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Sportiod and teen athletes

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Sportiod and teen athletes

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Content SPORTOID AND TEEN ATHLETES 1
Sportoid and Teen Athletes
Aisha Mitchell Washington, LCSW
In partial fulfillment for the degree
Doctor of Social Work
Doctoral Capstone Project
Suzanne Dworak-Peck School of Social Work
University of Southern California
Fall 2019
SPORTOID AND TEEN ATHLETES 2
Executive Summary
Though it receives less attention, the teen opioid epidemic is very dire. The United States
consumes 100% of the world's hydrocodone and 81% of the oxycodone ( McLaughlin, 2016).
As teens are attempting to gain that competitive edge in sports it could be a challenging factor
engaging in the use of prescription pills. Some may experience an injury, and the injury exposes
them to the possibility of gaining a prescription for opioids. Prescription opioids expose teen
athletes to chances of opioid addiction. Although many of the teens may take the prescriptions
appropriately, twenty percent of the teens between the ages of 12-17 misuse the prescription (
Frye, 2016). The American Academy of Pediatrics states that “opioid addiction is a chronic
relapsing neurologic disorder” (Anonymous, 2016). There are waivers that will allow for
pediatricians to prescribe and treat substance abuse. Many pediatricians are requesting waivers
to treat their patients who are dealing with addiction. The overprescription of opioids to teens is
a problem. Physicians were prescribing and refilling opioids to teens after surgery. It has created
a public health emergency. Opioids are the most abused drugs on the market. The manufacturers
of opioids encourage overprescribing of these medications that have led to health and social
problems, because of the income it generates. The prescribing practice that they have funded will
take many years to repair damages inflicted on our society (States News Services, 2015). A
SPORTOID AND TEEN ATHLETES 3

Journal of Emergency Medicine (2016) study indicated that for every opioid prescription given,
teen opioid abuse increased by 1.8%. Physicians, teens, and families should be aware of this
information.
Doctors must restrict the individuals that demand prescription opioids (Bass, 2016). Patient
counseling that includes risks and nonopioid alternatives for painful conditions should be
considered to ensure that people are prioritizing the right decisions (Bass, 2016). President
Obama signed the Comprehensive Addiction and Recovery Act in 2016 (Ventrell, 2016). It
addressed addiction in prevention, treatment, recovery support, criminal justice reform, overdose
reversal, and law enforcement. He recognized that teen opioid misuse was the largest most
preventable and costly public health problem in the United States
The application of the social learning theory by Albert Bandura to teen opioid addiction is
important in understanding, preventing, and treating the disorder. It states that individuals learn
by observing other people's behavior, attitudes, and results of their behaviors (David, 2015).
Teen opioid use has been related to peer influence as a predictor. By utilizing this theory, teen
opioid use disorder is learned based upon the principles of operant conditioning. The use of the
opioids is learned, and its frequency of occurrence is a function of the reinforcement, and hence,
it becomes an addiction. As a result, it has created the rules or norms by which this opioid abuse
occurs. Social learning theory is also very effective in dealing with the prevention of teen opioid
addiction. It indicates that people learn from one another and behavior is influenced in either a
SPORTOID AND TEEN ATHLETES 4

positive or negative way. The theory is important in understanding opioid use and determining a
strategy to cope with the issue.
By using social innovation to protect teens from opioid addiction, there is an obligation and
an opportunity for pediatricians to prevent and educate teen athletes. They are also responsible
for the education of families as well as encouraging support should addiction be identified
despite health insurance. Social innovation is changing opioid addiction and closing the health
gap.
Sportoid is an innovation that will utilize YouTube as preventive education. It will impact
youth athletes between the ages of 12-17. Sportoid will create a YouTube video that will
discuss the risks and alternatives to prescription opioids for injured teen athletes. Alternatives
will be previewed and ways to request those alternatives. The video will not be more than 5
minutes at length. The video will be mandated before the prescriptions. It will be sent through a
link to smart devices. A set of questions will be presented to test the knowledge of the injured
teens after the video before the prescriptions. All youth will be shown the video. The impact of
the video in regard to research will not be tested to determine if it reduces opioid addiction until
years after the pilot implementation has proven to be successful.

SPORTOID AND TEEN ATHLETES 5

Conceptual Framework

The grand challenge is closing the health gap. Closing the health gap is the responsibility of
social workers. In the 1990s there was an increase in prescribing opioids (Center for Disease
Control and Prevention, 2018). Purdue Pharmacy marketed that they created an alternative
acting safer, and less addictive opioid called Oxycontin (CNN Library, 2018). However,
oxycontin was more potent than any other opioid. The element could be crushed, liquified, and
injected and sales increased the addiction also increased (Quinones, 2015). By 2016 the
government had created policies and regulations to notify the United States Citizens of “abuse
deterrents” for oxycontin and physicians for prescribing guidelines. Unfortunately, 0.3% of the
United States population is 12 and older used heroin, and most of them began with prescription
opioids (CNN Library, 2018). There are 130 Americans dying daily from an overdose ( Center
for Disease Control and Prevention, 2018). The introduction of the Patient Protection and
Affordable Care Act required that all states expand medical and behavioral health coverage to all
citizens through Medicaid or the private market as well as integrating disease prevention into
primary health care, which included screening and education (McCabe & Wahler, 2016).
Thirty million youth participate in sports in the United States, and 3.5 million of them become
injured (Stanfords Children Health, 2019). Each with the dreams returning to the game that will
aid in paying for college through a scholarship. It is estimated that there have been 801 million
visits from 2005 to 2015 to an outpatient clinic by teens that resulted in opiate prescriptions
SPORTOID AND TEEN ATHLETES 6

