
higher kinetic energy transfers that contribute to an
increased number of cases with graver severity in comparison to female sports (Lincoln et al.,
2011).
Knowledge Transfer
In the 4th
International
Conference on Concussion in Sport,
concussion experts have agreed that
the most efficient method of
preventing concussion is through
Knowledge Transfer (Concussion in
Sport Group, 2002). Knowledge
transfer is defined as “methodical
replication of the expertise, wisdom,
and tacit knowledge of critical
professionals into the heads and hands
of their desire” (Trautman, 2011).
Given the appropriate assessment
technique and knowledge by utilizing
Knowledge Transfer strategies,
athletes can become more aware and
prepared to mitigate the risk of
concussions.
To establish a successful
Knowledge Transfer strategy,
Knowledge-to-Action framework
(KTA) should be applied. The
benefit of using KTA provides guideline for a step-by-step approach towards concussion
awareness. There are seven steps in KTA illustrated in Figure 3. Each step is vital and unique in
its own way. The first step of KTA will be appropriate evaluation on concussion knowledge
gaps and identify the particular problem. This step will set up the literature research on the
Figure 13: Knowledge to Action framework (KTA) flow chart for Concussion
(Provvidenza, 2013)
Figure 12: Age and Gender Demographic of Concussion
(CDC, 2011)

10
Figure 14: Pre-presentation and Post-presentation
passing rate (Bagley, 2012)
matter and assist further understanding of the problem. The second step of KTA is adapting the
knowledge to the context of the problem. For example, modifying the knowledge of concussion
management into specific coach-athlete scenarios will help facilitate acceptance and recognition
by athletes and coach. In the third step, the barrier between theories to practical knowledge use
should be evaluated. This step will help make the knowledge more practical and readily
accessible. For example, organization could assess and develop protocols for concussion. The
fourth step in KTA is to select the method of interventions. Organizations should look to choose
their preferred method of intervention. Different approaches to enhance education, including
videos, online resources and seminar, are crucial in conveying the information. In the fifth step,
knowledge use must be monitored. Organizations will carefully guide the actual use of
knowledge by coach and athletes. This will help enhance the attitudes toward concussion
management in the long run. In the sixth step, the outcomes of intervention will be assessed.
This will provide organization with report to determine the effectiveness of this strategy and how
to improve. Last but not least, the final step will be to sustain knowledge use. Organization
should reevaluate the effectiveness of the educational initiative after six months.
Successful Models of Knowledge Transfer
As many high schools have become aware
of the concussion epidemic, some have already
developed strategy to counter the complicated
situation of concussion. There are a couple of
successful examples that SMHS can model. For
example, a group of high schools have partnered
with Sports Legacy Institute Community Educators
(SLICE) in an effort to spread concussion
awareness.
In this strategy, the schools hosted a
concussion seminar under the guidance of SLICE.
The seminar is designed to provide concussion
education, prevention skills, and dispel common myths. The target audience included players on
the school‟s team, coaches, parents and school staffs. The SLICE plan featured experienced
medical profession who present “age-specific interactive
presentations that include discussion, videos, audience
demonstrations, and case studies of high school athletes”
(Bagley, 2012). SLICE presentations focused on improving students‟ ability to recognize the
symptoms of a concussion and react to concussion.
The SLICE Program is highly successful. There has been noticeable enhancement in
concussion knowledge in athletes across all gender and age groups who completed the SLICE
presentation (Figure 4). The results propose that the SLICE model perhaps can apply to other
concussion education programs. West Roxbury Academy is a major participant in the SLICE
program. They supported and believed in the effectiveness of SLICE since the beginning of the
program. The cost of this plan is approximately $1000. The cost includes the price of
refreshment, flyers, tools, and guest speakers. This plan is largely successful in West Roxbury
Academy. In fact, in one survey, 93% of athletes from West Roxbury Academy strongly agreed

11
Figure 16: Pre-test and Post-test on ACT (Glang et al., 2010)
that they will more likely to reveal a concussion to their coach. In additional, 89% strongly
agreed that they will tell their coach if they suspect their teammate having a concussion (Bagley,
2012). West Roxbury Academy is the ideal model for using SLICE model.
Mentorship
Mentorship is a crucial factor in
educating youth players about prevention and
long-term consequence of repetitive
concussions. Effective mentorship can
accelerate athletes‟ knowledge on
concussions. The roles of mentor are not
limited to just coaches, but parents, athletic
trainers, administrators, teachers and even
peers. Unsurprisingly, athletes can adopt the
mentor role if he exudes confidence and a
positive attitude (Thompson, 2003) on the
prevention of repetitive concussions.
Research has shown that better-educated mentor can
identify concussion symptoms and misconceptions
than non-educated mentor (Saunders 2013). Education can further immerse the mentor into
routines for increasing awareness for themselves and their athletes. As a result, educated mentor
scan play a crucial role in intervention, assessment, and consultation with athletes who have
sustained a concussion. Often, athletes have identified that social support from their mentor,
such as their coaches, players and peer... etc., are significant to their recovery (Johnson &
Carroll, 1998). With improved education, the mentor can provided better assistance to manage
athletes‟ concussion.
Model of Mentorship
Advanced Concussion Training (ACT) is
the most population education program for
coaches, parents, administrators, health
professionals and any concerned citizen in the
United States. In fact, high school football
coaches in Boston and Chicago public schools are
mandatory to attend ACT. The program aims to
help the participants develop improved
interactions between mentors and athletes. Also,
they provide the necessary education for mentor to
guide athletes. For example, topics include
coordination of care, return-to-school, and
changing the concussion cultures.
Carver Military Academy is a successful
model of ACT. The ACT program of Carver Military
Academy cost roughly $600. The costs include the price of food, guest speakers, and the trainer.
The outcome of this program was encouraging; the participants from Carver Military Academy
Figure 15: Mentorship Model (Brown et, al. 2010)

