Sport-Related Concussion: Knowledge and Reporting Behaviors Among Collegiate Club-Sport Athletes

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Context Concussions are a global public health concern, and education on the importance of self-reporting may not reach all athletes to the same degree around the world. Objective To determine if differences were present in the concussion awareness, understanding, and -reporting behaviors of collegiate athletes' in 3 countries with varied degrees of concussion publicity. Design Cross-sectional survey. Setting Collegiate sports medicine clinics. Patients or Other Participants Collegiate athletes in the United States (n = 964; high publicity), Ireland (n = 302; moderate publicity), and Jordan (n = 129; low publicity). The degree of concussion publicity was categorized based on the extent of national public health awareness initiatives, care guidelines, research publications, and mass media coverage. Main Outcome Measure(s) Participants completed a 10- to 15-minute survey on concussion awareness, understanding, and -reporting behaviors. The main outcome measures were concussion education (awareness; 21 options; select all sources of concussion information), concussion knowledge (understanding; maximum score of 49), and diagnosed/nondisclosed concussion history (reporting behaviors; self-report yes/no items). Results A higher proportion of Jordanian athletes reported never having received concussion information previously (73.6%) than Irish (24.2%) or US athletes (9.4%). Knowledge differed among countries (P < .0001, η2 = .28), with US athletes displaying higher total knowledge scores (40.9 ± 4.5) than Jordanian (35.1 ± 5.6) and Irish (32.1 ± 3.5) athletes. A greater percentage of Irish and US athletes reported a history of a diagnosed concussion (31.8% and 29.6%, respectively) and history of concussion nondisclosure (25.2% and 15.5%, respectively) than Jordanian athletes (2.3% and 0.0% for history of a diagnosed concussion and history of concussion nondisclosure, respectively). Conclusions In the United States, where concussion publicity is high, formal legislation exists, and sports medicine resources, concussion awareness and understanding were increased. More culturally appropriate concussion initiatives are needed globally to ensure that athletes around the world can identify concussive injuries and understand the dangers of continued sport participation while concussed.

Section: Concussion-reporting Behaviorsmentioning

confidence: 68%

Collegiate Athletes' Concussion Awareness, Understanding, and -Reporting Behaviors in Different Countries With Varying Concussion Publicity

Beidler

Wallace

Alghwiri

et al. 2020

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“…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.…”

mentioning

confidence: 99%

Factors Associated With Concussion Nondisclosure in Collegiate Student-Athletes

Anderson

Petit

Wallace

et al. 2021

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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.

“…18 As collegiate club sports popularity grows, so does the increased awareness for healthcare professionals to understand the injury risk and patterns associated with this population. [19][20][21] In particular, many campus recreational organizations employ athletic trainers to oversee the health and well-being of club sport athletes. With improved knowledge about club sport injury risk, athletic trainers can better serve this large population and advocate for the need of athletic trainers in these settings.…”

Section: O N L I N E F I R S Tmentioning

confidence: 99%

High School Sport Specialization and Injury in Collegiate Club-Sport Athletes

Biese

Winans

Hernandez

et al. 2021

Context: Sport specialization during adolescence may affect future injury risk. This association has been demonstrated in some professional sports athletes. Objective: Determine the association between adolescent sport specialization levels in high school and injuries sustained during collegiate club sports. Design: Cross-sectional study. Setting: Paper and online surveys. Patients: Collegiate club sport athletes. Intervention: An anonymous survey was administered from September 2019–May 2020. The survey included sport specialization classification via commonly used 3-point scale (Low, Moderate, High) for each high school year (9th–12th), high school sports participation, and collegiate club sport injury history. The number of years an individual was highly specialized in high school was calculated (0–4 years). Individuals who participated in the same sport in high school and college were compared to individuals who were playing a different sport in college than their high school sports. Main Outcome Measures: An injury related to sport club activities and classified as arising from a contact, non-contact, or overuse mechanism that required the individual to seek medical treatment or diagnosis. Injuries were classified into overuse and acute injury mechanisms for the upper and lower extremity, (UE and LE respectively) and head/neck. Results: Single sport participation or number of years highly specialized in high school sport were not associated with college club sport injuries (p>0.1). Individuals who played a different collegiate club sport than their high school sports were more likely to report a LE and head/neck acute injury compared to athletes who played the same collegiate and high school sport (LE=20% vs 8%, χ2=7.4 p=0.006; head/neck=16% vs 3%, χ2=19.4 p<0.001). Conclusions: Adolescent sport specialization was not associated with reported club sport injuries in collegiate club sport athletes. Collegiate club sport athletic trainers should be aware that incoming students exploring a new sport may be at risk for LE and head/neck acute injuries.