Reporting Skill: The Missing Ingredient in Concussion Reporting Intention Assessment

Abstract

Background: Extant literature suggests that a substantial portion of athletes may not report a possible concussion and that concussion knowledge is insufficient to predict concussion reporting behavior. One area that has not been explored is reporting skill; that is, mastery of the actions required to report a concussion. This study evaluated the relationship between reporting skill and reporting intention, introducing a measure of the reporting skill construct. Hypotheses: Reporting intentions will be more closely associated with reporting skill than with concussion/symptom knowledge. The relationship between concussion (or symptom) knowledge and reporting intentions will differ by level of reporting skill. Study Design: Repeated cross-sectional study. Level of Evidence: Level 2. Methods: A set of items was administered to young adults aged 18 to 24 years from the Survey Sampling International panel. Exploratory/confirmatory factor analyses were conducted on 2 waves of data to develop the scale (n = 899). Hypotheses were tested using structural equation modeling on the responses from the third wave of participants (n = 406). Results: Knowing the actions to take in reporting was more important than having knowledge of concussions or concussion symptoms. Reporting skill, not concussion or concussion symptom knowledge, was associated with higher intentions to report symptoms. Among those with higher levels of reporting skill, concussion symptom knowledge (but not general concussion knowledge) was associated with higher intentions to report symptoms. Conclusion: Reporting skill is an important and, until now, missing ingredient in the concussion literature and practice. Clinical Relevance: Incorporating reporting skill development in concussion education and team activities to teach athletes how to report is likely to improve actual reporting intentions. While further study is needed with particular sports and additional age groups, reporting skill holds promise as a new avenue for increased concussion reporting.

Improving concussion education: consensus from the NCAA-Department of Defense Mind Matters Research & Education Grand Challenge

“…Such a discussion could focus on the disclosure decision, providing site-specific information on the actions to take to report symptoms. 29 As more educational approaches and tools for student-athletes and military service members are developed and evaluated, guidance should be provided to institutions about which resources address recommended content and have demonstrated efficacy in improving disclosure behaviours.…”

Evaluating the Effect of Concussion-Education Programs on Intent to Report Concussion in High School Football

“…Concussion-reporting skill, therefore, represents a potential avenue for further improving perceived behavioral control and would likely result in additional gains in concussion reporting given the data linking it to concussion-reporting intention. 30 We found no changes in athletes' perceived concussionreporting norms after any study intervention. Although perceived norms are an important factor in athletes' concussion reporting, it is perhaps unsurprising that no improvements occurred across the 3 interventions.…”

Intentions to report concussion symptoms in nonprofessional athletes: A fuzzy‐trace theory approach

“…However, no relation with cognitive reflection was observed. Thus, prior theoretical models yield some significant effects, but they also leave substantial variance unexplained (Kroshus et al, 2014; Kroshus, Garnett, Hawrilenko, et al, 2015; Warmath & Winterstein, 2019).…”

“…Of the few studies incorporating theory, most focus on the theory of reasoned action and planned behavior, social cognitive theories (see Fishbein, 2008), which incorporate psychosocial factors, such as social pressures that influence behavior through effects of descriptive and injunctive norms (e.g., my parents would approve of…; Kroshus, Baugh, Daneshvar, & Viswanath, 2014;Kroshus, Garnett, Hawrilenko, et al, 2015;Register-Mihalik et al, 2012;Register-Mihalik et al, 2013). In another study by Warmath and Winterstein (2019), reporting skill, namely, knowing the actions to take in reporting, was more important than having knowledge of concussions or concussion symptoms; athletes with higher reporting skill had increased intentions to report concussions.…”