12
Figure 17: Community of Purpose Pyramid (Schatz 1990)
have a better “knowledge about concussion, management, and prevention; attitudes about the
importance of preventing sports concussion; and intention and self-efficacy in sports concussion
management and prevention” (Figure 7). This outcome suggests that ACT indeed is an effective
tool for developing and training mentors crucial to reducing the risks of concussion in football
athletes.
Community of Purpose
Another possible model for increasing
concussion awareness is the Community of Practice
Model. It consists of a community of people who are
in the same field and/or profession. The members of
the group share information and personal experiences
amongst each other, allowing personal growth
personally and professionally while at the same time
achieving the community‟s goal(s). A broader version
of this model is the Community of Purpose; instead of
people of the same field, it includes everyone who has
similar interests.
A successful Community of Purpose has three
major aspects: Awareness, Problem-Solving Approach, and Appropriate Caring Action (Schatz,
1990). As illustrated in Figure 5, Awareness is the foundation towards creating a functional
community. The member must be aware of Self, Others, and the Environment. Fundamentally,
people who want to attain a goal are already aware of their own desires, but not of other similar
people or the current situation. By joining the particular community of purpose, members
discover other like-minded people and the current situation, such as the sociopolitical
environment. The next step is developing a Problem-Solving Approach. This is one of the main
functions of the community. Members collaborate using knowledge unique to their fields to
identify the problem, explore options, and set goals for the community. Lastly, Appropriate
Caring Action builds off of the previous step; it is the actual implementation of the problem-
solving approaches developed. Actions that improve Self and Others consist of those that
improve personal growth, skills development, and resource utilization. Through the Community
of Purpose, the individual skills and knowledge of many like-minded people can be combined to
achieve a goal unattainable alone.
Successful Models of Community of Purpose
A successful model of Community of Purpose is Colton High School‟s School
Concussion Management Team (CMT). The Team has three sub-teams within it: Academic,
Athletic, and Medical. Each team has certain professionals suited for a particular team. Last, but
not least, there is the Student & Family. The student is the concussion patient himself, and the
three teams revolve around alleviating the concussion. For this program, there is no cost
involved except for the volunteers‟ time. CMT is highly successful. Many schools in Oregon use
this program because there is noticeable improvement in the student‟s outcome post-concussion.
The teams and their members create a large network that supports the student among many
aspects, such a physical, psychological, and emotional therapy. CMT exemplifies perfectly the
Community of Purpose Model.

13
Success Model of Preseason Baseline Testing
In order to address the problems associated
with concussions and meet the needs of the students,
one must be able to accurately test for its presence.
How else will the CMT know which student to treat?
A short yet reliable exam needs to be designed to
assess the brain functions that can be affected by a
concussion, such as reaction time, verbal and visual
memory, and attention span. Ideally, an exam should
be given to all football athletes during the preseason,
when the student usually is not as involved in rough
activity, to establish a reference to his normal
functional status. That way, the results of an exam
given upon the athlete suspected of having a
concussion can be compared with his normal results to
produce an objective diagnosis (Figure).
The test provided in the ImPACT Concussion
Management Model in Summit High School, Portland is
an ideal model for basing the concussion exams on. The
cost of this program is $350 (ImPact, Inc, 2013), which
is the price of the ImPACT Testing Package. ImPACT is a twenty-five minute computerized test
to be administered by the school nurse, athletic director, team doctor, psychologist, or ImPACT-
trained athletic trainer. The exam tests for symptoms and changes in mental function associated
with concussions. Baseline tests are given every two years, which will be compared to tests
given to suspected concussion patients. After the patient has been treated by a licensed doctor,
another test is administered to assess the amount of recovery and whether or not he is suited to
return to normal activity. ImPACT has been observed to have a 98% rate of predicting
concussions in athletes suspected of covering up their ailment (Schatz, 2012). Like all medical
diagnoses, it is essential to have an accurate and easily-administered test in order to provide
quick and correct treatment, which is fully exemplified by ImPACT‟s test.
Successful Models of Social Media
In the current Internet age, almost everyone uses the social media site Facebook. In fact,
there are over 1 billion people worldwide actively using Facebook(Associated Press, 2012). Due
to the immense traffic that Facebook receives 24/7, social media is an invaluable asset for
spreading information, good or bad. Many of the media outlets promoting the NFL player as
immutable idols for young players have spread their reach to Facebook. Likewise, Facebook can
serve as a powerful medium for broadcasting information on sports concussions (Sullivan 2012).
With the advent of smartphones, Facebook is even more accessible; instead of turning on the
computer every time, users only need to take their phones out of their buttons and tap the screen
to get on. As a result, many young adults are constantly immersed in their computers and
smartphones surfing the Web and going on Facebook. Creating a group page devoted to
information and advice on concussions on the site most-visited by the target audience is a
Figure 18: The ImPACT Concussion
Management Model (ImPACT, Inc, 2013)

