Designing, implementing and evaluating a framework for managing concussions in New Zealand secondary schools: A study protocol

Adolescent concussions can potentially lead to cognitive and behavioural changes, affecting concentration and performance at school and in other activities. Although the Ministry of Education provides web-based guidelines for post-concussion student support, the implementation of these in the school setting is limited. Due to the complex school environment, a pragmatic methodology is needed to co-design implementation with relevant community stakeholders. We outline the protocol for designing and implementing a FRAmework for maNaging Concussions in New Zealand Secondary Schools (FRANCS) to support safe return to learn and activity for students. The framework draft was co-designed by school stakeholders and will be refined at organisational levels. We describe the theoretical underpinnings that informed the study design and outline the project phases. We use a systems thinking approach, Community Based Participatory Action Research, and Appreciative Inquiry approaches to co develop FRANCS with community, policy, and professional stakeholders. The implementation and evaluation phases of FRANCS is guided by Step 5 of the Intervention Mapping protocol, Implementation outcomes, and Realist process evaluation. FRANCS will be adaptable to the context of individual secondary schools in Aotearoa New Zealand, ensuring that return-to-learning and -activity guides are implemented to support students who have sustained a concussion.