Managing concussions in New Zealand secondary schools: Let's take it seriously.

INTRODUCTION

Concussion can cause lasting cognitive, physical, and emotional challenges, impacting academic performance. New Zealand secondary schools lack sufficient knowledge and resources to support affected students. We co-designed and implemented the Framework for Management of Concussion in New Zealand Secondary Schools (FRANCS).

AIM: To explore experiences and perceptions of school stakeholders during 2 years of FRANCS implementation.

METHODS

Sixty-nine participants from 12 schools (students, parents, staff, and healthcare providers) took part in semi-structured interviews or focus groups. Data were analyzed using framework analysis to identify themes.

RESULTS

Four themes were developed: (1) Flexibility of implementation - friend or foe; (2) Owning the process; (3) The process is too onerous; and (4) External context and confounders.

CONCLUSION

FRANCS' flexibility enabled some schools to adapt and integrate it into existing communication pathways, supporting students' return-to-learn. Others faced challenges, resource limitations, and low engagement. Effective implementation requires initial external support to tailor FRANCS to school contexts, establish communication and monitoring systems, and embed return-to-learn processes.