Sustaining a School-Based Concussion Management Program Using an Implementation Science Framework

Each year, 1.1–1.9 million children and adolescents in the United States experience a concussion or mild traumatic brain injury (TBI), and many return to school (RTS) with symptoms disrupting learning and well-being. Although effective RTS care requires coordinated support, implementation remains inconsistent across the United States. This study explored how one RTS program, the Central Oregon TBI (COR-TBI) model, was established and sustained over time. Using a deductive qualitative design guided by the National Implementation Research Network framework, we interviewed nine key organizers and coded data using leadership, competency, and organization drivers. Five themes emerged: (a) leadership-driven awareness and communication; (b) cross-disciplinary TBI champions; (c) partnerships, collaboration, and funding; (d) ongoing training and coaching; and (e) fidelity of implementation. Findings offered an implementation blueprint for schools and districts seeking sustainable RTS programs.