SPOT Concussion:Systems to Prevent Overlooking Teen Concussion
This study identifies barriers and facilitators to the use of paediatric concussion clinical practice guidelines among primary care providers in Toronto.
Background
Background: Evidence-based Clinical Practice Guidelines (CPGs) help improve the quality and consistency of care provided by healthcare professionals. However, despite the existence of multiple concussion-related CPGs, published studies suggest that CPG awareness and adherence is low for the management of paediatric concussion. Not using CPGs could contribute to missed diagnoses or the mismanagement of children at risk for persisting post-concussion symptoms (PPCS), such as anxiety and learning disabilities, which can last for years following injury. There is a need to increase the utilization of paediatric concussion CPGs by primary care providers (PCPs).
Objective: We aimed to improve the use of CPG guidelines among community-based PCPs in Toronto by first identifying the facilitators and barriers to the uptake of CPGs.
Methods: A qualitative descriptive study design was used. Family physicians, paediatricians, and nurse practitioners were recruited via purposive and snowball sampling. Semi-structured interviews were conducted online. A combination of deductive and inductive coding was used, and a reflexive thematic analysis process followed for data analysis.
Results: Eight participants met our eligibility criteria and were interviewed. Four overarching themes were identified:
- Diverse conceptualizations of concussion CPGs and their relevance
- Limited opportunities to learn about paediatric concussion
- The important role of intermediaries
- End-user needs remain unmet
Conclusion: Participants shared their perspectives, insights into their decision-making process, and helped identify the barriers and facilitators to the use of concussion CPGs. With this knowledge, custom strategies for community-based PCPs in Toronto could be created to improve concussion CPG uptake.
Project team
- Amelia Di Meo
- Bethany Tong
- Maryam Fereig
- Sarah Diaz
TRP supervisors
Project advisory committee
- Heather Boon
- Gabrielle Freire
- Charlene Welsh
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