Table 2

Parent-stated facilitators and barriers to appropriate use of the concussion guidelines in community Australian Football

SubthemesExample quotes
Having an understanding of what the children are like normally‘It helps if you know the kid I think’.
If the concussive incident was observed by the person making the decision‘I think it helps you judge the situation better if you saw the incident’.
Guidelines enforced at the professional (Australian Football League) and state governing (Victorian Football League) levels‘I think you’ll find that the … how the leagues will work is that basically they’ll follow the AFL direction. … but certainly, yeah, I don’t think you’ll find the the leagues moving until the AFL moves’.
Enforce a clear club policy that supports best practices for concussion management and enforcement of the guidelines‘Once you know about it and you know that the club’s going to enforce it. If you have an episode like this that you’re going to have a week off or you may need a couple of weeks off. I think that would hurt them [the players] less because they wouldn’t maybe put up as bigger fight as they do’.
Stakeholder (players/parents/umpires/coaches) education and knowledge‘Yeah, I think let’s just say parents don’t know enough about it really. I think it’s all sort of still a grey area for them… The under eighteens and all the senior boys do it. They come off you know, blood … they come straight off the ground. Well, why can’t they get that into their noggins? Into their … you know, why can’t they think the same way [about concussion]? That’s why I think they [the players] need to be a bit more informed, yeah’.
Players wanting to play at all costs‘Yeah. If they generally just sort of you know, “I don’t care. I’m going back out there”’.
Players refusing to be taken to medical provider for care/evaluation‘But I felt bad. I could not get him into emergency that Saturday afternoon, he would not go’.
Lack of support from parents due to their lack of knowledge about the seriousness of concussion‘But a lot of the time I must admit, like especially out in the bush, parents don’t give two hoots about it. Let him back on you know? You’ll get that every day of the week’.
Inconsistency in medical care due to difference in practices or lack of knowledge (eg, general practitioners or emergency department doctors)‘Well, that’s one of my question marks. Because … I’m not convinced that they all would have the same abilities of assessing a concussion. And … and they might not. You know, because there’s a more extensive SCAT isn’t there? … And yeah, I’m not convinced that that … they would all be able to do that well and even know of its existence in some cases’.
Concussive incidents or symptoms that occur outside of direct contact of the team/club (eg, delayed concussion presentation; playing in a different league/sport)‘Whereas reading this, you can be concussed but especially with delayed, you don’t even have to cop a knock to the head. You could … cop a knock in a game where you’re spinning around and you could … it’s says in here, whiplash. And no one will pick on that during the game. And yet your son will … go home and then have the delayed reaction and no one’s picked up on it’.
Cost/time associated with visiting the medical provider‘Yeah. I’d say cost and time. People are flat out these days aren’t they? Like you know, trying to find time to make an appointment, get in. You know, trying to get into your GP’s almost impossible’.