Sex Differences in High School Athletes' Knowledge of Sport-Related Concussion Symptoms and Reporting Behaviors

Abstract

Context: Recent researchers have reported that athletes' knowledge of sport-related concussion (SRC) has increased but that athletes still lack knowledge of all the signs and symptoms of SRC. Understanding the signs and symptoms of SRC and the dangers of playing while symptomatic are critical to reporting behaviors in high school athletes.Objective: To examine sex differences in knowledge of SRC symptoms and reasons for not reporting a suspected SRC to an authoritative figure in high school athletes.Design: Cross-sectional study. 2%]).Main Outcome Measure(s): A validated knowledge-of-SRC survey consisted of demographic questions, a list of 21 signs and symptoms of SRC, and reasons why athletes would not report their SRC. The independent variable was sex. Athlete knowledge of SRC symptoms was assessed by having participants identify the signs and symptoms of SRC from a list of 21 symptoms. Knowledge scores were calculated by summing the number of correct answers; scores ranged from 0 to 21, with a score closer to 21 representing greater knowledge. Reporting-behavior questions asked athletes to choose reasons why they decided not to report any possible SRC signs and symptoms to an authoritative figure.Results: A sex difference in total SRC symptom knowledge was found (F 286 ¼ 4.97, P ¼ .03, d ¼ 0.26). Female high school athletes had more total SRC symptom knowledge (mean 6 standard deviation ¼ 15.06 6 2.63; 95% confidence interval ¼ 14.54, 15.57) than males (14.36 6 2.76; 95% confidence interval ¼ 13.97, 14.74). Chi-square tests identified significant relationships between sex and 8 different reasons for not reporting an SRC.Conclusions: High school males and females had similar SRC symptom knowledge; however, female athletes were more likely to report their concussive symptoms to an authoritative figure.Key Words: mild traumatic brain injuries, secondary school, sport culture Key PointsHigh school males and females had similar concussion knowledge, but females were more likely to use that knowledge to report a sport-related concussion. Males were 4 to 11 times more likely than females to not report a sport-related concussion for reasons focused on the reactions and perceptions of others. Large percentages of male and female athletes did not report a sport-related concussion because they did not think it was serious. Theory-based interventions are warranted to overcome the stigmas associated with the male sport culture.

Challenges Faced by Collegiate Athletic Trainers, Part II: Treating Concussed Student-Athletes

“…Therefore, the opportunity for improvement via educational outreach remains, especially with male athletes, as they were less likely to report symptoms than females. 19 Yet despite recent educational and awareness efforts, some athletes or coaches with certain personal attributes prioritize competitiveness and success over anything else. Outreach must extend beyond knowledge to improve effectiveness because increasing knowledge alone may not provoke behavior change.…”

Demographic, Parental, and Personal Factors and Youth Athletes' Concussion-Related Knowledge and Beliefs

“…33,34 In high school and collegiate cohorts, young women in sex-comparable sports (eg, girls' versus boys' soccer) were more likely to disclose symptoms compared with their male counterparts. 18,35 This may be a result of improved concussion-related knowledge and attitudes, the inherent characteristics of sports, or additional unknown factors. Our findings suggest that sportspecific educational messaging is indicated, specifically concerning symptom identification in youth ice hockey players.…”

“…9 In addition, we need to understand key intrapersonallevel factors in youth sports, such as the athlete's age, history of concussion, and exposure to concussion education. These factors may play roles in high school and collegiate athletes' [15][16][17][18][19] concussion-related knowledge and behaviors, with older athletes having better knowledge and those with a concussion history displaying no difference in knowledge. However, public health investigators 20 have observed that previous experience with other conditions influences the responses to subsequent experiences with that condition.…”

The Influence of Athletic Trainers on the Incidence and Management of Concussions in High School Athletes

“…30 A third factor may be related to the distribution of male versus female athletes. In a recent study, Wallace et al 37 reported that males were much less likely to report an SRC than females. The percentage of males was indeed higher in the LoAT group than in the HiAT group, but the percentage of males was similar between the LoAT and MidAT schools.…”