14
resource that absolutely must be exploited. The fact that creating a Facebook group page is free
makes it that much more appealing.
A successful model of Social Media is Glebe Collegiate Institute. In this model, a private
Facebook group page for concussion information was created. Only students of the school,
mainly members of the football team, were allowed to join the group. It was observed that
individuals mainly utilized the Facebook group to relate personal experiences of concussion
(65%), although it was also used to seek (8%) or offer advice (2%) (Ahmed al, et. 2010). For
students searching for quick facts and advice, a readily-accessible Facebook group is great asset.
The cost of this Facebook page is relatively cheap, adding up to around $50 annually for
maintenance and design. Glebe Collegiate Institute is a perfect model for using Social Media to
broadcast information.
Current efforts in South Milwaukee High School
South Milwaukee High School requires all athletes and parents co-sign a “Participant and
Parental Disclosure and Consent Document” to signify that they acknowledge the newly-
implement concussion law in Wisconsin. The new law mandates the removal of any athletes
who have suffered a possible concussion from the field. The removed athletes may not
participate in any athletic activities until he or she receives clearance from a qualified healthcare
provider. Failure to sign the agreement will result in immediate prohibition from participation.
The document also provides a six-step guideline for concussed athletes to return to play.
This guideline provides a step-by-step procedure for to gradually resume athletic activity for
patients. The document also displays some of the signs and symptoms of concussion to look out
for, and encourages athletes to notify a medical profession, coach, and/or parent about a possible
concussion. However, current efforts are largely ineffective. After the implementation of the
“Participant and Parental Disclosure and Consent Document”, the number of concussion
incidents has actually risen from 7 to 9 during the 2012-2013 school year (Galewski, 2012).
Conclusion
Sports-related concussions are a largely hidden epidemic, with few signature symptoms.
The effects side effects are sometimes delayed and/or long-lasting, only appearing later in one‟s
life and with little or no options for a cure, such as memory loss and recurring headaches. The
problem is exacerbated by high school athletes and coaches lack of proper knowledge regarding
getting proper rest or knowing when to stop playing. Oftentimes, athletes try to overlook the
pain and continue playing for the sake of becoming a star athlete, and even if they do get
treatment, they downplay the pain so that they can return to the field earlier with insufficient
treatment. High school coaches are usually parent volunteers, and as such, know just as little
how serious concussions can be.
Therefore, education programs, like the SLICE Program, with professional speakers can
be implemented. Education is one of the best ways of reducing incidences, allowing athletes to
play more carefully and take better care of their own health. Another possible program is CMT,
which creates teams using the Community of Purpose principle to give the student well-rounded
treatment and therapy. Lastly, ACT, which uses the Mentorship model, is similar to the SLICE
Program in that it uses education to prevent concussions, but it is more of a one-on-one program.

15
Not only that, athletes can become mentors for other athletes; the relationship is not solely
coach-to-athlete.

16
Plan
Elements that influence players‟ reactions to concussions have been extensively studied.
Players ignorant of the dangers of concussions typically play roughly with no regard to their
wellbeing and hide their symptoms to continue playing. Even if they are removed from play,
players will try to get back onto the field as soon as possible at the cost of sufficient rest and
treatment. All of this is usually done as a show of strength perpetrated by the current football
culture idolizing professional players. It has been confirmed that the community and supporters‟
involvement in the problem can decrease such risky behavior. The models were effective at
reducing repeat concussion rates and integrating school-based concussion education with
community engagement. The objective of this program is to decrease the excessively high
concussion rate in South Milwaukee High School by utilizing a four-phase operation:
Phase I: Educate and Raise Awareness (ERA) in the Community
Phase II: Advanced Concussion Training (ACT) for the Community
Phase III: Establish and Utilize Concussion Management Team (CMT)
Phase IV: Preseason Baseline Testing & Post-Injury Testing
Phase V: Utilizing Social Media to Convey Concussion Information
This program will utilize different educational seminars aiming to promote community
engagement in the athletes‟ lives, communication with athletes, and enhance the bonds between
supporters and athletes. As a result, this will reduce concussion rates and increase community
members‟ awareness of the issue. The studies from the models have validated that community
engagement contributes greatly towards lowering risky behavior in football athletes. Community
involvement will help misled athletes gain knowledge in concussion prevention and alleviation,
while simultaneously advising them on reliable decision-making.
Literature Overview
Source Glebe
Collegiate
Institute
West
Roxbury
Academy
Colton High
School
Carver
Military
Academy
Summit High
School
South Milwaukee High
School
Facebook
Pages
SLICE Concussion
Management
Team
Advanced
Concussion
Training
Preseason
Baseline Test
Return to Play guideline
Flyers Recruit
Volunteers
Post Injury Test Participant and Parental
Disclosure and Consent
Document
T-shirt
Distribution
Table 1: Models integrated into the Plan
Phase I: Educate and Raise Awareness (ERA) among Community
The introduction of Educate and Raise Awareness (ERA) is to develop a consensus
amongst the community that concussion ignorance is serious and severe. Football athletes are in
need of protection and education. Because concussion ignorance did not gain media attention
until recently, it is justified that the program needs to take a more aggressive approach in