(Carroll, 2019). The possibility of the teens becoming addicted to the opioids after the visits are
high. The youth are not informed of this information before prescriptions. They are not aware of
the alternatives. After addiction their treatment options are even less. The importance of a
s uccessful intervention to yield positive changes in norms and removal of the negative
consequences from the primary actors should be the primary goal (Leitner,2016).
Sportoid is willing to provide an intervention to assist in allowing injured athletic youth in
obtaining education prior to prescriptions. Sportoid is a subsidiary of AR Mitchell Consultants
LLC. It was founded to address the gap in healthcare between injured teen athletes and
prescription opioids by utilizing a mandated Youtube video as preventive education. This
for-profit organization will focus on injured teen athletes between the ages of 12-17. Teen opioid
addiction is a wicked problem. The YouTube video will discuss the risks and benefits of opioids.
The video will provide information to identify addiction as well as proper disposal. Alternatives
will be previewed and ways to request those alternatives. The video will not be more than 5
minutes at length. It is estimated that 62% of teens have a smartphone ( Wartella et al., 2016). A
link will be sent to teens and parents smartphones before prescription opioids. This capstone is
innovating because it will be mandated for teens to view before the prescriptions which are
currently not done.
To fully understand the importance of the intervention, it is imperative to understand how vital
Youtube is to the success of this intervention. Youtube is based in San Bruno, California. It was
purchased by Google in 2006. There are more than 300 hours of video uploaded each minute
(Ahern, Sauer, and Thacker, 2015). Youtube is a social media platform. Social media refers to an
SPORTOID AND TEEN ATHLETES 7

internet-based platform that allows a user to share and discuss information (Park, Im, and Kim,
2018).
The theoretical framework of the innovation that Sportoid feels will yield success in Social
Learning Theory. The innovation is based on Albert Bandura’s Social Learning Theory. The
application of the social learning theory by Albert Bandura to teen opioid use disorder is
important in understanding, preventing, and treating the disorder of addiction. It states that
individuals learn by observing other people's behavior, attitudes, and results of their behaviors
(David, 2015). People influence other people and hence they form a basis for the development
of behaviors that are as a result of peer influence. Self-efficacy is at the very center of healthcare
when it comes to outcomes because the belief of the value individuals place on their health (
Nugent and Wallston, 2016). Many teens get caught up in the street’s conversations and are
easily seduced or initiated through the verbal and social trends that exist. These teens want to
fulfill their sporting goals and become the next great athlete such as Colin Kaepernick or Lebron
James and hence they get influenced to use opioids. They do not realize that it is a skill that has
created these athletes and not the prescription opioids that enhance their recovery time to return
the game. It is only the perception. The impact of virtual peer relationships has a significant
impact on teens (Miller and Morris, 2016). Through Social Learning Theory teens learn deviant
behavior imitated by others that they have observed the rewards and punishments (Miller and
Morris, 2016). If the teen chooses the norm or the deviant, depends on the rewards and
punishments (Miller and Morris, 2016). Upon viewing the video, there is attention given to the
concerns and risks of prescription opioids of teen athletes. The education provided by the non
SPORTOID AND TEEN ATHLETES 8

injured teen athletes will be retained and tested for retention. By utilizing Youtube teens as
trusted influencers, it is hoped that the injured teens will be motivated to use prescription opioids
appropriately or choose alternative methods. Youtube videos are very influential and can play a
huge role in communicating to the teens about opioids prescription. The videos will clarify the
risks that come with using prescription drugs like opioids and how to deal with the social
pressure that forces the teens to use these drugs.

Problem(s) of Practice and Innovative Solutions

Outpatient Medicaid records of more than one million children and adolescents between the
ages of two and seventeen were examined after prescription opioids that resulted in death and
related adverse events, 23 % resulted in misuse or self-harm ( Crane and Walco, 2018). Youth
sports continue to become more competitive. In 2016 there were three out four households in the
United States that had youth participated in sports (Swanson, 2019). Forty-nine percent of that
group continues to participate in a single sport report an injury (Swanson, 2019). There are two
million high school students that are injured, which results in 500,000 office visits or 30,000
hospitalizations (Mangan, 2018). Typically, these injuries are due to overuse for a majority of the
youth due to poor training and repetitive training (Mangan, 2018).
Teens are abusing prescription drugs more than any other drugs and the rate is alarming. It is
evident that accessing prescription drugs is easy also compared to accessing other illegal drugs.
SPORTOID AND TEEN ATHLETES 9

There are varying prescribing practices for youth due to their body size, composition, and their
ability to ingest orally ( van Cleve and Grigg, 2017). This makes it hard to create a gold standard
of guidance for physicians. It has led to many problems for teens. It is estimated that ninety-one
Americans die every day (Messer, 2017). However, teens feel prescription medications are safer
to uses than any other drug (Messer, 2017). It is essential to consider the challenge and to raise
awareness regarding prescription drugs. People need to understand that it is not alright to use
prescription drugs especially with over the counter approach. The most important step in
stopping teen opioid addiction is prevention education by educating the teen and the family
(Messer, 2017).
Stakeholders/Collaborators

