Sport-Related Concussion Prevention Programs in Soccer: A Scoping Review Using the RE-AIM Framework.

Abstract

Objective: To map and evaluate the implementation of soccer concussion prevention programs and identify barriers and facilitators across all demographics using the RE-AIM framework.

Data source: A scoping review was conducted in accordance with PRISMA-ScR guidelines. The protocol was registered on the Open Science Framework (10.17605/OSF.IO/DBT8M). Studies were eligible if they reported quantitative outcomes of concussion-related programs implemented in soccer settings. Searches were conducted in 6 electronic databases and gray literature, with the search period limited to 2010 to 2025. Data extraction was completed independently by 2 reviewers. Program characteristics and outcomes were mapped to the 5 RE-AIM dimensions: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Risk of bias was assessed using the ROBINS-I tool.

Main results: Fourteen studies met inclusion criteria, primarily from the United States (n = 7) and the United Kingdom (n = 4). Interventions focused on concussion education, baseline neurocognitive testing, guideline implementation, and neuromuscular or neck-strengthening exercises. All studies reported Reach, and most demonstrated short-term improvements in knowledge or recognition (Effectiveness). Adoption and Implementation were inconsistently reported, often limited by organizational and resource constraints. Maintenance was the least addressed dimension, with minimal long-term follow-up and no standardized outcomes beyond 6 months. Evidence for reduced concussion incidence was limited.

Conclusions: Concussion programs in soccer seem to produce short-term benefits but remain inadequately evaluated in adoption, implementation, fidelity, and sustainability. Future research should prioritize longitudinal designs and comprehensive RE-AIM reporting to support scalable and sustainable concussion program implementation strategies.