17
promoting the problem (Glang 2010). ERA is modeled off the SLICE program in recognition of
the latter‟s success. In order to have community involvement, it is crucial to allow community
members to take a dominant role in the plan.
The organizer of ERA will have to arrange the seminars on one evening at South
Milwaukee High School through the school board of education of South Milwaukee, Wisconsin.
During the beginning of each football seasons, flyers advertising the education seminar will be
distributed to all students and parents (Appendix A). Also, flyers will dispersed at high influx
locations, such as cafeteria and school entrance. The seminars will target all members of
community including students, athletes, parents, teacher and adults.
Two seminars will be scheduled for the same day in South Milwaukee High School. One
seminar will target at adults and be conducted at night, while the other is aimed at the students
and athletes of the community after school. The adult seminar (Appendix B) will include a
review of basic concussion education, the essentials of community-athletes communication, and
how to create dialogues of responsible concussion management with athletes. A major point will
focus on the fact that South Milwaukee has an enormous number of concussions; in the academic
2012-2013 academic year, there were a total of 9 reported concussions for the football team, with
estimate of just as many unreported cases (Galewski, personal communication, 2013). The
community must be made aware of the potential problems of athletes engaging in risky behavior
due to their ignorance of the severity of concussions.
There are many external factors that cause players to ignore and downplay their injuries.
The cultural view of playing through injuries as a show of strength is widespread, and athletes
fall for it because they lack appropriate knowledge on the subject. The media tends to glorify
skilled players who rarely get injured, thus indirectly teaching players to hide their injuries to
become just as skilled and famous. This occurs because concussion management is not
sufficiently discussed (Glang, 2010). Ignoring a severe concussion may lead to serious
consequences include Alzheimer‟s disease, Parkinson‟s disease and possibly death. Athletes
who already ignore their injuries tend to persist in such risky behavior (Bloom, 2008). In
additional, athletes have demonstrated that they would like to learn about the issues of
concussion (Meehan, 2011). However, coaches, parents and teachers often do not possess the
appropriate knowledge and approaches either (Shaughnessy, 2009). The seminar will focus on
developing concussion knowledge among parents and adults and offering them ways of
approaching athletes suspected of having a concussion.
The student and athlete seminars will consist of the biological mechanism and cultural
implication of concussions. Athletes often feel internal or external demand to resume play while
injured. This pressure occurs because they do not want to lose their hard-earned reputation,
disappoint their teammates, or simply be label as “weak” (Daneshvar, 2011). Also, sports
advertisements glorify ignoring concussions and praise doing so as heroic. The information that
the athletes receives have often decided the way they handle concussions, yet society does not
provide them with appropriate guidance or knowledge to make accountable concussion
management decisions (Shaughnessy, 2009). Another purpose of this seminar is to focus on the
misconceptions and dangerous mindset of playing through injury.

18
This seminar will last one and a half hour with a 15 minute intermission including
refreshments. The seminar is designed to be interactive, fun, and educational, with the first
twenty minutes consisting of a presentation about concussions. The next twenty minutes will
present videos and demonstrations, and the last twenty minutes will present a case study of a
high school football athlete who suffered a concussion and chose to ignore the seriousness of his
problem. The final ten minutes of this seminar will include a Q&A section. With this seminar,
students and athletes will hopefully learn to be more careful when playing rough sports and
discover the importance of getting immediate and complete treatment.
Phase II: Advanced Concussion Training (ACT) for Community
After completing the seminars in South Milwaukee High, the coordinators will review the
importance of community engagement in lowering South Milwaukee High School‟s concussion
rate. Volunteers Wanted flyers (Appendix C) will be distributed to all audiences. In order to
change the mindsets of community members, people from different aspect of the community
must be strongly involved (Glang, 2010). The objective of this phase is to facilitate training to
community members and to utilize their support to enhance the program itself. Community
engagement will not only disperse the important messages of the program but also circulate
values among members.
Separate seminars will be held to offer further training and knowledge to community
volunteers. The training seminar will last a total of two and a half hours with two ten minute
breaks with food and drinks. The curriculum will contain fourteen different topics, including
Return to Play, Return to School, Coordination of Care, and Changing the Concussion Culture
(Appendix D). Volunteers will be assigned to different regimens based on their unique roles in
the community. Although training will be varied based on the role of the volunteers, the
curriculum will cover the same topic but from a different perspective. This will allow volunteers
to possess similar knowledge base but be able utilize it in different ways. For example, in the
topic of Return to School, teachers will learn how to provide proper classroom accommodations
to the student, while parents will learn how to determine whether their child is ready to return to
school through a strong understanding of the cognitive, behavioral, emotional, and physical
symptoms of a concussion. The last twenty minutes will be designated as the Q&A section. At
the end of the seminar, free labeled T-shirts will be distributed to all volunteers. The T-shirts
will strongly reinforce the identity of the community and unite its members towards the goal of
concussion prevention (Bucholtz, 1999). This is essentially reinforcing the central dogma of the
Community of Practice model.
Phase III: Established and Utilized Concussion Management Team (CMT)
After Advanced Concussion Training (ACT), volunteers will be assigned into four
different teams: The Academic Team, The Athletic Team, The Medical Team and The
Community Team. In the initial four weeks, a sponsor organization will provide training for the
four concussions teams. They will teach effective communication skill and coordination skills
between teams. Also, each individual team will be assigned different responsibilities (Appendix
E).