Collaboration is essential for prevention. The potential collaborators with this wicked problem
are referred to as first and second actors related to the social problem of teen athlete opioid
addiction. The first actors are youth between the ages of 12 -19 years old; pediatrician or family
practitioners; and family members. Pediatricians are expected to prevent teens from prescription
drug misuse. Health practitioners have the role to oversee the behavior of their patients and to
determine the right approach to deal with their situation. Doctors play an important role in
preventing addiction in teens with parents. In this sense doctors should intervene with parents
and indicate the risk of addiction if drugs are used before the age of sixteen; that they could end
up causing addiction. Most people use prescription drugs blindly. There is also a temporal
SPORTOID AND TEEN ATHLETES 10

progression that is initiated upon opioid use that teens are not aware (Bass, 2016). The
involvement of doctors, schools, coaches, and hospitals with parents in the prevention of opioid
addiction to opioid addiction of injured teen athletes is important. The team should be ready to
provide teens with information that would raise their awareness on the use of prescription drugs
and ensure they take caution.
Although the sports are supposed to reduce the risk of drug misuse and abuse, injured teen
athletes are at greater risk of addiction than teens that are not athletes ( NJ CARES and NJSIAA
Announce Release of Opioid Education Video for Student-Athletes Featuring Advice from
Professional Sports Icons, 2019). Although parents are concerned about various risks faced by
their children, they seem less likely to talk about prescription drugs when they lack enough
knowledge and awareness regarding its dangers. Parents often feel prescription opioids are the
best means of addressing pain; unfortunately, only a third of parents want to know the alternative
for prescription opioids (American Society of Anesthesiologists, 2019). Parents remain
ill-informed of risks and alternatives.
Treating pain for the teens remains very difficult and it is a challenge in the attempt to reduce
and control opioid addiction. There are many factors that come in between the relationship of the
patient and the provider. For instance, insurance companies reimburse the medications for paid
and fail to consider other alternatives for treatment of pain and this encourages more people to
use prescription pills. Physicians also may lack the basic information needed to provide teens
about prescription opioids. To aid physicians in educating the youth on opioids and their risk,
Congress enacted a limit called the John Thomas Decker Act of 2016 was created. It is a public
SPORTOID AND TEEN ATHLETES 11

health service act created to require the Department of Health and Human Services to report on
the availability of information regarding prescription of opioids after youth sports injury,
including information on opioid use and misuse, injury treatments that do not involve opioids,
and treatment for opioid addiction (Library of Congress, 2016). Another federal intervention was
the Comprehensive Addiction and Recovery Act by President Barack Obama. He requested $1.1
billion in funding for this act to expand access (Bass, 2016). The Comprehensive Addiction and
Recovery Act of 2016 expanded prevention and education for teens dealing with opioid
addiction ( Jones, Novitch, Sarrafpour, Ehrhardt,Scott, Orhurhu,Gill, Kay, Viswanath, and
Simopoulos, 2019). The act also required the amount of Scheduled II opiates such as oxycontin
and Percocet be reduced by twenty-five percent or more (Brunk, 2017). Teens must be
empowered to decide on their care. Respect demonstrates that they care and establishes a
stronger provider relationship. These issues are barriers to teen prevention of the wicked problem
of prescription opioid addiction.

Second Actors

The second actors are social workers, policymakers, and federal/state government
organizations. They have a definite relationship with the social problem. They contribute to the
gaps in healthcare by not recognizing the needs and addressing access to healthcare when there
are deficits in prevention or treatment (Zimlich, 2017). The founding principle of a social
SPORTOID AND TEEN ATHLETES 12

worker is to improve the health of vulnerable populations such as teen athletes through system
approaches (Raheb et al., 2016). They have the opportunity to increase and improve screening
for addiction in the pediatric population.
The wicked problem of prescription opioid addiction is actionable. The innovation needed to
address the wicked problem of opioid addiction in injured teen athletes between the ages of 12
through 17 is a preventive educational video that will be accessed through the Youtube platform.
In a study conducted by Pew Research Center, eighty-five percent of teens used Youtubes
(Farokhmanesh, 2018). It has been stated that for every $1.00 spent in prevention means there is
$4.00 savings in healthcare costs (Patry, Bratberg, Buchanan, Pavia, Balestrieri, and Matson,
2019). Youtube is a free media platform. Youtube has two billion viewers and the ability to be
used on any network-capable device ( May, Wedgeworth, and Bigham, 2013). Youtube is
shared in 75 countries and 61 languages on mobile devices (Dysart, 2017). The average viewer
is 13-24 years of age. Youtube only requires a Google account to upload a free video. YouTube
video social media has become a very effective prevention measure. Teens that watch Youtube
videos can learn in the cognitive, psychomotor, and affective domain ( May, Wedgeworth, and
Bigham, 2013).
The YouTube video will be designed to provide preventative education to injured teens
between the ages of 12 to 17 years old. Programs are usually targeted at teens refusing drugs and
utilizing social skills as part of their prevention strategies ( Jones, et al. 2019). The program is
expected to influence teens and address the risk of opioid addiction. Currently, the youth are
more independent and want to think and act freely and autonomously. They are influenced by
SPORTOID AND TEEN ATHLETES 13

social norms more than their family members and a great risk is that they have a huge access to
information than before. Research has indicated that video-based education is effective in
increasing self-efficacy in teens and reducing opioid addiction risk if the video is tailored to the
population ( Tavakoli Ghouchani, Niknami, and Hojjat, 2017).

