Australian Football League Brain Health Initiative: monitoring player brain health.

The AFL BHI is a prospective, longitudinal, observational clinical research program in which current and retired AFL and AFLW players are offered the opportunity to participate. CURRENT PLAYERS: Data for current players will be collected at draft into the competition (entry), annual pre-season baseline assessment and following concussion (if any) throughout their playing career, and upon retirement (exit) from the competition. Secondary data collection will involve concussion measures (baseline and sideline assessment tools, computerised tests, match video footage), some neurocognitive test measures, self-report questionnaires) - as they form part of routine clinical care of players they will take no additional time to complete. Primary data collection will involve additional self-report questionnaires, neurocognitive testing and the completion of a case report form. Current players will also have the option to consent to an MRI brain scan at entry and exit only, as well as the option to wear an instrumented mouthguard throughout training and matches. The total time taken for primary measures is as follows: additional questionnaires 20 min, MRI scan 1.5 hours (including travel), instrumented mouthguard 30 min for initial scan, and 5 min pre-post training/match. Consent will also be requested for access to concussion screening data from 2019 which will not take additional participant time. RETIRED PLAYERS: Once current players retire from the competition, they will then participate as retired players. Additionally, retired players can consent to participate in the BHI from 2026/7 onwards, even though they did not participate as current players. Data for retired players will be collected at 2, 5, 10, 20, 30 and 40 years from the point of retirement (exit) from the competition. Data collection will involved limited concussion measures (computerised tests), neurocognitive test measures, self-report questionnaires, informant based questionnaires, case report form and MRI brain scan as an optional add-on. The total time taken for these measures is as follows: computerised tests 15 min, neurocognitive test measures 2 hours, self questionnaires 30 min, informant based questionnaires 10 min, and optional MRI brain scan 1,5 hours (inc. travel time). Consent will also be requested for access to concussion screening data from 2019 which will not take additional participant time.