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Concussion/TBI Work Group Teleconference Meeting – Minutes

October 19, 2012

10:00 am - 11:30 pm

Chair: Loretta Bernard (York)

Minutes: Angela Merrett (TPH)
Present: Loretta Bernard (York), Tracy Dahms (York), Silvana Farrace-Perry (York), Heather Quance (KFL&A), Matt MacLeod (Grey-Bruce), Lorraine Gravelle (Algoma), Cindy Kirkpatrick (H&PEC), Angela Merrett (Toronto), Sheree Shapiro (Toronto), Jessica Ackerman (Durham), Lori Pinkerton (Durham), Lorna Boratto & Angela (Oxford), Pat Cliche (NIPPN), Steve Soroko (Healthy Schools, Ministry of Education), Mia Brown (Simcoe-Muskoka), Carolyn Jones (Simcoe-Muskoka), Janine Monahan

1. Welcome and introductions

2. Volunteer for Minutes

  • Addition to agenda - Ophea conference update under 4.0. Minutes taken by Toronto Public Health

3. Review of previous minutes (taken by York Region).

  • No changes noted.

4. Ophea Update

York Region Public Health presented at Ophea conference on October 12th to share local perspective with their concussion initiative. Attendees include Principals, Ministry of Education, Teachers and Public Health. Discussion included the challenges of implementing return to play/learn protocol and identifying the role of the teacher/parent given level of knowledge required to identify/manage concussions. Discussed the need for a coordinated response between all parties. Discussed looking at existing return to learn processes in schools and not re-inventing new policies/procedure in schools but rather embed concussion into existing processes.

From a PHU perspective, discussed role being to explore what PHU's can offer to promote best informed practice, education and awareness. Discussed protocol form being sent home with parents to include fact card and information for parents to understand importance of concussion management as a comprehensive piece.

Suggestion from group for PHU's to explore working with their local brain injury association who have resources for the student/parent (e.g. Hotel Dieu Hospital ABI program). Heather (Kingston) mentioned the Hockey toolkit from ThinkFirst and fact sheet for parents. There is a Play Safe app (Play Safe Initiative) available that was promoted at the Ontario Summer Games and has student log injury/data collection and provides resources and where to go – local health care. In Hamilton, Can Child through McMaster University has worked on return to play/learn guidelines for children/youth.

5.    Updates from Health Units


  • Getting ready for October 2012 symposium and consulting with Hamilton PU related to their experience from their symposium.

  • Will be attending upcoming summer kids festival to share concussion information


  • Has been working with the Public board on policy and return to plan/learn

  • Trained Physical Ed teachers and schools are using the Return to Play forms

  • Continue to work with School Boards to help assist them in meeting their requirement.


  • Dr. Zenotta supporting concussion prevention and presented to area physicians and hockey personnel

  • Have been consulting with teachers

  • Attending Athletic banquets to promote messaging/awareness

  • Program funded by Bruce Power is providing bike helmets for low income families

  • Looking at new baseline testing in hockey and connecting minor hockey associations with testing

  • Thinking about connecting with soccer/minor hockey leagues


Concussion Management Symposium for Health Care Providers

  • took place on Sep 19th 2012

  • collaboration with Think First Hamilton Chapter

  • had 68 attendees from various healthcare backgrounds and some educators preliminary look at evaluations shows that people found the information had a positive impact on their knowledge and awareness relating to the management of concussions. Were able to measure this because we did a pre/post comparison in the evaluation.

  • provided attendees with sample pamphlets on concussion id/management for Return to Learn, Return to Activity and Toddlers provided by CanChild/McMaster University.

  • will finalize evaluation compilation by year end

Concussions: Getting your head back in the game. For Parents and Coaches

  • takes place on Oct 27th 2012

  • collaboration with Think First Hamilton Chapter

  • other community partners include: Sport Hamilton, Tourism Hamilton, McMaster Children's Hospital, Hamilton Safe Communities Coalition, Hamilton Tiger Cat Alumni.

  • open to parents and coaches in Hamilton and surrounding communities

  • promotion has been done though:

    •  existing email networks in healthcare, community, education and sport networks.

    • hard copy flyers distributed in various community locations and at a large sporting awards event in early October

    • media alert and media releases

    • newspaper articles/columns

  • will be using similar format for evaluation with pre/post comparison

  • target # is 150 plus attendees.

  • will provide attendees with sample pamphlets on concussion id/management for Return to Learn, Return to Activity and Toddlers provided by CanChild/McMaster University.

  • You are welcome to share the word within your networks. We are taking registration up to the day before the event.

Low Cost Bicycle Helmet Program

  • There is an opportunity to promote affordable helmets to schools and community groups through a local helmet manufacturer.