Project Structure, Methodology, and Action Components

In the United States, 881,000 teens between the ages of 12 and 17 are misusing prescription
opioids (Patry et al., 2018). T een athletes are unaware of the risks prescription opioids bring with
addiction. Injured teen athletes between the ages of 12-17 are unaware of the increased risk of
opioid addiction, and they are exposed prior to obtaining a prescription for opioids. The benefits
of prevention to the health of the youth and healthcare system are insurmountable. It has been
estimated that for every dollar spent on prevention is a four dollar savings in healthcare (Patry et
al., 2018).
The Sportoid prototype is a video designed for a Youtube channel. The channel will be the
official location for the videos. It will have the official Sportoid brand and other digital assets.
The upload will typically occur between 7-11 a.m. PST. The video is 2.33 minutes in length. It
contains a voice over. Original footage of games in softball and tennis were captured.
Information was provided by all teen athletes for injured teen athletes. It ends with additional
information to services and a request to share. When presented to a small group of professionals
SPORTOID AND TEEN ATHLETES 14

and paraprofessionals in the healthcare field and teens, the reviews were good. They enjoyed the
video and found it to be very informative. Viewers felt the innovation to be very necessary in
preventing opioid addiction in injured teen athletes. There are currently no recommendations.
The concept of using video to provide preventive education is not new. It was done by the
Truth Initiative. In 2000 the Truth campaign launched throughout the United States. It began as
a national campaign known as The Legacy Foundation in Washington, D.C. (Beer, 2015). The
company employed an industry manipulation strategy to attack and portray the predatory
mentality of the drugs and pharmaceutical industries. The campaign was aired during Superbowl,
MTV and other famous programs that usually targeted teens. Months after the campaign was
initiated, a huge number of youths could recognize some of the advertisements in the campaign
that had a life lasting impact regarding awareness and prevention. In essence, it is important to
focus on interventions that will work with the target audience. Currently, video-based
intervention promises great results as intervention tools for the teens and youth.
The Center for Disease Control and Prevention (2018) encourages awareness and shares
information about the risks of prescription opioids with teens and their families. The targeted
population for this intervention is 12 to 17-year-old injured sports athletes who are given opiate
prescriptions. Teen athletes can be used in these videos to aid in the intervention since their
message would be more direct and addressed to the right targets. Their intervention can be more
effective in reducing the behavioral use of opioids and the addiction including informing on the
right decisions and practices to adopt. By utilizing other teens to present education information,
supports the norm of peer group’s influence through social media. The idea of perceived
SPORTOID AND TEEN ATHLETES 15

expertise is given because there are no adults involved ( Pattison et.al., 2018). Teens are
empowered to become involved in their healthcare.
The prototype impacts the implementation of innovation in many ways. It allows the pilot to
begin for the first year. There is ability for feedback from investors. The video will be updated
based on any new guidelines and training in pain management and addiction medicine to meet
requirements ( Vashishtha, Mittal, and Web, 2017). There is a need for continuous creativity and
innovation. Therefore, monitoring current events and research aids in maintaining creativity for
the videos is needed.
The intent is to address the major issue of prescription opioids on injured teen athletes
between the ages of 12-17 through technological innovation, Youtube video. It is estimated that
92% of youth reported going online daily (Lauricella, 2016). Every injured youth that entered a
primary care office would receive the video. The video will be distributed to pediatricians by
them subscribing to a paid Youtube video. The video teens will be able to educate and explain
the severity of the possibility of addiction while being relatable to teen athletes (Baker, 2017).
To obtain positive effects the youth would have to be a positive influence on other teens to
discourage the sharing of prescription medication for nonmedical use, therefore, decreasing
opioid use. This link will be provided to teens and parents of athletes before appointments that
have sustained a sports-related injury. In a recent study, 94% of physicians felt an obligation to
educate teens about the risk, while only 42% discussed prevention (Wilson et al., 2018).
SPORTOID AND TEEN ATHLETES 16

When an injured teen athlete receives education about opioid prescriptions through the
Youtube video before being prescribed opioids, he/she will have a greater awareness of the risk
and alternatives of prescription opiates, which will reduce risk of addiction. Teens rely on easily
accessible and convenient health information ( Wartella, Rideout, Montague, Beaudoin-Ryan,
and Lauricella, 2016). The short-term goal is to pilot one Youtube video to injured teen athletes
at least one primary care office in the metro Atlanta area in one year and by the second year
expand to an emergency room to increase the awareness of opioid prescriptions. The measures of
the process are completed with key performance indicators. The indicators are the number of
injured teen athletes participating in the pilot. All injured teens will be provided the opportunity
to view the video. Teens will then speak with physicians about the information they viewed in
the video. Physicians will discuss risks and alternatives that have been iterated in the video to
reinforce the knowledge obtained. Nurses will ask five questions before providing the final
prescription to confirm education of prescription was obtained.
YouTube is a subsidiary of Google Incorporated ( Graves and Lee, 2017). Youtube creators
can utilize the platform to create an account and upload video content. People can upload more
than 4,000 video resolutions and 60 frames per second. Youtube allows live streaming as well
(Graves and Lee, 2017).
If the YouTube video obtains more than 500 views and receives four likes per 100 viewers, it
is considered to be successful and would indicate the need for more of a randomized and
longitudinal study. The engagement of the viewers should be greater than 15 seconds will also
be considered. These will be the successful benchmarks in obtaining success for the video.
SPORTOID AND TEEN ATHLETES 17

