Context High schools and youth sport organizations 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 and information sources used by high school athletic departments and youth sport organizations. Design Cross-sectional study. Setting Surveys of high school and youth sport organization programs from across the United States. Patients or Other Participants A total of 1296 high schools and 584 youth sport organizations, representing 519 241 adolescent athletes, responded to the surveys. Main Outcome Measure(s) Surveys regarding restarting sport, COVID-19 cases, risk-reduction procedures, and the information sources used to develop risk-reduction plans in the fall of 2020 were distributed to high school athletic directors and youth sport directors throughout the United States. The proportions of high schools and youth sport organizations using different risk-reduction procedures and information sources were compared using the X2 test. Results High schools used more risk-reduction procedures than did youth sport organizations (high schools = 7.1 ± 2.1 versus youth sport organizations = 6.3 ± 2.4; P < .001) and were more likely than youth sport organizations to use symptom monitoring (high schools = 93% versus youth sport organizations = 85%, X2 = 26.3; P < .001), temperature checks on site (66% versus 49%, X2 = 53.4; P < .001), face masks for athletes during play (37% versus 23%, X2 = 38.1; P < .001) and when off the field (81% versus 71%, X2 = 26.1; P < .001), social distancing for staff (81% versus 68%, X2 = 43.3; P < .001) and athletes off the field (83% versus 68%, X2 = 57.6; P < .001), and increased facility disinfection (92% versus 70%, X2 = 165.0; P < .001). Youth sport organizations relied more on information from sport national governing bodies than did high schools (youth sport organizations = 52% versus high schools = 10%, X2 = 411.0; P < .001), whereas high schools were more likely to use information from sources such as the National Athletic Trainers' Association (high schools = 20% versus youth sport organizations = 6%, X2 = 55.20; P < .001) and the National Federation of State High School Associations (high schools = 72% versus youth sport organizations = 15%, X2 = 553.00; P < .001) for determining risk-reduction strategies. Conclusions High schools and youth sport organizations reported using a broad range of risk-reduction procedures, but the average number was higher among high schools than youth sport organizations. Use of information from the Centers for Disease Control and Prevention and local health authorities was high overall, but use of information from professional health care organizations was low. Professional health care organizations should consider using additional measures to improve information uptake among stakeholders in youth sports.
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