Youth Tackle Football Head-Impact Estimation by Players and Parents: Is the Perception the Reality?

Abstract

Context: With growing concerns surrounding exposure to head impacts in youth tackle football, players and parents must understand the exposure level when assenting and consenting to participate. Objective: To determine whether youth football players and parents could estimate on-field head-impact frequency, severity, and location. Design: Prospective cohort study. Setting: Football field. Patients or Other Participants: We administered a 10-question head-impact estimation tool to parents (n ¼ 23; mean age ¼ 36.5 years [95% CI ¼ 31.7, 37.3 years]) and players (n ¼ 16 boys; mean age ¼ 11.1 years [95% CI ¼ 10.3, 11.8 years]). Main Outcome Measure(s): Player on-field head-impact exposure was captured using the Triax SIM-G system. We determined the accuracy between player and parent estimates relative to on-field head-impact exposures using κ and weighted κ values. Results: Youth tackle football players and parents did not accurately estimate on-field head-impact frequency (κ range ¼ 20.09 to 0.40), severity (κ range ¼ 20.05 to 0.34), or location (κ range ¼ 20.30 to 0.13). Players and parents overestimated head-impact frequency in practices but underestimated the frequency in games. Both groups overestimated head-impact severity, particularly in games. Most players and parents underestimated the number of head impacts to the top of the head, particularly during practices. Conclusions: Underestimations of head-impact frequency in games and to the top of the head suggest that informed consent processes aimed at educating players and parents should be improved. Overestimations of head-impact frequency in practices and severity may explain declining rates of youth tackle football participation.