There will be one video for the first year. If the video for the first year yields success, then it will
continue to expand to the emergency room.
The YouTube Channel industry is lucrative. As more businesses generate website traffic
through the use of smartphones and tablets, businesses have also adapted it to make their
businesses grow. In the next five years, Youtube will continue to grow, as more effective tools
and technology platforms that measure consumer demographics are developed.
The growing trend with Youtube is to make it easier for youth to spend more time on the
internet. This exposes the youth to additional marketing and advertising. Social media
networking sites such as YouTube provide a major boost in the revenue generated to a business.
Advertising and marketing on Youtube is common.
The teens in the video are not paid actors but local teen athletes with personal success stories
of avoiding prescription opioid addiction after an injury. The use of famous and not famous
athletes to influence their peers is not unusual. Famous athletes have often been used to endorse
messages. Currently, it has been stated that the concept of celebrity has shifted in a 2014 survey
of teens; it stated that YouTube actors are considered more influential than celebrities (Fils-Aime
and Wang, 2016). Millenials do not often watch television. They also do not care much about
celebrities (Arnold, 2017). They provide about $1.3 trillion in buying power by trusting their
peer to peer advice (Arnold, 2017). Research indicated that 63% of youth indicated that they
would support a product or idea recommended on Youtube (Arnold, 2017). The marketing and
SPORTOID AND TEEN ATHLETES 18

branding of the video is important because it is appealing to this audience and their parents to get
the engagement needed to support the sustainment.
The lack of regulation to provide mandatory education is a barrier to prevention. Georgia has
96 primary care service areas. This indicates there are a majority of patients living within the
county that use primary care services within the surrounding area. There has been an interest in
partnering with Sportoid. The collaboration with a primary practice office will benefit this writer
by lowering the start-up cost for the pilot and increasing the borrowing capacity for a small
business loan. The business is in LaGrange, Georgia, which is a rural area. There are 159
counties in the state of Georgia, and of those, 85 are considered rural. Research has indicated that
of those rural counties 77% of the rural counties have limited or no access to evidence-based
practice for opioid use disorder (Georgia Prevention Project, 2016). The economic cost of opioid
misuse and addiction is $447 million (Georgia Prevention Project, 2016). The clinic is owned
and operated by a nurse practitioner. She is aware of the concerns in regard to the opioid
epidemic concerning the teen population. Her clinic treats a large amount of acute illness and
injuries from a very diverse population. By utilizing the Youtube video via smart device, it
provides great potential for positive outcomes for those that come to the clinic (Wartella et al.,
2016).
The benefit of social workers assuming a leadership role on a macro- and micro- scale in
partnership in closing off the health gap in targeted areas that present public health crises such as
the opioid epidemic to ensure that evidence-based systems are utilized is great. The Patient
Protection and Affordable Act of 2010 attempted to address the gaps in health care in the United
SPORTOID AND TEEN ATHLETES 19

States as well as establishing the first national preventive measure with a public health focus (
Shah et al., 2014). It established the National Prevention Health Promotion and Public Health
Council that was chaired by the United States Surgeon General which created prevention and
public health funds (Shah et al., 2014). Through the use of these funds, physicians should be
able to access money to purchase the Sportoid YouTube videos for their patients. The grand
challenge will be successful at closing the healthcare gap by addressing the wicked problem of
teen athletes with opioid addiction with prevention education.
Action Components
Sportoid is a start-up business. It is for profit. Educational videos are one of the highest-rated
videos on Youtube (Mendez, 2017). Research has indicated that a limited budget or cost increase
could render the innovation nonviable so additional funding must be considered (Douglas and
Prentice, 2019). A start-up loan is needed from the Small Business Association (SBA) to help
achieve Sportoids business development objectives for the next 12 months. The start-up loan
requested is $10,000.00 from Bank of America. A request for SBA 7(a) with an interest rate of
5% prime rate + 4.75%. It will be repaid within seven years with working capital. AR
MitchellConsultants LLC, the parent company of Sportoid, currently has a banking relationship
with Bank of America .
Funding has been requested by pharmaceutical companies and insurance providers for a
startup budget. There has been little or no interest from any providers in this area. This remains a
barrier to the project. Although there are no other programs currently attempting to provide
SPORTOID AND TEEN ATHLETES 20

pharmaceutical education on an outpatient basis to teen athletes in the health care setting prior to
the prescription to prevent teen opioid addiction.
As a for-profit social enterprise, its main objective is sustainability through profits that will
allow impacting the wellbeing of others such as the injured teen athletes (Douglas and Prentice,
2019). Profits are of secondary benefits only to expand the YouTube pilot and sustain the
innovation. It will track both outcomes, net profits, and annual profits to measure growth.
The use of strategic storytelling to motivate donors to fund the business will assist in
marketing and sustainment. It will be imperative that we confirm that the issues of injured teen
athletes and opioid misuse is real. To do this the organization must tell a story that portrays why
the teens and physicians need the Youtube video’s and the mandate is required. The teen athlete
in the videos on the channel provides the story to market to paid subscribers. These stories
connect the audience and funders.