  • Their program has been taken up by the Manitoba govt and is run through all their schools grades 1-12. Nova Scotia has also taken on the program. Toronto Public health in collaboration with Parachute is looking at administering a similar program in Toronto. Some individual schools in Ontario are also providing the program

  • The program is easy to administer and can be run annually. All family members can have access to the helmets at the same discounted prices.

  • They offer a range of helmets from biking, to all purpose to sport specific.

  • Part of the proceeds for the helmet purchases can be used to raise funds.

If people want more information about the program, they can connect directly with:

Tarick Mirza

Seven Star Sports
Hamilton, Ontario
Canada L8W 2Z9
Tel: 905-574-9270: Canada Mobile: 905-741-9568
E-Mail:; MSN:

Brain Injury Prevention and Helmets bookmark

  • we redesigned a pamphlet on helmet safety into a two-side bookmark with very limited and focus messaging

  • content includes: 2V1 principle, wear right helmet for right activity, quick facts and parent tips.

  • we will distribute about 5500 to school kids grades 6-8 through our ThinkFirst presentations

  • If anyone wants to see a copy, let Zsuzsi know. (   

Hastings-Prince Edward County (H&PEC):

  • There is a Concussions in School Sport Making the Right Decisions conference in Niagara Falls on December 13th & 14th, 2012. Visit for more information. Early Bird Registration (before Nov. 1) is $399 (before tax). The conference is sponsored by the Niagara District School Board and is taking place at the Hilton Fallsview.

  • Adapted concussion poster from KFL&A & ThinkFirst and sent to all hockey arenas in our region for display

    • Promoted concussion policy from BMHA to other local hockey associations

  • Provided a banner to all skate parks in our counties to promote helmet use during all wheeled activities

  • Conducted a Positive Ticketing & Helmet Give Away campaign with local partners during the month of August in Prince Edward County

  • Assisting partner organization with resources (helmet training manual & helmet fit bookmarks) for a helmet lending program for ice skating at an elementary school in Prince Edward County

  • Continue to promote and support helmet lending program at Quinte Sports Complex for public skating

  • Developing a banner for a local ski hill to display on a chair lift to promote helmet use

Kingston, Frontenac, Lennox & Addington (KFL&A):

In partnership with ThinkFirst/Parachute, there are a number of projects underway:

  • Organizing for our 2nd PA Day Secondary School teacher in-service. ThinkFirst and Public Health presented in the fall of 2011 and will return to present on the Safety Guidelines Nov. 2012. Every secondary school in our board will send two physical education teachers to the in-service.

  • Invitations are going out to local hockey associations for concussion display / information at hockey tournaments this winter. Some hockey leagues have replied that they feel “saturated” at the present time with concussion information, others are showing interest.

  • Hockey helmets for elementary schools – we have approached the Kingston Frontenac’s to partner with delivering hockey helmets to area elementary schools for use as “loaner” helmets for school skating trips. We also to hope to have “Smart Hockey” played during intermissions at Kingston Frontenac’s home games.

  • ThinkFirst Ambassador Pilot Project – presently recruiting a family medicine resident who is working in a rural community to provide concussion information and resources in that community. ThinkFirst has received a Community Foundation grant to assist with this project. We hope to make resources and information more accessible to families.

Oxford County:

  • Grade 8 event where York resources distributed

  • Conducting a week long focus for concussion awareness/prevention with kids and Information being sent home with parents

  • Active giving out helmets and doing more a skate parks


  • Working in partnership with ABI collaboration and athletic association – leads for Phys. Ed. Dept. in School Boards

  • Continue to explore support in schools

  • Will being doing more come 2013

  • Dr. Goudie – local concussion champion, spoke to approx. 40-50 Public Board Phys. Ed. Leads and had good media coverage


  • Workgroup formed in June to support schools in concussion prevention/awareness – involves staff working with children and youth

  • In process of revising York Region's brain card

  • Revising ThinkFirst Fact Sheet

  • Have put up Tweets on TPH Corporate Twitter Page and Youth site – Be Your Best Self

  • Have an activity for students involving interactive game wheel with Q & A. TPH to share with group once complete

York Region:

  • We have updated our concussion fact card over the summer to make it more comprehensive (include return to play & return to learn language) and now have both a secondary and elementary version of the fact card. This was initiated after receiving feedback from attending various school meetings with Phys. Ed Heads, Secondary and Elementary Office Administrative Staff as well as discussions with the curriculum consultants of both our school boards. For secondary schools, the content expanded to included concussion management and procedures to follow post-concussion as well as specific instructions for parents to follow. It also outlined the return to play guidelines. The elementary fact card was initiated as a resource for office administration staff who see injured students and provides a resource on assessment of symptoms and proper management steps to follow. Launch for this and large quantities of our other resources will be in late Fall 2012

