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Craniofacial Injuries: Community-Based Interventions to Encourage Use of Helmets, Facemasks, and Mouthguards in Contact Sports

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 8 studies (search period 1946-November 2012). The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to oral health. This finding updates and replaces the 2000 CPSTF finding on Population-Based Interventions to Encourage Use of Helmets, Facemasks, and Mouthguards in Contact Sports to Prevent Oral and Facial Injuries pdf icon [PDF - 223 KB].

Context

There is evidence to support the efficacy of mouthguards and facemasks in preventing craniofacial injuries in contact sports (Knapik et al., 2007; Benson et al, 2009; Asplund et al, 2009). There is also a large body of evidence to support the efficacy of helmets in non-contact sports such as cycling and skiing (Thompson et al, 2009; Benson et al, 2009).

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 178 KB]

Eight studies were included in the review.

  • Study results were inconsistent.
  • The diversity in sports, potential injuries, and population characteristics across the studies limited the ability to pool data and draw any general conclusions about intervention effectiveness.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help fill remaining gaps in the evidence base. (What are evidence gaps?)

  • More research is needed on the efficacy of various protective equipment devices in preventing injuries in different contact sports.
  • Further research is required to establish the effectiveness of community-based interventions that provide and promote the use of protective equipment. Ideally, researchers will use consistent outcome measures and definitions.
  • Finally, research should examine potential harms of the intervention, especially with regard to risk compensation behavior.

Study Characteristics

  • Included studies were associated with six different contact sports.
  • Studies evaluated three broad categories of interventions including legislative mandates, provision of safety equipment, and health promotion and education.
    • Legislative mandates attempt to ensure compliance by removing choice.
    • Provision of equipment attempts to improve access, empower, and provide additional choice.
    • Health promotion and education interventions aim to educate and raise awareness of the benefits of sports safety equipment.
  • Seven of the included studies were conducted in high-income countries.