19
Since South Milwaukee High School is a large school with many resources, including a full-
time guidance counselor and school nurse, concussion management Team will use a Two-Leader
Model. In this Model, the guidance counselor is the Concussion Management Leader (CML) and
Academic Leader (AL), and the school nurse is designated as the Medical Leader (ML). This
plan consists of six steps:
1) The concussion is reported the
concussion to the guidance
counselor (CML and AL)
2) CML contacts student‟s family
and meets with the student when
he or she returns to school
3) The school nurse (ML) assesses
medical needs and communicates
the information to AL
4) AL assesses academic needs
5) AL distributes accommodations
to teachers and contacts ML,
family, and the coach/physical
education teacher with relevant
information
6) AL and ML discuss plans for re-
assessing the student‟s status.
The purpose of this model is to provide a constant link between the ML and AL in order to keep
information updated. This also allows the leaders to clearly and accurately designate tasks and
responsibilities to other school faculty.
The Community Team Volunteers will then be utilizing to revise the adult and students
seminar in phase 1 and provide advanced training to volunteers in phase 2. Using volunteers in
those seminars will be crucial. Volunteers will be able to provide first personal experience and
reasoning for trusting in the concept foundation of the program. The adult members will offer
responsible dialogue of effect of concussions and prevention on concussions to audiences.
Possessing help from community volunteers will eventually change the culture and general
conception on playing with concussion. Increasing communication between community and
athletes will offer athletes with appropriate knowledge and it will also provide community
members the chance to propagate their values on concussion.
Phase IV: Preseason Baseline Testing & Post Injury Testing
As ERA stabilizes in the South Milwaukee High School community, a separate seminar
will be conducted prior to the start of football season. This seminar will be aimed at the school‟s
football athletes and will offer a preseason cognitive baseline test (Appendix F). Identifying
concussions has been difficult and inconsistence. This is mainly due to most concussion being
examined with subjective clinical judgment (Randolph & Kirkwood, 2009). The cognitive
baseline test will provide an objective cognitive function measurement to be utilized in the
concussion management process. It will be mandatory for all football athletes to attend this
Figure 19: Two Leader Mode of CMT (Nationalwide
Children‟s, 2013)

20
seminar. If an athlete is unable to, he will not be permitted to participate in any team activities
until he makes up the preseason baseline test. An individual baseline test will last approximately
eight to ten minutes. In the meantime, there will be four baseline tests occur at the same time to
accommodate all the players. Because there are approximate fifty football athletes in the school,
the seminar is expected to last approximately two hours.
After a suspected concussion occurs, the athlete will be removed from the field
immediately. They will undergo the same cognitive baseline test, after which the results will be
compared to the preseason data. Therefore, the comparison will allow a more evidence-based
clinical judgment based on the difference between the two cognitive baseline tests. The athletic
trainers and school nurse will be responsible for performing the cognitive baseline test. Once the
athlete recovers from the concussion and is symptom-free, he will undergo another baseline test
to approve his return to athletic activity. The last baseline test will ensure athletes are
completely concussion-free and qualified to resume playing football.
Phase V: Utilizing Social Media to Convey Concussion Information
After the formation of CMT and educational seminar, a concussion education Facebook
page will be endorsed (Appendix G). As studied showed that social media is a powerful medium
to spread the information of sport concussion (Sullivan, 2012), the Facebook page will be a
powerful tool to spread the messenger of concussion. This Facebook page will offer concussion
knowledge and serve as an interactive platform for community members. CMT volunteers will
regularly update and maintain the page. Essential links and information will be placed on the
page. Community members will be allowed to post questions and placed remarks relevant to the
topic. Maximizing the benefit of social media is crucial to raising concussion awareness. Some
members of the community may not feel comfortable being physically present at public seminars
and asking questions in front of other people, so utilizing social media as a medium for
promoting and spreading information allow people to easily access the information they require
from a site they visit daily.
Table 2: Plan of Action
Plan of Action
 Arrange education seminars for the community of South Milwaukee
 Create fliers and promote the seminars
 Recruit volunteers
 Provide advanced concussions training to volunteers
 Established Concussions Management Team (CMT)
 Utilize volunteers to help improve program
 Established preseason baseline testing and post-injury testing
 Advertise Facebook page

21
Dr. Rita Olson, Superintendent for the School District of South Milwaukee
With a history of funding concussion prevention programs in South Milwaukee High
School, Dr. Rita Olson is the ideal patron to fund this project. Dr. Olson had been seeking
solution to improve the current situation of concussion issues in South Milwaukee High School
Football Team. Previously, she has supported the program that involved “Participant and
Parental Disclosure and Consent Document”, a document requiring athletes and their parents to
cosign before participating in any athletic activities in an effort to raise awareness sports-induced
concussion. This plan, in comparison to the previous plan, is more effective and complete.
Therefore, Dr. Olson will be very interested to consider this plan.
Conclusion
ERA will be beneficial for athletes at South Milwaukee High School who are confronted
with concussion issues. The CMT will provide valuable support, as it operates directly at the
front line with athletes who are struggling with concussions. The volunteers will earn the faith
and admiration of those athletes who receive their support. While ERA will be crucial for
providing concussion knowledge to athletes, the execution of this program will also aid the
whole community. By utilizing such functions as educational seminars and the Facebook page,
the community and athletes will be inspired to recognize concussion as a problem that truly
needs to be dealt with. These functions will not only obstruct the expansion of concussion, but
teach athletes and community about the characteristic of concussion so that they can mitigate
future cases. By way of ERA‟s advertising to the community, the stigma towards reporting
concussions will dwindle, thereby eliminating the misconceptions and changing the mindsets of
athletes battling concussion. All these functions will alleviate anxiety and embarrassment
experienced by concussion patients, develop a friendly atmosphere where athletes can search for
skilled supports without the additional stress arising from the embarrassment of being a patient.
As ERA starts to change the community‟s opinion of concussions and destroys the stigma related
to concussion, ERA will improve the overall health of the South Milwaukee High School
community.