  • Distribution will be to all grade 9’s, and all students taking phys.ed in grades 10-12 or are participating in team sports

  • We are currently exploring cost sharing with our boards to print and disseminate to a larger number of students and teachers/coaches

Awareness & Education:

  • We have sought out different opportunities to communicate our initiative to a variety of audiences. Our latest group we have presented to is senior admin (Principals/VPs). They are a key champion in supporting their teachers and school community around this issue and it’s important they are informed about the relevance and magnitude of the issue


  • Last Friday we attended the OPHEA conference and presented our YR concussion initiative – a local perspective. We had teachers, principals, Ministry of Ed. Representative and public health attend our seminar. There was some great discussion around recognizing issues and challenges that school boards have been facing in implementing concussion management practices. Specifically, the role of the teacher. There was some concern voiced that teachers aren’t qualified to “mange” a concussion and are more observers. Moving forward will require a coordinated approach between schools, doctors and parents to properly manage the re-integration of a student back into the classroom as they are all individual cases. It may require the additional support of guidance for students to return optimally.

  • We talked about the role of public health and how we can support this process. Each Health Unit will have a different capacity in the level of support they can provide. For example, best practices, education & awareness, policy development, assistance with meeting the requirements of the OPHEA safety guidelines

  • In addition, we were asked by OPHEA to provide a summary of our initiative and the role public health could play in the area of concussion management. This was part of a pre-conference panel discussion and our update was provided Bob Soroko who is a Health Consultant with Halton District School Board. *If anyone attended this and has any feedback on how that session went, we would love to hear an update on how the session went


We have started expanding the initiative to the broader York Region community.

  • Concussion Web pages – going live within the next week

  • Clear Digital Imaging billboard – running for 1 month

  • Theatre ads (Rainbow Theatres) – starts this Friday for 2 months

  • Active Communities newsletter – goes to school boards, community centres and interested community and workplaces

  • Workplace Wellness newsletter – interested workplaces

  • Provided our fact card, brain card and pens to the Richmond Hill Stars Hockey league - Novice Coaches. We plan to expand further to other sports associations/teams in YR

Ministry of Education (Steve Soroko):

  • Ophea safety guidelines are now open access – use to be a cost

  • Free in English/French

NIPPN (Pat Cliche) – Parachute:

  • Hoping to bring York Region and Dr. Tator to North for a conference soon

Concussion Update from Parachute (via Pat)

  • Parachute is engaging with bureaucratic representatives in relation to Bill 39: An Act to amend the Education Act with respect to concussions. Bill 39 calls for the introduction of return to play guidelines in the school system for students that suffer a concussion while engaging in school sports. Parachute is engaging with bureaucratic representatives to support the passage of the legislation.

  • Parachute met with colleagues from the Ontario Medical Association on areas of mutual interest and activities related to advocacy in health promotion in the province.

~Information from Amy Wanounou, Government Relations Parachute
5.0 Proposed Concussion Legislation (Bill 39) – Discussion

(Bill 39) The Education Amendment Act (Concussions), 2012

At this point, Bill 39 has been suspended until Legislature resumes.

Parties were supportive however they have been absorbed in other issues. In April and June a Committee of Educators and Health Sectors advised on what would go in to a draft policy for schools using the Ophea guidelines. Has begun working on Return to Learn guidelines. Loretta Bernard attended the June meeting as a member of the Manager's Alliance to bring the Public Health perspective.

The Ministry of Tourism, Culture and Sports is going forward with a public awareness campaign and has a lot of material. Inquiry from the group to learn more in order to be able to support campaign. Stressed the importance of common messaging to the public.

Return to Play Steps were taken from the Zurich statement. Group will reconvene November 2012 to relook at the guidelines. Hopeful that they will explore the Return to Learn guidelines as well. There is a gap in children < 14 years and how the guidelines apply to this group that needs to be explores since the guidelines focus more on the adolescent athlete (Dr Tator).

Reminder: Please circulate any resources you have created for sharing with our Concussion/TBI Work Group
6.0 Provincial Landscape: Parachute – Discussion
The organization, Parachute: Leaders in Injury Prevention launched over the summer and is a merger of Safe Communities Canada, Safe Kids Canada, SMARTRISK and ThinkFirst Canada into one strengthened and united voice for injury prevention. Parachute has met with the Ontario Medical Association and they are working together around concussion prevention.

Other Discussion - Baseline testing – York Region noted that they heard that baseline testing can be a challenge to use with children and youth and may not be an accurate measure for this group. Another participant also validated that Dr. Tator noted that in younger athletes, there could be other factors (e.g. sleep) leading to skewed baseline results. There is a cost involved for baseline testing and varies among administrators.

7.0 Next Meeting:

March 2013. Tracy will send out a Doodle poll so the group can select possible dates for the next teleconference

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