Effect of RISE Bundle implementation on school adoption of a student-centered return-to-learn program in Washington state

Issue title: Pediatric Educational Re-Entry After TBI

Guest editors: Melissa McCart and Susan Davies

Article type: Research Article

Authors: Avery, Aspen^{a; b; *} | Takagi-Stewart, Julian^{a; b} | Qiu, Qian^{a; c} | Philipson, Erik B.^{a; b} | Moore, Megan^{a; d} | Kroshus, Emily^{a; c} | Weiner, Bryan J.^e | Graves, Janessa M.^{a; f} | Glang, Ann^g | Jinguji, Thomas^c | Coppel, David B.^h | Sidhu, Manrita^{i; j} | Vavilala, Monica S.^{a; b}

Affiliations: [a] Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA | [b] Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA | [c] School of Social Work, University of Washington, Seattle, WA, USA | [d] Department of Pediatrics, University of Washington, Seattle, WA, USA | [e] Department of Global Health, University of Washington, Seattle, WA, USA | [f] College of Nursing, Washington State University, Spokane, WA, USA | [g] Department of Psychology, University of Oregon, Eugene, OR, USA | [h] Department of Neurological Surgery, University of Washington, Seattle, WA, USA | [i] foundry10, Seattle, WA, USA | [j] Radia, Seattle, WA, USA

Correspondence: [*] Address for correspondence: Aspen Avery, University of Washington, Seattle, WA, USA. E-mail: [email protected].

Abstract: BACKGROUND:Appropriate concussion care in school is vital for full recovery, but school return-to-learn (RTL) programs are lacking and vary in quality. Establishing student-centered RTL programs may reduce disparities in RTL care. OBJECTIVE:To examine the effect of RISE Bundle (Return to Learn Implementation Bundle for Schools) implementation on high school adoption of a student-centered RTL program. METHODS:A convenience sample of fourteen (4 rural and 10 urban) small and large Washington (WA) State public high schools were enrolled in a stepped-wedge study with baseline, end of study, and monthly measures over the 2021–2022 academic year. Schools identified an RTL champion who led RISE Bundle implementation in 6-week steps. Concussion knowledge and impact of RTL program on concussion care were examined. RESULTS:Ten schools (71.4%) successfully completed RISE Bundle implementation and established a functional RTL program. Self-reported concussion knowledge from RTL Champions increased post intervention. Establishing RTL programs facilitated provision of tailored accommodations, and perceived variation and inequities in RTL care were reduced. CONCLUSION:RISE Bundle implementation proved feasible, supported the establishment of a functional RTL program, and perceived to reduce disparities in concussion care in rural and urban WA State public high schools of varying sizes.

Keywords: Youth concussion, return to learn, traumatic brain injury

DOI: 10.3233/NRE-220200

Journal: NeuroRehabilitation, vol. 52, no. 4, pp. 641-650, 2023