Provision of concussion information from coaches and presence of athletic trainers: Findings from the 2021 YouthStyles Survey
Daugherty J, Waltzman D, Sarmiento K. J Athl Train. 2023 Jan 16. doi: 10.4085/1062-6050-0454.22. Epub ahead of print. PMID: 36645830.
Take-Home Message
Over 40% of adolescents participating in sports reported that their coach did not provide concussion education information to them in the past year. This lack of communication may be associated with a lack of access to athletic trainers during games and practices.
Background
Coaches can provide concussion education and exert a positive influence, translating concussion knowledge to healthy behaviors, such as reporting suspected concussions. Coaches who complete concussion training and relay that information to their athletes positively influence an athlete’s view on concussions. However, it is unknown how often coaches discuss concussion education with the athletes or whether the presence of an athletic trainer aids in better coach-to-athlete concussion communication.
Study Goal
The authors used survey data to examine how often coaches provide concussion safety information to their athletes and if this varied based on the presence of athletic trainers at games and practices.
Methods
In June 2021, adolescents living with parents who are members of the Ipsos’ KnowledgePanel were invited to answer the annual YouthStyle Web-based survey. About 48% of invited adolescents completed the survey questions regarding concussion history, concussion safety information, how concerned they believe their coach is regarding concussion safety, and the frequency of athletic trainers at games and practices in the past year. The authors took statistical steps to ensure that the data represented adolescents throughout the United States.
Results
Among 829 adolescents, 39% reported participating in sports during the past 12 months: 1) only in school-based sports (19%), 2) only in sports leagues (13%), or in both (7%). The most commonly reported sports included basketball and soccer. Almost half (47%) of youth athletes reported that their coach discussed concussions. Furthermore, 32% stated they received a handout, and 23% indicated that their coach sent them an email or had a video to watch in the past 12 months. Overall, 58% of adolescent athletes reported that their coach discussed or provided information about concussions. More youth athletes participating in school-based sports (65%) reported receiving this information compared with athletes only in non-school sports leagues (39%). About half of the youth athletes reported having an athletic trainer at practice (55%) or games (55%). Youth athletes participating in school-based sports reported more frequent access to athletic trainers (72%) than those competing on non-school-based sports teams (49%). Among youth athletes that always/sometimes had an athletic trainer, 63% reported that the coach talked to them about concussions, compared to 24% of youth athletes that rarely or never had access to athletic trainers.
Viewpoints
Four in 10 athletes report that their coaches do not discuss concussions nor provide concussion information. The authors found that having access to an athletic trainer may increase communication between coaches and youth athletes. It would be interesting to know if the athletic trainer increases the amount of communication because they provide resources to the coaches to share with athletes. Understanding how athletic trainers can increase a coach’s concussion communication with athletes would be helpful. Furthermore, this study focused on whether the coach provided information, not the quality of that information. It would be interesting to know how well the education worked. Coaches without access to athletic trainers may provide the athletes with concussion information, but the athlete doesn’t remember it because it wasn’t helpful.
Clinical Implications
We must encourage coaches to consistently educate athletes about concussions to improve reporting behaviors among youth athletes. Furthermore, athletic trainers positively influence coach-to-youth communication. Hence, when we encourage administrators to hire full-time athletic trainers, we can remind them that athletic trainers can help coaches better communicate about concussions and other injuries to their athletes.
Questions for Discussion
Do you try to get coaches to speak to the athletes about concussion education? If so, have you seen better outcomes in communication, knowledge, and reporting behavior?
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Written by Jane McDevitt
Reviewed by Jeffrey Driban
My name is Maggie McMullan and I’m a second year master’s in athletic training student at James Madison University. All of my clinical experience has consisted of D1 collegiate rotations, so I haven’t gotten to see many situations where coaches have to take on a primary role in concussion education because of the constant availability of an assigned athletic trainer. For the most part we provide education resources at the beginning of the season to athletes then are available at practices and games to evaluate incidents we witness and individuals that approach us. We then do incorporate the coaches into the conversation once we’ve determined if the patient has a concussion as it will affect their availability. I have noticed across clinical placements that those conversations, and sometimes athlete’s comfortability with reporting symptoms, go more smoothly when the team’s AT has taken the time to discuss the basics of concussions with their coaching staff. Coaches are better equipped to understand the mechanisms, symptoms, and importance of proper treatment for concussions which decreases pushback towards the AT and pressure placed on the athlete to not report future symptoms and/or unsafely speed their current injury recovery. I haven’t seen this at any rotations thus far, but I think incorporating the coaching staff into the preseason concussion education of athlete’s would increase reporting as many athletes come from previous teams where concussions may have been mishandled. This would also be crucial in the high school setting when athletic trainers are less likely to be present when injury occurs so the coaching staff would assume that role of identifying and then referring athletes.
