Knowledge, Awareness, and Attitudes Regarding Concussion Among Middle Schoolers

Abstract

Introduction: Given the widespread prevalence of concussions in children under the age of 19, the adolescent perspective, as well as an understanding of the mechanisms behind traumatic brain injury (TBI), is extremely important. The authors sought to assess the knowledge, awareness, and attitudes regarding concussion among middle school children and whether a brief educational intervention based on clinical data and science resulted in a change of their knowledge or attitudes towards concussions. Methods: A 20-question survey design was administered before and after an educational intervention. The surveys were anonymous, but they were paired so that it was possible to correlate the pre- and post-test answers to the respondents. An eighth-grader at a Florida middle school conducted this study after school hours after the student and their parent or legal guardian signed informed consent. This project was approved by the Science Department at Howard Bishop Middle School in Alachua County, Florida. JMP® 14.0 (SAS Institute Inc., Cary, NC) was used for statistical analyses. Results: The cohort was 64% female, age range: 13 - 15, and consisted of local eighth-grade students. Forty-three percent never wore a helmet when riding a bicycle or skateboard. Only 68% knew that the state had a helmet law for kids. Participants were significantly more likely to feel they had good TBI knowledge after the intervention (p = 0.0005, 95% confidence interval (CI) 0.1937 to 0.6863) and that the didactic lectures changed the way they thought about safety (p = 0.0034, 95% CI 0.1025 to 0.5175). Students reported that their mothers (vs. fathers) were significantly more likely to wear seatbelts (p = 0.05, 95% CI 0.0036 to 0.5036), and they themselves reported wearing seatbelts more often after the survey. Conclusions: There still exists a knowledge gap when it comes to pediatric concussion. Expanding awareness is important in order to bolster safety measures among adolescents.

Concussion Education in the School Setting: A Scoping Review

“…The majority of studies were conducted in the United States (n = 23; 85.2%), 27‐49 with two conducted in Canada (7.4%) 50,51 and one in both Ireland (3.7%) 52 and Australia (3.7%) 53 . The studies were published in 25 different peer‐reviewed journals, with two published in the Clinical Journal of Sport Medicine 29,30 and two published in the Orthopedic Journal of Sports Medicine 49,52 .…”

“…Six studies (22.2%) were delivered to a mixed audience which included some combination of students, coaches, educators, parents, and healthcare professionals 28‐30,32,39,41 . Among education delivered to students (n = 13; 48.1%), eight studies were delivered to only athletes 32,35,37,40,44,49,50,52 and five were delivered broadly to students within the school 27,31,42,48,51 …”

“…The most commonly addressed concussion topic was concussion signs and symptoms, which was discussed in 17 studies (63.0%) 27‐31,35,37,38,40,42‐44,46,49,50,52,53 . The second most commonly addressed topic was medical management of a concussion, which was addressed in 15 studies (55.6%) 27,28,30,32,35,38‐40,42,43,46,48,49,51,52 . Return to school (managing a concussion in the school setting) was discussed in 10 studies (37.0%) 28‐30,32‐34,39,41,44,53 .…”

“…Many studies (n = 12; 44.4%) involved the presence of, or delivery by, a member of the research team, 28,33,35,37,38,40,44,49‐53 as opposed to being self‐directed (n = 7; 25.9%) 29,32,34,41,43,45,46 or were delivered by another individual (eg, student healthcare professionals) (n = 4; 14.8%) 27,30,31,42 . Four studies (14.8%) provided no details on who delivered the education 36,39,47,48 …”

“…The primary format of the education included a presentation (n = 12; 44.4%), 27,28,30,31,34,37,39,44,48,50,52,53 online module (n = 7; 25.9%), 29,32,33,36,38,41,51 toolkit (n = 3; 11.1%), 43,45,46 video (n = 1; 3.7%), 35 combination of a presentation and a video (n = 1; 3.7%), 40 active learning activity (n = 1; 3.7%), 49 interactive arts‐based component (n = 1; 3.7%) 42 and unspecified format (n = 1; 3.7%) 47 . The majority of studies (n = 21; 77.8%) 27‐31,33,36‐39,41‐43,45,46,48‐53 described facilitation techniques used to enhance the education, such as opportunities to ask questions, group discussion, reflection periods, quizzes, demonstrations, and discussion of shared experiences. The length of the education varied from 9 minutes 35 to components delivered over 2 weeks 42 .…”