Sportoid will fund the production , distribution , and marketing. Youtube video. Youtube is a
free media platform and people view videos on the platform billions of times a day. Youtube is
shared in 75 countries and 61 languages on mobile devices (Dysart, 2017). The average viewer
is 13-24 years of age. It was estimated that by the year 2017 2.15 billion people would view
online video and generate revenue ranging from $38 billion to $42 billion by 2020 (Graves and
Lee, 2017). The prototype of the Youtube video will be formed initially for free. Youtube only
requires a Google account to upload a free video. The goal of the Youtube video is to obtain
SPORTOID AND TEEN ATHLETES 21

more than 500 views and receive four likes per 100 viewers. The engagement of the viewers
should be greater than 15 seconds. These will be the successful benchmarks in obtaining and
sustaining success for the video.
The innovation will need to use a paid video that is often not used by people. Sportoid will
need at least 1,000 subscribers (primary care offices) to enable this feature. New channels on
Youtube need to reach 10,000 views before the channel can monetize. It is possible that the first
12 months will yield no profit. In the second year to fifth year, it is estimated 10,000 views at
$5.00 per 1000 views. This would yield $50 per subscriber.
It is also important to gain additional funding for the Youtube video through ads by adhering
to the new regulations for Youtube Partner Program (Writer, 2018). The Federal Trade
Commission guidelines must be assured that they are compliant before there can be an
endorsement of a product on a Youtube channel (Graves and Lee, 2017). The new regulations
with Youtube Partner Program policies innovators utilizing Youtube must have a total of 4,000
hours of overall viewing with a minimum of 1,000 subscribers to apply for monetization and
have ads through Google (Writer 2018).

Sportoid financial model is based on a business concept that we will focus on marketing our
business in the first year. We have approached the financial plan as follows: The First-Year
projections anticipate low sales volume. This position will help us ensure visibility of our
YouTube Channel. This is a start-up business. There have been no previous sales or profit trends.
SPORTOID AND TEEN ATHLETES 22

It is estimated that sixty-four percent of consumers purchase after watching branded social
videos. Videos up to 2 minutes long get the most engagement. This is a paid video. Sportoid
will need at least 1,000 subscribers. This is the equivalent of 1000 primary care offices providers
to enable this feature. New channels on Youtube need to reach 10,000 views before the channel
can monetize. It is possible that the first 12 months will yield no profit. The second to fifth year
it is estimated at 10,000 views at $5.00 per 1000 views. This would yield $50 per subscriber.
Subscribers will get notified each time a new video is uploaded.
Sportoid will request small amounts of capital from investors to raise capital by selling the
vision of Sportoid continuously throughout the first year five years. Sportoid will also seek funds
from mega corporations such as IBM, Google, Microsoft, or Toyota that fund innovations
through competitions during the second year after sales have been made. At this point the
innovation will have been validated.
It is also important to gain additional funding for the Youtube video through ads by adhering
to the new regulations for the Youtube Partner Program (Writer, 2018). The new regulations with
Youtube Partner Program policies innovators utilizing Youtube must have a total of 4,000 hours
of overall viewing with a minimum of 1,000 subscribers to apply for monetization and have ads
through Google (Writer 2018). YouTube requires a channel reach a minimum of 10,000 total
views before ads will be served and any revenue will be earned by the creator ( Graves and Lee,
2017).
SPORTOID AND TEEN ATHLETES 23

Success metrics for social innovation will be measured quantitatively. The Youtube video will
be shared with pediatricians that treat the teen athlete’s injuries. Pediatricians should mandate
teens to watch the video prior to prescriptions of opioids. The goal of the Youtube video is to
obtain more than 500 views and receive 4 likes per 100 viewers. The engagement of the viewers
should be greater than 15 seconds. These will be the successful benchmarks in obtaining success
for the video. These metrics will be tracked through the YouTube dashboard that provides
creators analytics on the performance of its videos.
Sportoid will be branded; this means that it will be well known to the teens through social
media. The video will be marketed on Snapchat. Creators of Youtube videos make significantly
more revenue through brand deals and branded content than they do from ads or YouTube videos
(Graves and Lee, 2017). Sponsorship of teen sports with logos emblazoned on their kits will
make people associate the brand. By utilizing the Sportoid brand, the YouTube videos will carry
prestige that target its marketing and advertisements toward not only teens but investors. When
Sportoid is searched , the web traffic will be directed to the YouTube channel through Google
searches. Google My Business is a platform used to manage and organize the information
received about Sportoid such as the website; reviews that can be responded to; and track
performance. The utilization of Google My Business is a particularly useful tool for Sportoid
potential customers see its profile and accompanying good reviews; Sportoid automatically gains
credibility and people will be more willing to trust the brand.
Sportoid is a subsidiary of a for-profit single-member LLC organization. The management
team consists of the owner. The power has 100% control over the management and operations of
SPORTOID AND TEEN ATHLETES 24

the organization. The business tax obligations flow through the owner under S Corp obligations.
A weakness funding is more difficult, and most investment comes directly from the owner rather
than from outside investors. This can slow growth.
The top goal of Sportoid is to increase the awareness of the risk of opioid addiction in teen
athletes between the ages of 12 through 17 years of age. The videos will be displayed in a
primary care office starting in January 2020 for the 12 months in Georgia. If it is successful
then we will expand into the hospital emergency rooms, specifically, pediatric emergency rooms
while maintaining mandated views by shares on mobile devices. Sportoid will use 100% year to
year of the sales growth in Georgia to expand its YouTube geography. The expansion will be
completed by business development as a joint venture with Canadian federal government to
expand into Canada.
Ethical Consideration

Ethical Considerations for the Youtube application are important. They encourage
accountability and trust with teen athletes and families. Institutional Review Board (I.R.B.)
approval is required prior to beginning the pilot to ensure ethical guidelines are being followed.
Teens are considered a vulnerable population due to their emotional and intellectual capacity.
They are not legally of age to give consent. Informed consent must be signed by the parents and
assent by the teen prior to participation. Participation is completely voluntary.
SPORTOID AND TEEN ATHLETES 25

