Knowledge, Attitude, and Concussion-Reporting Behaviors Among High School Athletes: A Preliminary Study
Register-Mihalik JK., Kim N., Guskiewicz KM., Valovich McLeod TC., Linnan LA, Mueller FO., Marshall SW. Journal of Athletic Training. 2013; 48(3).
Take Home Message: Over half of the athletes recalled concussive events in this study but did not report their problem to their supervising adult. Additionally, both concussion knowledge and attitude may play a role in reporting concussive events.
Many athletes continue to practice and play games while experiencing concussion-related symptoms. Knowledge and attitude regarding concussions are changeable factors that may contribute to concussion-reporting and care-seeking behaviors; however, few researchers have investigated concussion knowledge or attitude and reporting frequency. Therefore, the purpose of this study was to examine the influence of concussion knowledge and attitude on concussion reporting among high school athletes. The authors collected 167 surveys (10% return rate) from 25 out of 28 high school that received the 1,669 surveys. An athlete could participate in this study if he or she was listed on the roster as a member of the varsity football, cheerleading, boys’ soccer, girls’ soccer, boy’s lacrosse, or girls’ lacrosse team. The survey contained questions about athlete’s knowledge, attitudes, and beliefs regarding concussion, as well as whether they reported their past concussive and bell-ringer events, and how they handled those events. A total of 89 (53%) athletes recalled having at least 1 possible concussion or bell-ringer event; however, only 15 athletes indicated that they reported the event. Athletes recalled a total of 84 concussions and 584 bell-ringer events but they only reported 41 and 71 of these events to a coach or medical professional, respectively. The athletes provided 3 common reasons for failing to report a concussion or bell-ringer event: 1) the athlete thought it was only minor (70%), 2) they wanted to stay in the game (36.5%), or 3) they wanted to avoid letting their teammates down (27%). The athletes were fairly knowledgeable about concussions and correctly answered 55% to 100% of the questions on the knowledge portion of the survey. An athlete with a more favorable attitude toward wanting to understand and report a concussion was less likely to report that he or she continued to play in games or practices while symptomatic. Athlete knowledge and attitude total scores were not associated with reporting recalled concussion or bell-ringer events in games. Though, an athlete with more concussion knowledge or a more favorable attitude towards concussion often recalled more events in practice, particularly bell-ringer events. Finally, an athlete with more concussion knowledge or a more favorable attitude towards concussion typically reported bell-ringer events to a coach or medical professional more often compared with individuals with lower scores.
This study highlights that most high school athletes do not report concussions. Athletes described an alarming amount of bell-ringer events but yet they only reported 12% of the events to a coach or medical professional. These events might have been concussions, where athletes continued to play in a vulnerable state. This study also emphasizes that even though concussion knowledge in this study was higher than previously reported there is room for more education since athletes do not consider bell-ringer events concussions, and the most common reason an athlete did not report his/her concussion was because they thought it was only a minor problem. This study also suggests that concussion knowledge and athlete’s attitude plays a role in athlete’s reporting behaviors. Athletes with a positive attitude toward reporting a concussive injury may have a better understanding of the importance of reporting concussion injuries. This may suggest that if we increase an athlete’s knowledge about concussions we could affect their attitude, which may encourage athletes to report a concussion. While we can implement more education programs today it will be beneficial to see more research to determine which education strategies and lesson plans may be most effective at increasing knowledge and changing attitudes.
Question for Discussion: How can you teach students to have a better attitude with their concussion reporting habits?
Written by: Jane McDevitt PhD, ATC, CSCS
Reviewed by: Jeffrey Driban