The Effect Of School Size, Demographics, And Socioeconomic Status On Headgear Use In Girls Lacrosse

PURPOSE: Headgear (HG) use in girls’ high school lacrosse (GLAX) is associated with a reduced rate of concussions; however, voluntary use of HG is low. The purpose of this study is to evaluate the effect of school enrollment factors (eg. size, demographics, and socioeconomic status (SES)) on GLAX HG use. METHODS: The total number and number of athletes using HG were recorded for each public school GLAX team (N = 1569) in states without a HG mandate using a national game film database for the 2022 season. Teams were classified as All (AHG; N = 16), Partial (PHG; N = 171), or No (NHG; N = 1382) players on the team wearing HG. School enrollment factors of size (# of students), demographics (% non-white), and SES (% qualifying for free or reduced lunch) were obtained via federal data from 2018-2019. ANOVAs were used to compare variables by HG group, and logistic regression analyses were used to evaluate if school enrollment factors were predictive of HG group (α = 0.05). RESULTS: Differences were observed in school size, with AHG teams (mean+/-SD: 799+/-574) being significantly smaller than PHG (1747+/-812) and NHG (1534+/732 p < 0.01) teams. Although AHG teams tended to be from schools with lower % non-white and lower SES, no significant differences were observed in school demographics (AHG: 31+/-27%, PHG: 36+/-24%, NHG: 35+/-24%, p = 0.32) or SES (AHG: 33+/16%, PHG: 26+/-17%, NHG: 27+/-18%, p = 0.65). School size was minimally predictive of AHG team category (R2 = 0.05, β = 0.003, p < 0.01). CONCLUSIONS: School size is slightly associated with HG use in high school GLAX, specifically that teams in which all athletes wore HG tended to be from smaller schools. These findings suggest that factors other than crude measures of demographics and SES may be contributing to the low rate of HG use in high school GLAX. Further research is needed to more thoroughly investigate the determinants of HG usage in GLAX in order to inform interventions aimed at education on HG use within this population.