National Association of Social Workers Code of Ethics (2019) states that social workers have a
duty to Social workers engaged in evaluation or research should carefully consider possible
consequences and should follow guidelines developed for the protection of evaluation and
research participants. Appropriate institutional review boards should be consulted.
The Sportoid YouTube video has given careful consideration to ethical concerns and possible
negative consequences of addressing the gaps in healthcare. The cost of the video is fair and
equitable. Informed consent was obtained before videotaping teen athletes. This will continue to
be an ethical concern as the videos continue. Consent must be obtained from all participants in
the video and observing the video. It is the obligation as social work leadership of the innovation
that the teens receive the information in the video in language and terms that they understand.
The final decision and authorization will be obtained from the parent or the guardian.
The current teen ecosystem is considered to be a social media environment ( Aran-Ramspott,
Fedele, and Tarrago, 2018). By providing the preventive education video before prescription of
opioids to injured teen athletes, teens are able to maintain autonomy in their care. Giving teens
the chance to utilize self-directed learning through Youtube videos allows them to fulfill their
self-efficacy (Lee, Osop, Goh, and Kelni, 2017). Teens have the benefit of utilizing comments to
interact with the teens in the video (Lee, Osop, Goh, and Kelni, 2017). They are able to make
their own informed decisions with information about risks and alternatives.
Teens must have the desire to learn the material presented. The teens' ultimate goal is to
return to their prior state of functioning. By utilizing the Youtube video, the teen can be
SPORTOID AND TEEN ATHLETES 26

proactive in his or her care and avoid addiction the desired outcome (Lee, Osop, Goh, and Kelni,
2017). Teens will have an opportunity to develop an emotional attachment to the youth on video
because they recognize them as ordinary athletes facing the same issues, not celebrities. From
this emotional attachment they will be able to sustain through the support of the teens.
The teen athletes on Youtube do not have a barrier that separates them from the injured teen that
famous athletes are perceived to have. The videos and testimonies are authentic. The information
is factual.

Future Implications

The YouTube video will provide some similarities to the Truth Initiative. In 1998 a Master
Settlement Agreement was reached between the United States and major tobacco industries to
provide funds designated to a nonprofit organization to prevent youth from tobacco use (Vallone
et al., 2016). The Legacy Foundation received $1.45 billion to prevent tobacco-related deaths.
The funding from this settlement ended in 2003. The settlement included several provisions, as
well. It forbids tobacco companies from targeting youth ( Public Health Law Center, 2019). It
also restricted use of cartoons and billboards for tobacco advertisements (Public Health Law
Center, 2019). In 2000 the Truth campaign launched throughout the United States. They used
an industry manipulation strategy by attacking the industry and portraying its executives as
SPORTOID AND TEEN ATHLETES 27

predatory (Sly et al., 2001). Some states allocate no funds in prevention programs. They fail to
address the growing epidemic against youth.
The same concepts of providing parents, teen athletes, school personnel, and community
leaders with interactive tools and resources focused on educating them about dangers of
prescription drug abuse. The sustainability of the Youtube video is based upon its remaining
relevance to the current issues of teen athletes and the relevance of opioids. The goal of the
Youtube video is to obtain more than 500 views and receive four likes per 100 viewers. The
engagement of the viewers should be greater than 15 seconds. Youtube allows peer assessment,
which aids in enhancing the video quality to improve learning for teens (Lee et al., 2017). These
will be the successful benchmarks in obtaining and sustaining success for the video.
There may be an opportunity to co-brand between Sportoid and the Truth Initiative that will
introduce their product or service to the devotees of Truth brand. The audience potential on
YouTube is huge for Sportoid. When the video is shared on other social media platforms such as
Snapchat, it becomes a part of a robust social content strategy that increases the numbers. The
advantage of utilizing the Sportoid as a YouTube video is that it will appear on YouTube and
Google search engines. YouTube will allow Sportoid to associate with a Google AdSense
account and will enable the company to earn money from uploaded videos. Since YouTube is
public, anyone can see the videos that are posted. This means that there is a possibility that there
could be copyright infringement issues and privacy invasion. For the teens in the video, they are
exposed to criticism and privacy invasion. Because of the possibility that YouTube could change
its advertising policy, shut down the site, lose brand support, or subscribers are a loss. Sportoid
SPORTOID AND TEEN ATHLETES 28

has considered ways of diversifying its income streams and stretching themselves over multiple
projects to protect themselves financially .

Conclusions, Actions, and Implications

Since the opioid epidemic is a national public health concern across the United States, it is not
the federal government that should address and fund the efforts of teen opioid use. It is not
enough to place measures in place with little and no funds as the youth die. There is a need to
provide educational outreach and intervention strategies aimed at teens.
Access to appropriate prevention, early intervention, and treatment to teens is a challenge
despite advances in science and policy (Begun & Clapp, 2015). The Youtube video will educate
the teen . The information obtained from the video will challenge the youth’s norm about the use
of opioid prescriptions, which will lead to a change in behavior (Cherry, 2018). Researchers
believe that Youtube normalizes behaviors for teens; therefore, teen athletes in the video will
create the deviate that will be normalized ( Ahern, Sauer, and Thacker, 2015). Youth can share
and comment on the videos (Ahern, Sauer, and Thacker, 2015). Closing the health gap is
imperative. Research indicated that females are 21% less likely than males to get the
recommended treatment (Zimlich, 2017). They also stated that Black teens were 42% less likely
to receive medication treatment. Hispanic teenagers were 17% less likely to receive the same
treatment than white teenagers (Zimlich, 2017). Doctors did not prescribe opioids to blacks and
SPORTOID AND TEEN ATHLETES 29

