Non-disclosure in Irish collegiate student-athletes: do concussion history, knowledge, pressure to play and gender impact concussion reporting?

O’Connor, Siobhán; Geaney, Deirdre; Beidler, Erica

doi:10.1080/00913847.2019.1671141

Cited by 28 publications

(42 citation statements)

References 36 publications

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“…11 , 12 A primary difficulty for improving concussion management strategies is the level of injury non-disclosure, which is documented internationally and across numerous sports. 18–21 Studies looking specifically at rugby support this trend. 22–25 Concussion non-disclosure has been attributed to a variety of factors such as a lack of standardized reporting criteria, misunderstanding concussion signs and symptoms, 25 and hesitancy by players to disclose symptoms to avoid being withdrawn from active sport participation (i.e., removed from play).…”

Section: Introductionmentioning

confidence: 88%

Concussion knowledge, attitude and reporting intention in rugby coaches and high school rugby players

Salmon

Romanchuk

Sullivan

et al. 2020

International Journal of Sports Science & Coaching

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The aim of this study was to evaluate New Zealand high school rugby union players’ and community coaches’ concussion knowledge (CK), concussion attitude (CA) and concussion reporting intentions (CRI) and to explore the impact gender, age, ethnicity, socio-economic status, experience, and concussion history had on these outcome measures. This cross-sectional study utilised the Rosenbaum Concussion Knowledge and Attitudes survey to evaluate CK, CA and CRI. The survey and demographic information were completed by 533 high school players (61.5% male, M = 16.2 yrs) and 733 community rugby coaches (93.0% male, M = 42.2 yrs). Coaches displayed greater awareness, safer attitudes, and stronger reporting intentions towards concussion than players. Among players, differences in CK, CA and CRI were observed by gender, ethnicity, and socio-economic status. Among coaches, differences in CRI were found by age and coaching experience. No differences were observed for age or concussion history in players. Gender, ethnicity, and grade coached were not significant for coaches. Players who identified as Māori or Pasifika and those from schools in low socio-economic areas displayed poorer CK and CA. Years of experience for both players and coaches played a critical role in improving CA and is a factor that should be considered when welcoming new participants to either role. Concussion non-disclosure is a systemic issue and is common across gender, ethnicity and socio-economic status and appears to worsen as the playing season progresses. More work is needed to develop educational strategies that are both culturally responsive, sustainable, and address reporting behaviours.

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Section: Introductionmentioning

confidence: 88%

Concussion knowledge, attitude and reporting intention in rugby coaches and high school rugby players

Salmon

Romanchuk

Sullivan

et al. 2020

International Journal of Sports Science & Coaching

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“…In addition to these identified sex differences, self-reported concussion history also influenced concussion nondisclosure. 9,[14][15][16] Evidence of this has been demonstrated in high school 15 and collegiate 9,14 student-athletes as well as in military cadets. 16 More specifically, when investigating collegiate student-athletes, researchers 9 found that those with a history of concussion were 2.6 times more likely to not disclose a future concussion.…”

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confidence: 97%

“…5 Although football has been found to have the highest prevalence of concussion nondisclosure, significant percentages of women's soccer (42%), men's lacrosse (36%), and wrestling (36%) collegiate student-athletes have also reported previous concussion nondisclosure. 5 This high prevalence of nondisclosure persists among collegiate student-athletes, [6][7][8][9] suggesting that concussion knowledge may not be the only factor motivating nondisclosure.…”

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confidence: 99%

“…11 Therefore, although concussion knowledge is an important predictor to consider, several other factors may influence a student-athlete's intention to report a head injury. 5,6,12 Factors such as student-athlete sex, 5,6,9 sport, 5,13 concussion history, 6,9,14 and pressure from external stakeholders (ie, coaches, teammates, fans, parents) 6 have all been documented as influencing collegiate athlete concussionreporting behavior. When evaluating former collegiate student-athletes, Kerr et al 5 observed that males were more likely than females to not disclose a concussion.…”

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confidence: 99%

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Factors Associated With Concussion Nondisclosure in Collegiate Student-Athletes

