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With new tool, Mass. hopes to get more schools to report concussions

Football helmets given to a group of youth football players in Ohio.Gene J. Puskar/Associated PRess

With fall sports just around the corner, the state is rolling out a new electronic reporting tool it hopes will encourage more public schools to submit mandated statistics about concussions and other head injuries among athletes.

The latest push comes amid rising concern nationwide about the long-term health ramifications of concussions, particularly for young, developing brains.

Under regulations implemented six years ago — and designed to help ensure that administrators, coaches, parents, and students take head injuries seriously — schools have been required to submit the data after each academic year. The number of schools doing so has risen over the years.

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But even in the most recent year, about 200 schools failed to submit data, despite the legal requirement. Others reported incomplete information or data believed to be inaccurate, including questionably low numbers.

For example, more than 100 schools reported no head injuries for 2015-16, the most recent figures available.

In the past, schools submitted data to the Department of Public Health by either filling out a Word document form and e-mailing it to state officials, or by printing out the form and sending a hard copy via traditional mail.

At times, the process has been clunky. There have been typos and fields left blank by school administrators. And it has required state officials to manually transfer information into their database, leaving the door open for more mistakes.

The data are believed to be so flawed that state officials, as well as medical experts interviewed by the Globe, have urged against analyzing or publishing the figures.

The new system allows schools to submit the information using a Web-based form that will automatically populate responses into a health department database. Schools cannot submit forms if key fields are left blank.

State officials said they expect the change “will streamline the collection process and improve the accuracy of the data.”

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Experts said data collection remains an important missing piece from the conversation about youth concussions.

“We’re trying to stop something from happening. If we don’t count when it happens, how can we stop it?” said Hosea Harvey, a professor at Temple University’s Beasley School of Law who has closely studied youth concussion laws around the country.

The state has also assigned an official to strengthen the collection of data and is making changes in how it stores and checks the information to help ensure accuracy, and to make it easier to identify and follow up with schools that fail to report.

State health officials are also seeing another problem: They do not know, in every case, if a school is required to report.

The law calls for data to be submitted by all public schools that have students playing extracurricular sports in grades 6 to 12. Private schools affiliated with the Massachusetts Interscholastic Athletic Association also must report.

Officials have a rough idea of which schools must report, based on lists of schools serving those grades available from the state Education Department and the MIAA (and the department has been sending e-mails to those schools annually reminding them to report). But health department officials have yet to pin down which schools have extracurricular sports and which don’t.

They have been asking schools that question on data reporting forms, and are working to contact school officials to sort out remaining issues.

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The health department will get its next chance to improve the data collection process soon: Schools are required to report by Aug. 31 each year. There is no penalty if they fail to do so, or if they submit the data late.

Experts said the state may want to add penalties or incentives to boost compliance.

Even with the flaws in Massachusetts, national experts said the state is a leader in collecting the data from schools, because few states require the statistics to be tracked at all.

“It isn’t good that 20 or 30 percent of the schools [in Massachusetts] are noncompliant, but that’s still more information than almost every other state has,” Harvey said.

Harvey said officials should make the collection of the statistics a higher priority, saying the data are a central part of measuring public health issues. And, he said, other data that already exists about youth concussions have their limitations.

Experts said there is some added work and cost for schools and states to collect the data, and typically state youth concussion laws were passed without any additional funding or resources to implement and enforce them. But Harvey shot down the notion that asking schools to collect the data and submit it to the state for further analysis was overly burdensome.

Coaches track the score of each game, and how many points players score, he said.

“You need permission to give a kid an aspirin. You have to document when they go on a field trip or someone brings in a special lunch. And you can’t write down when someone has a concussion?” the Temple professor asked.

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In Massachusetts, the reporting requirement was just one component of a law implemented in 2011 and aimed at increasing awareness and prevention of youth head injuries and concussions.

The law, overall, has led to significant improvements in attention to concussions, but gaps remain.

In addition to schools failing to report data, a survey conducted in the spring of 2015, released last fall, found that about half of Massachusetts student-athletes who had concussion-like symptoms continued playing that day.


Matt Rocheleau can be reached at matthew.rocheleau@globe.com. Follow him on Twitter @mrochele.