Background Concussion in sport has become a major injury prevention priority worldwide because of its potential severity. International consensus guidelines for concussion in sport have been developed and promoted. To date, there has been little consideration of the barriers that might influence how well these guidelines are adopted and implemented in practice, especially in community sport.

Methods A self-report online survey was developed from Theory of Planned Behaviour constructs. 111 coaches and sports trainers from community Australian Football and Rugby League completed both pre- and post-season surveys and data on their attitudes towards using concussion guidelines was extracted. Post-season attitudes were assessed relative to pre-season attitudes and whether or not responders had used the guidelines during the intervening playing season. Specific feedback about any challenges in using the guidelines was also sought.

Results 71% of respondents had used the guidelines. Post-season attitude was related to pre-season attitude (p = 0.002), football code (p = 0.015), and team role (p = 0.045). There was a significant interaction between team role and guideline use (p = 0.012), with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and formal witnessing of advice given.

Conclusions This is the first study to examine the implementation of concussion guidelines in community sport. Information from those who attempt to use them is valuable to inform the refinement of implementation and dissemination processes around concussion guidelines across sports. New education should be developed about the importance of advice given to parents/players them by those who follow these guidelines.