Anderson

Petit

Wallace

et al. 2021

Journal of Athletic Training

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Context Mandated concussion education has aimed to improve student-athlete knowledge; however, some collegiate student-athletes continue to not disclose concussion. Concussion knowledge may not be the only factor influencing reporting, as student-athlete sex, sport, and pressure from external stakeholders (eg, coaches, teammates, fans, parents or family) have all been documented as influencing collegiate concussion-reporting behavior. Objective To examine factors associated with concussion nondisclosure in collegiate student-athletes. Design Cross-sectional study. Setting Four National Collegiate Athletic Association Division I and two Division II universities. Patients or Other Participants A total of 1125 collegiate student-athletes completed the survey, and 741 provided viable responses and were included for data analysis. Main Outcome Measure(s) We used a 10- to 15-minute electronic or paper-and-pencil survey that asked about personal and sport demographics, diagnosed concussions and nondisclosed concussion history, concussion knowledge, and level of agreement regarding pressure to play after a head impact experienced during collegiate sport participation. Significant univariable factors were entered into a multivariable logistic regression analysis. Results Sex (P = .005), sport-risk type (P < .001), diagnosed concussion history (P < .001), concussion knowledge (P = .017), and pressure from coaches (P < .001), teammates (P < .001), fans (P = .024), and parents or family (P = .003) were factors associated with concussion nondisclosure in individual univariable logistic regressions. After we conducted multivariable analyses, male sex (P = .001), high concussion-risk sport participation (P = .048), diagnosed concussion history (P < .001), increased concussion knowledge (P = .013), and experiencing pressure from coaches to continue playing after sustaining a hit to the head (P = .002) were factors associated with concussion nondisclosure in collegiate student-athletes. Conclusions Our results suggest that concussion-education programs should go beyond the identification of signs and symptoms to include the dangers of continuing to play, long-term consequences, and transparency about concussion protocols. Comprehensive concussion-education programs should involve coaches and athletes to improve the reporting culture.

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“…Differentiation by “known groups” was assessed as the correlation between the new measure and history of previously diagnosed concussion. Based on prior literature (Register-Mihalik et al 2017 ; Kroshus et al 2020 ; O’Connor et al 2020 Apr 2 ), we expected that those who had previously had a concussion would be less likely to expect to report a future concussion.…”

Section: Methodsmentioning

confidence: 99%

Development of a scale to measure expected concussion reporting behavior

et al. 2021

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Background Most concussion education aims to increase athlete self-report of concussive symptoms. Although the population burden of concussion is high, frequency with which this injury occurs on a given sports team in a given season is relatively low. This means that powering concussion education evaluation studies to measure change in post-injury symptom reporting behavior requires what is often a prohibitively large sample size. Thus, evaluation studies are typically powered to measure proximal cognitions. Expected reporting behavior, a cognition that reflects planned and reactive decision-making, is a theoretically indicated construct for inclusion in evaluation studies. However, previously no scales were available to measure this construct with demonstrated reliability and validity among youth athletes. The objective of this study was to develop and assess the validity of a brief single-factor scale to measure expected youth athlete concussion reporting behavior (CR-E) in a sample of youth athletes. Methods A mixed methods approach was used, including cognitive interviews with youth athletes, and quantitative item reduction and validation. Participants were youth athletes (aged 9–16) from the Seattle metropolitan and rural south-Georgia regions. After refining an initial pool of items using cognitive interviews with a diverse group of youth athletes (n = 20), a survey containing these items was administered to youth soccer and football players (n = 291). Item reduction statistics and sequential confirmatory factor analyses were used to reduce the initial scale using a randomly selected half of the sample. Then, a final confirmatory factor analysis and validation tests were applied to the other half of the sample of youth athletes. Predictive validation was conducted longitudinally in a separate sample of youth athletes (n = 155). Results Internal consistency was high (alpha = 0.89), model fit was excellent, validation tests were in the hypothesized directions, and the scale was feasible to use. Using the finalized 4-item scale, we observed that less than one-third of youth soccer and football athletes expect to “always” tell their coach about symptoms of a suspected concussion. Conclusions The CR-E measure should be included in future studies evaluating concussion education programming in youth athlete populations.

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Non-disclosure in Irish collegiate student-athletes: do concussion history, knowledge, pressure to play and gender impact concussion reporting?

Cited by 28 publications

References 36 publications

Concussion knowledge, attitude and reporting intention in rugby coaches and high school rugby players

Concussion knowledge, attitude and reporting intention in rugby coaches and high school rugby players

Factors Associated With Concussion Nondisclosure in Collegiate Student-Athletes

Development of a scale to measure expected concussion reporting behavior

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