To date, CARE has enrolled >50,000 MSA cadets/midshipmen and NCAA student-athletes from 30 participating collegiate institutions, representing 26 NCAA sports and military training, and other recreational activities. In addition, the CARE study has captured data on over 5,000 concussed cadets/midshipmen and athletes – the largest concussion database of its kind.

From the outset, this public-private study was designed to answer key knowledge gaps around clinical and neurobiological recovery, brain structure and function, and factors predicting outcomes in military service academy members and NCAA student-athletes.

The CARE data collected to date represents the most diverse concussion data of its type ever collected and allows for analysis of groups often neglected in the medical literature. The CARE data set is diverse in terms of race (36% non-white), gender (40% female), and levels of head impact exposure from participants in contact sports, limited-contact sports, non-contact sports, and military service academy members. It is also the first major concussion study to assess both women and men in 24 sports; prior to CARE, most concussion literature came from men’s football and men’s ice hockey.

The CARE Consortium has published more than 90 scientific papers and has been influential in improving sport participation for athletes of all ages.

Results from CARE studies have direct translational impact on current practices in the assessment, diagnosis, and management of concussion in military service members and athletes. CARE has begun to yield evidence to inform our understanding on the natural history of clinical and neurobiological recovery after acute concussion, as well as identifying which factors are most strongly associated with recovery, and risk for poor outcomes in military service members and NCAA athletes. Findings from CARE will have direct impact on current best practice in the management and return to activity by military personnel and athletes after acute concussion. The ability to more precisely determine the diagnostic and prognostic utility of fluid and imaging biomarkers is a key deliverable for ongoing studies.

The initial phase of CARE (“CARE 1.0”, 2014-2018) focused on the short-term outcomes (i.e. six-months) following concussion.

The second phase of the study (“CARE 2.0”, 2018-2021) investigated the effects of sport, military training, and concussion over the course of a collegiate career and outcomes up to five years after graduation.

The third phase of CARE is known as the CARE-SALTOS Integrated (CSI) Study, or CARE-Service Academy Longitudinal mTBI Outcomes Study Integrated. This phase will investigate the nature and causes of long-term effects of head impact exposure and concussion/mild traumatic brain injury (mTBI) in former NCAA student-athletes and military service members. CSI will build upon existing CARE-SALTOS research by following former CARE participants beyond graduation to evaluate the long-term or late effects of HIE and/or concussion/mTBI for over 10 years or more after initial injury or exposure.

UNIVERSITY OF MICHIGAN

Research staff at the University of Michigan (UM), in cooperation with the UM Institute for Social Research, will be conducting the “Tier 1” Online Assessments for the CSI Study. For Tier 1, we would like all former CARE Study participants to complete two different sets of study questionnaires over the course of the five-year CSI Study period. These study questionnaires are completed online at your convenience through a secure study portal that is available 24/7.

When you receive your invitation to participate through email, a text message, or a telephone call from the UM Survey Research Center at the Institute for Social Research, you will be prompted to verify your identity, create a password and answer an eligibility question. Once those tasks are complete, you may begin the study questionnaires. The secure study portal and CARE research databases are maintained by QuesGen Systems, Inc.

INDIANA UNIVERSITY & MEDICAL COLLEGE OF WISCONSIN

Research staff at Indiana University and Medical College of Wisconsin will be conducting the Tier 2 Civilian In-Person Study Visits. The teams at IU and MCW will be conducting detailed assessments of CSI research participants, including clinical testing, advanced magnetic resonance imaging (MRI) and positron emission tomography (PET) studies, and biological marker analysis.

UNIFORMED SERVICES UNIVERSITY/HENRY JACKSON FOUNDATION

The Uniformed Services University/The Henry M. Jackson Foundation team will lead the Tier 2 In-Person Assessments for all former military service academy participants at one of the following sites: National Intrepid Center of Excellence (NICOE), Ft. Hood Intrepid Spirit Center (ISC), Ft. Bragg ISC, or Joint Base Lewis-McChord ISC. Additionally, a new cohort of military personnel from the Naval School Explosive Ordnance Disposal (NAVSCOLEOD) at Eglin Air Force Base will be invited to participate.