Community‐Engaged Approach to the Development and Implementation of a Student‐Centered Return to Learn Care Plan After Concussion

• Published in: The Journal of school health 2020-11, Vol.90 (11), p.842-848
• Main Authors: Conrick, Kelsey McGuire, Moore, Megan, Abbotts, Laurel, Widdice, Laura, Hoag, Samara, Kroshus, Emily, Philipson, Erik Bruce, Jinguji, Thomas, Weiner, Bryan Jeffrey, Glang, Ann, Rivara, Frederick Peter, Chrisman, Sara Powell Dow, Dickason, Celeste Quitiquit, Vavilala, Monica Shanta
• Format: Article
• Language: English
• Subjects: Adjustment; Brain; Care plans; Check Lists; Checklists; child and adolescent health; Classrooms; Coding; Company business planning; Concussion; Coordinators; Educational materials; Feasibility; Fidelity; Guidelines; Head Injuries; High Schools; Implementation; Individual Needs; Instructional Materials; Interviews; Medical diagnosis; Nursing; Planning; Program Effectiveness; Program Implementation; Public Schools; Qualitative research; Reentry Students; return to learn; School employees; school health services; school nurses; School personnel; Secondary schools; Social aspects; Special Needs Students; Student Adjustment; Student health services; Student Needs; Student-centered learning; Students; Symptoms (Individual Disorders); Teamwork; Teenagers
• ISSN: 0022-4391; 1746-1561
• DOI: 10.1111/josh.12948

ABSTRACT BACKGROUND Current return to learn (RTL) after concussion guidelines lack specificity for individualized student care, limiting potential for adoption and implementation. We used a community‐engaged research framework to develop and evaluate the implementation of a student‐centered care plan that assists school personnel in facilitating RTL. METHODS We used best‐practice RTL guidelines and input from administrators and medical experts to iteratively develop a flexible student‐centered care plan. Thirteen schools participated. Coding completion of care plans indicated feasibility and fidelity; interviews with RTL coordinators indicated acceptability. RESULTS The care plan includes educational materials, symptom checklists, and guidelines for classroom adjustments linked to student symptoms. Care plans were initiated for 24 (70.6%) of 34 students with concussions, indicating feasibility. Fidelity was high, with the following subsections completed: Action Checklist (90%), Symptom Evaluation (91%), Temporary Adjustment Recommendations (95%). Qualitative analysis of interviews suggested care plans were acceptable and facilitate consistent communication, prioritization of individual needs of students, and increased ability to delegate tasks to other school staff. CONCLUSIONS Implementation of a student‐centered, individually tailored care plan for RTL is feasible and acceptable in public high schools. Future research should examine how to expediently initiate student‐centered concussion care plans after diagnosis to optimize recovery.