Hispanics, because they believed that they didn’t feel pain as much as whites and were more
likely to misuse and sell them. The public assumed that these youth avoided the prescription drug
misuse epidemic. They didn’t avoid the opioid use epidemic. These youth sought alternative
measures to treat their pain by accessing other pain prescriptions and not reporting issues with
use to physicians. The importance of focusing on youth disparities is developing effective,
appropriate prevention and education strategies.
The implications of the brain development of teens by opioids should be enough to encourage
physicians to utilize preventive alternatives. Teens are not interested in norms but creating
deviants that challenge those norms. They will often choose risky behaviors to challenge
boundaries. This makes them at high risk of opioid addiction, especially after an injury. For
example, mild traumatic brain injuries experienced in competitive sports may lead to further
cognitive problems. Their cognitive problems are often difficult to recognize and often
underestimated as it is expected to have resolved or had little impact on the youth (van
Heughten, Renaud, and Resch, 2017). For these youth preventative education is important. The
Youtube video is targeted directly for this population of athletes that have experienced injuries as
a part of sports. Research indicated education with prescription opioids or alternatives yield
positive results (Heugten, Renaud, and Resch, 2017).
To continue to address these teen injuries and reduce opioid addiction in the future through
prevention education, Sportoid plans to expand the Youtube videos will target injured teen
female, Hispanic, and/or Black athletes in collaboration with state school systems as early as
elementary school. The school system is considered ground zero for learning. They spend the
SPORTOID AND TEEN ATHLETES 30

greatest amount of their day in the school system. Many educators are not equipped to deal with
the issue of prescription opioids. This will be an excellent opportunity to mandate students and
parents that when injuries occur this is a possible treatment and risk that exists. In 2016 the Drug
Enforcement Administration (DEA) met with Discovery Education to develop Operation
Prevention (Anonymous, 2018). It was an initiative directed at third to twelfth graders that
encouraged a science-based conversation between teachers and students about the effects of
opioid use. Funding currently exists in the school system for these programs.
The opioid epidemic is a national public health concern across the United States. There are
formal and informal limits set in place to prevent opioid use addiction; however, they have
resulted in at times the increased use in prescription opioid use by teen athletes. A very high
number of teens are increasingly using prescription medicine. The conventional threat of
methamphetamine, heroin, and cocaine has been replaced by prescription pills. There is a
common misconception that prescription pills are safe and are not harmful to the body compared
to other types of drugs. However, prescription drugs have side effects, which could lead to
various short term and long-term health issues. Opioids especially act on the same part of the
brain as heroin and are known to cause constipation, nausea, drowsiness and slow breathing
depending on the usage. The effects are serious, and they can depreciate the health of the
developing body and brain (NIDA, 2019). Opioids are addictive to the teen brain which is in the
development stage until past the age of twenty. The prefrontal cortex of the brain is known to
enable people to formulate strategies, setting priorities, controlling impulses and allocating
attention (NIDA, 2015). Also, the brain experiences significant growth and development
SPORTOID AND TEEN ATHLETES 31

allowing adolescents to comprehend complex issues and be able to understand rules and complex
information (NIDA, 2015). In this sense drug use is an issue for the perception of teenagers and
affects their skills when they should develop and cultivate pathways to sustainable lives.
As impactful as the video is at addressing the risk and alternatives for prescription opioids to
the injured teen athletes to reduce the risk of opioid addiction, should the teen choose
prescription opioids. The risk continues for the injured youth and their friends with continued
use of prescription opioids. Fourteen percent of United States High School students report use of
illegal prescription medications (Rusher, 2018). The use of formal limits set in place to identify
patients to physicians such as Prescription Drug Monitoring Programs is only being used by 53%
of primary care physicians (Rusher, 2018). There are so many factors after prescription opioids
are introduced to teens. Prevention is the key to reducing the risk of opioid addiction and
decreasing the number of youths affected by the epidemic.
In conclusion, my grand challenge is closing the health gap. I plan to address the growing
epidemic of teen opioid addiction of youth between the ages of 12 to 17-year-old athletes. My
capstone innovation will be the use of video education as prevention. YouTube video social
media has become a very effective prevention measure. This innovation will influence and
change the youth as well physician’s prescribing behavior toward opioids.
YouTube allows teens the ability to access content anytime and anywhere. As teens always
have technology in their hands, it is important that the information be in their hands as well. The
YouTube intervention is implemented with that ideology in mind to end the opioid epidemic.
SPORTOID AND TEEN ATHLETES 32

Appendices 1: Business Plan
Appendices 2: Articles of Organization
Appendices 3: Video
Appendices 4: Survey

SPORTOID AND TEEN ATHLETES 33

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Asset Metadata

Creator Mitchell Washington, Aisha Resha (author)

Core Title Sportiod and teen athletes

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Publication Date 04/06/2020

Defense Date 11/22/2019

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,opiate abuse,opioid addiction,teen athletes

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Enrile, Annalise (committee chair), Feuborn, William (committee member), Orras, George (committee member)

Creator Email armitchell52@gmail.com,mitc4525@hotmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-278181

Unique identifier UC11673595

Identifier etd-MitchellWa-8243.pdf (filename),usctheses-c89-278181 (legacy record id)

Legacy Identifier etd-MitchellWa-8243.pdf

Dmrecord 278181

Document Type Capstone project

Rights Mitchell Washington, Aisha Resha

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA