Context: High school (HS) and youth sports organizations (YSO) that restarted participation in the fall of 2020 during the COVID-19 pandemic relied on information sources to develop risk mitigation procedures.

Objective: To compare the risk mitigation procedures being employed and the information sources being utilized by HS athletic departments and YSO.

Design: Surveys were distributed to HS athletic directors and youth sports directors throughout the US regarding sport restarting, COVID-19 cases, risk reduction procedures, and the information sources used to develop risk reduction plans in fall 2020. The proportion of HS and YSO using different procedures and information sources were compared using chi-square tests.

Setting: HS and YSO programs from across the US

Participants: 1296 HS and 584 YSO responded, representing 519,241 adolescent athletes.

Main Outcome Measures: Risk reduction procedures used and information sources employed

Results: HS employed more risk reduction procedures (7.1±2.1 v 6.3±2.4, p<0.001), were more likely to use symptom monitoring (93%v85%, p<0.001), temperature checks on site (66%v49%, p<0.001), face mask use for players on and off the field (37%v23%, p<0.001 and 81%v71%, p<0.001, respectively), social distancing for staff (81%v68%, p<0.001) and players off the field (83%v68%, p<0.001), and increased disinfection (92%v70%, p<0.001). While HS and YSO had similar use of information from local health authorities, there were still some differences. For example, HS were more likely to use information from the National Athletic Trainers Association (72%v15%, p<0.001) than YSO.

Conclusions: HS and YSO report using a broad range of risk reduction procedures, but the average number was higher among high schools than youth sports organizations. Use of information from the CDC and local health authorities was high overall, but low from professional healthcare organizations. Professional healthcare organizations should consider additional measures to improve information uptake among stakeholders within youth sports.

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