22
Budget
Cost Break down
Description Cost Quantity Justification
Phase I
Two Topping Pizza $6 20 Domino Menu
Speaker $0
Provided by Brain Injury Alliance of
Wisconsin
Auditorium $0 Provided by South Milwaukee High
Projector $0 Provided by South Milwaukee High
Flyers $0.1 1500 Office Depot
Posters $.15 10 Office Depot
Microphone $0 Provided by South Milwaukee High
Seat Arrangement $0 Provided by South Milwaukee High
PowerPoint Presentation $0
Provided by Brain Injury Alliance of
Wisconsin
Pepsi (24 cans) $5 6 Wal-Mart
Total $101.5
Phase II
Speakers $0 Provided by Sport Legacy Institute
Flyers $.1 100 Office Depot
Two Topping Pizza $6 10 Domino Menu
Projector $0 Provided by South Milwaukee High
Microphone $0 Provided by South Milwaukee High
Volunteers T-Shirts $4.12 50 Custom Ink
Total $291
Phase III
Two Toppings Pizza $6 10 Domino Menu
Concussion Management
Team Training
$0 Provided by BrainSTEPS
Total $75
Phase IV
ImPACT Baseline Test &
Post-Injury Package (75
Baseline and 25 Post-Injury)
$350 1 According to official site of ImPACT
Credentialed
ImPACT™ Consultant (CIC)
Training
$0 Provided by ImPACT

23
Total $350
Phase V
Facebook Pages $0 Run by student volunteers
Advertising Flyers $.1 150 Office Depot
Total $15
Overall Total: $832.5
Table 3: Budget Details Breakdown
Justification
In comparison, this plan is significantly cheaper than other plan with similar goals, since
most of the necessary components are either covered by nonprofit organizations or provided by
school itself. There will be a total of three seminars per season: two educational seminars and
one advanced training seminar. One educational seminar will target student and athletes and the
other one will target adults and other community members. The advanced training seminar will
be focus on training coaches and parent volunteers over a course of four weeks. South
Milwaukee High School will provide the auditorium, projector, microphones and seating
arrangements in all seminars. Brain Injury Alliance of Wisconsin will provide speakers and
presentation materials for Phase I (Appendix M), while Sports Legacy Institute will provide
speakers and presentation materials in Phase II (Appendix O). Concussion Management Team
Training will be providing by BrainSTEPS (Appendix N). Approximately 1300 students are
enrolled in South Milwaukee High School. One flyer costs $0.10 in Office Depot (Appendix H).
In Phase I, 1500 flyers will be printed in anticipation of students losing theirs. 1300 flyers will be
distributed to all students. The remaining 200 will be distributed to all faculty, staff,
administrators, parents, and community members. Because 100 people interested in attending the
Phase II presentation, 100 flyers will be distributed. Out of that 100, about 50 volunteers willing
to participate and completed the training are anticipated. Therefore, 50 T-shirt designed for the
volunteers will be purchased through Custom Ink. Each one will cost approximately $4.12.
Refreshment will be served at all seminars and CMT training. Nine packs of 24 cans of Pepsi are
to be provided at each seminar. One pack of 24-can Pepsi costs $5 (Appendix J). Also, ten boxes
of Domino‟s “Two Topping Large Pizza” per seminar and training session are required, adding
to a total of forty boxes. One “Two Topping Large Pizza” from Domino‟s will cost $6
(Appendix I). In Phase IV, the ImPACT Package will cost $350 for 75 Baseline & 25 Post Injury
Tests (Appendix L). The ImPACT training will be providing by ImPACT for free. Since the
Facebook page will be run by volunteers, the page will have no cost. However, advertisement
flyers are needed to promote it. The total cost for all five phases of the plan adds up to
approximately $832.50.

24
Discussion
Physical head trauma resulting in damage to the brain, also known as a concussion, is a
widely hidden and misunderstood problem in the United States. Most cases of concussions today
occur in high school students involved in athletic activities, especially football. Due to the nature
of the sport, players tackle each other with as much force as they can muster, resulting in all
kinds of injuries. While exterior injuries such as broken bones and torn muscles have obvious
symptoms and appearances, interior injuries like concussions do not have such clear symptoms
and appearances. Some symptoms of a concussion are memory loss, headaches, and changes in
psychological behavior; all of these symptoms vary widely in severity, duration, and recurrence.
As a result, concussions cannot be precisely diagnosed, and patients often receive insufficient
treatment. To worsen the problem, the current football culture glorifying “invincible”
professional players has ingrained in young players a mindset that they are weak if they show
signs of injury. This causes young athletes ignorant of the problems of a concussion to hide their
injury to give an appearance of strength, and no injury is better hidden than the “invisible”
concussion. This results in improper treatment and rest; students return to the field sooner than
recommended and possibly receive more concussions, repeating the cycle and accumulating the
damage from concussions. The main problem in propagating concussions is ignorance; coaches
and students alike generally do not know how to diagnose or treat a concussion.
Football is most played in the Midwest, resulting in the highest rate of incidence at 578.4
per 100,000 people (Bazarian 2005). In fact, Milwaukee, Wisconsin, has a 30% incidence rate
compared to the national average of 5.6% (Guskiewicz 2000). Therefore, this proposal focuses
on creating programs for South Milwaukee High School to educate the high school community
and create a suitable environment for students with concussions. The first program will involve
creating an education program for raising awareness using the SLICE program as a model:
Educate and Raise Awareness (ERA). ERA‟s purpose is to design an assembly to provide
general concussion education to the members of South Milwaukee‟s football program, mainly
the students, coaches, and parent volunteers. It will involve general facts so that everyone knows
what to do in general when a concussion occurs, such as immediately leaving the field upon
suspected concussion and resting for however many days it takes to recover. The second
program, Advanced Concussion Training (ACT), involves detailed training of coaches and
parent volunteers on how to dealing with concussions. While it will be mandatory for them to
attend, other members of the faculty, like teachers and the school nurse, are allowed to join them
if they wish. The final step of the proposal will be creating a Community Management Team
(CMT) to create a caring and helpful environment for the student/patient. CMT involves
academic, medical, and athletic staff, and will involve all aspects of proper care. By following
this proposal, South Milwaukee High School can reduce concussion by increasing awareness and
improving care. As is commonly stated, prevention is the best cure.

25
Reference
Associate Press. (October 23, 2012). Number of active users at Facebook over the years. The
Associated Press. Retrieved from http://news.yahoo.com
Ahmed, O. H., Sullivan S., Schneiders A., Mccrory P. iSupport: do social networking have a
role to play in concussion awareness? Informa healthcare (2010), Vol.32, No.22, Pages
1877-1883
Aubry M, Cantu R, Dvorak J, Graf-Baumann T, Johnston K, Kelly J, Lovell M, McCrory P,
Meeuwisse W, Schamasch P; Concussion in Sport Group. (2002). "Summary and agreement
statement of the first International Conference on Concussion in Sport, Vienna
2001*". British Journal of Sports Medicine 36 (1): 6–10.PMC 1724447.PMID 11867482.
Ajzen, I. & Fishbein, M. (1980). Understanding attitudes and predicting social behavior.
Englewood Cliffs, NJ: Prentice-Hall.
Bagley, A.F., et al., (2012) Effectiveness of the SLICE Program for Youth Concussion
Education. Clinical Journal of Sport Medicine. 22(5): p. 385-389.
Bazaarian J, Mcclung, J et al. Mild traumatic brain injury in the United States, 1998–2000.
2005, Vol. 19, No. 2 , Pages 85-91
Broglio SP, Sosnoff JJ, Shin S, He X, Alcaraz C and Zimmerman J. Head Impacts during high
school football: a biomechanical assessment. Journal of Athletic Training. 2009;44:342-349.
Brown, S. E., Takahashi, K., and Roberts, K. D. (2010). Mentoring individuals with disabilities
in postsecondary education: A review of the literature, Journal of Postsecondary Education
and Disability, 23 (2), 98-111.

26
Bucholtz, M. (1999) “Why be normal?”: Language and identity practices in a community of
nerd girls. 1999 Cambridge University Press
Cantu, R. C. (2001). Posttraumatic retrograde and anterograde amnesia: Pathophysiology and
implications in grading and safe return to play.Journal of Athletic Training, 36(3), 244-248.
Centers for Disease Control. Nonfatal traumatic brain injuries related to sports and recreation
activities among persons ≤ 19 years - United States, 2001-2009. MMWR 2011;60:1337-
1342.
Children‟s Hospital of Wisconsin. Sports Medicine Concussion Volume. (2011) Retrieved from:
http://www.chw.org/display/PPF/DocID/48041/router.asp
Cohen, A. Football player hospitalized after big hit (2012). Retrieved from:
http://fox6now.com/2012/10/19/1-8/
Cox, R. H. (2002). Sport psychology: Concepts and applications (5th ed). New York: McCraw-
Hill.
Daneshvar DH, Nowinski CJ, McKee AC, Cantu RC. The Epidemiology of Sports-Related
Concussion. Clinics in Sports Medicine, 30(1), 1-17, January 2011.
Delaney JS, Lacroix VJ, Leclerc S, et al. Concussions during the 1997 Canadian Football League
season. Clin J Sport Med 2000;10:9-14.
Finkelstein E, Corso P, Miller T and associates. The Incidence and Economic Burden of Injuries
in the 2010) Head United States. New York (NY): Oxford University Press; 2006.

27
FORTUNE, N. & WEN, X. (1999), The definition, incidence and prevalence of acquired brain
injury in Australia, Australian Institute of Health and Welfare, Canberra.
Galewsk J, telephone interview to author, July 20, 2013.
Gean AD, Fischbein NJ. (Trauma. Neuroimaging Clin N Am. 2010 Nov;20(4):527-56. doi:
10.1016/j.nic.2010.08.001
Gessel LM. Fields SK. Collins CL. Dick RW. Comstock RD. "Concussions among United States
high school and collegiate athletes" J. Athl Train. 2007; 42(4): 495-503.
Glang A, Koester MC, Beaver SV, Clay JE, McLaughlin KA. Online training in sports
concussion for youth sports coaches. Int J Sports Sci Coach. 2010 Mar 1; 5(1):1-12.
Halstead M, Walter K. Clinical Report - Sport-Related Concussion in Children and
Adolescents, Pediatrics 2010; 126(3): 597-615 at n. 22, 23 (citing studies);
Huizinga, D.H., Loeber, R., Thomberry, T.P., and Cothern, L. (2000). Co-Occurence of
Delinquency and Other Problem Behaviors. Ofﬁce of Justice Programs: Washington, DC.
ImPACT, Inc. (2013) Select Clients. Retrieved July 22, 2013, from http://www.impacttest.com/
Lincoln A, Caswell S, Almquist J, Dunn R, Norris J, Hinton R. "Trends in Concussion Incidence
in High School Sports: A Prospective 11-Year Study" Am. J. Sports Med. 30(10)
(2011), accessed January 31, 2011
McCrea M, Hammeke T, Osen G, Leo P, Guskiewicz K. Unreported concussion in high school
football players: Implications for prevention. Clin J Sport Med14:1 (Jan 2004): 13-17

28
Meehan WP, d'Hemecourt P, Collins C, Comstock RD, Assessment and Management of Sport-
Related Concussions in United States High Schools. Am. J. Sports Med. 2011;20(10) as
dol:10.1177/0363546511423503 (accessed October 3, 2011).
Nationalwide Children‟s. A School Administratior‟s Guide to Academic Concussion
Management. Retrieved July 15, 2013, from http://www.nationwidechildrens.org/academic-
concussion-management
Powell, J.W., and Barber–Foss, K.D. (1999). Traumatic brain injury inhigh school athletes.
J.A.M.A. 282, 958–963.
Saunders, Elizabeth A.; Burdette, G. Trey; Metzler, Jonathan N.; Joyner, A. Barry; Buckley,
Thomas A. Knowledge of Coaching Education Students Regarding Sport-Related
Concussions. Athletic Training & Sports Health Care: The Journal for the Prac;Jan2013,
Vol. 5 Issue 1, p11
Schultz C, Parsons C. The theory and practice of empowerment in the context of family health.
Journal of Family Studies April 1990, Vol. 3, No. 1: 7–24.
Schatz P, Moser RS, Solomon GS, Ott SD, Karpf R. Incidence of invalid computerized baseline
neurocognitive test results in high school and college students. Journal of Athletic Training,
1997
Steve Trautman. (2011, September 23). “You Are Here.” Knowledge Transfer Defined.
Retrieved from http://www.stevetrautman.com

29
Sullivan SJ, Schneiders AG, Cheang CW, Kitto E, Lee H, Redhead J, Ward S, Ahmed OH,
McCrory PR. (2011) „What‟s happening?‟ A content analysis of concussion-related traffic on
Twitter. Br J Sports Med. 2012 Mar; 46(4):258-6.
Tate, R., McDonald, S., & Lulham, J. M. (1998). Incidence of hospital-treated traumatic brain
injury in an Australian community. Australian and New Zealand Journal of Public Health,
22(4), 419-423.
The Research Fondation of State University of New York. Cerebral Concusion form 1865-Dec-
01 to 2009-Dec-20. (2009) Retreived from http://www.textmed.com/disease/cerebral-
concussion.htm#timeseries-2
Thompson, J. (2003). The double-goal coach: Positive coaching tools for honoring the game and
developing winners in sports and life. New York: HarperCollins.
Tieves KS, Yang H, Layde PM. The epidemiology of traumatic brain injury in Wisconsin, 2001.
WMJ. 2005 Feb; 104 (2): 22-5, 54.
Tomei KL, Doe C, Pestigiacomo CJ, Gandhi CD. Comparative analysis of state-level
concussion legislation and review of current practices in concussion. Neurosurgical
Focus 33(6):E11, 2012.
University of Pennsylvania, School of Medicine. Traumatic Brain Injury: A “Silent Epidemic”
Retrieved from http://www.med.upenn.edu/cbir/silent_epidemic.shtml
Wisconsin Department of Health Service. (2008). State of Wisconsin Public Health Profile.
Wisconsin Department of Health Service.

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Appendix
Appendix A: Concussion Educational Seminar Flyer
Appendix B: Flyer for Adult Concussion Seminar

31
Appendix C: Volunteer Flyer
Appendix D: Advanced Concussion Training (ACT) Curriculum

32
Appendix E: Responsibilities Flyer of CMT

33
Appendix F: ImPACT Testing Day Flyer
Appendix G: Facebook Concussion Blog

34
Appendix H: Office Depot Price of 1 Letter sized Page
Appendix I: Domino Pizza Menu

35
Appendix J: One pack of 24 cans of Pepsi price
Appendix K: Volunteer T-Shirt Price

36
Appendix L: ImPACT Baseline Test Package
Appendix M: Sponsorship of Brain Injury of Alliance

37
Appendix N: Sponsorship of BrainSTEPS
Appendix O: Sponsorship from Sports Legacy Institute

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