Hello! My name is Annie Tynes and I am a second-year athletic training master’s student at James Madison University. I really enjoyed reading this article, concussion education is so important and I feel like the conversation about concussions has been growing over the past few years. I find this study very interesting because I feel like I can relate. I have been an athlete throughout my entire youth and played sports in high school as well as at the collegiate level. In high school, we didn’t have access to our own athletic trainer so I can’t recall having any type of concussion education. My coach also never educated us about concussions in high school. Whenever my teammates or myself got hit by a ball, we never thought anything of it, which looking back with the knowledge I have now about concussions, is pretty scary. However, in my collegiate career, we did have an athletic trainer and our team was very educated and it was required to perform a baseline concussion test every year. Although, even with an athletic trainer, our coach never continued education regarding concussions or communicated about concussion education with our athletic trainer which I find interesting. I feel like once I become a certified athletic trainer, I want to be sure to educate the team as well as the coach, since they may be a novice, about the importance of concussion education. It is also essential to inform the coach about concussions in case the athletic trainer isn’t available during practice so the coach can notice warning signs and prevent further injury.
Hi my name is Emma Stanton, I am an Athletic Training Student at James Madison University. As an athlete growing up I never had a coach that was able to educate our team on concussions. Even in high school when there was an athletic trainer, there was very little communication between them on a proper concussion procedure. I think it is very important for coaches to have education on concussions especially because a lot of youth athletes have little information on concussions or they have misconceptions about concussion care. If a coach has access to an athletic trainer it is important that they feel comfortable to have an open discussion with each other so that there can be a common procedure put into place. It is especially important in a high school setting that a coach is educated on concussions because the athletic trainer has so many other patients to take care of, and if a coach knows the proper care then that will benefit everyone involved. It is also helpful if a coach knows about concussions because they are around the athlete a lot more than a athletic trainer is. They see every play that the athlete makes so if they are educated they can help an athlete after it happens and continue to educate them through out recovery. When I am an athletic trainer I will make sure that the coach I work with is educated and knows how to educate through out a patients recovery.
Hi, my name is Cassidy Fox and I am a second year masters of athletic training student at James Madison University. I strongly agree that the perception parents, coaches and health care professionals give off about concussions and their severity resonates with their children, athletes and friends – this is something everyone needs to be aware of before publicly stating their views. This is also something I don’t feel can be emphasized enough through a handout or email, you also can’t expect an athlete to read it or take it seriously. Going into each season with an attitude that concussions are severe and preventive measures should be taken at all times when possible is essential. Two statistics that stood out to me as an AT student were 42.4% of youth receiving no concussion education from their coaches in the past year and 31.9% of youth rarely/never having an AT at their practices or games – this should not be the case, however if it is, the coaches and athletes themselves should be thoroughly educated on concussions and signs to look out for in order to avoid potentially life threatening situations such as second impact syndrome. In my high school setting clinical experiences, I have participated in the parents’ nights where my preceptor speaks to educate parents, coaches, and athletes on concussions and many other potential injuries that could occur during sport participation. There is then a day for each sport team where we speak again, play videos and educate the athletes on concussions and consequences of ignoring them or returning to play anyway. I definitely believe this was beneficial during the seasons as players began to admit their symptoms and coaches took removal from play more seriously. Educational sessions like this should be mandatory at all schools.
Hi! My name is Kylie Brincks and I am a second year MATSA student at James Madison University. I grew up playing sports my whole life and I was never once talked to or educated about concussions and the severity of them. Even in high school it was never talked about, we had to fill out a sheet saying we understood what concussions were, but half of the time we really just signed them so we were able to play. It was not until I started my graduate program that I knew that coaches had the ability to educate their players on concussion protocols, I believe that this is an important aspect to every sports team no matter the level of competition because they can lead to serious problems down the road if not handled and dealt with the firs time around. Having a coach that has the education on concussions is extremely important, not only because they can recognize the signs and symptoms, but they can then educate their team on how to take care of a concussion or get a better understanding of what concussions really are. After working at my clinical rotations at both a high school and collegiate level, I see the importance there is to having an athletic trainer on staff because this gives the coaches opportunities to form a professional relationship with the athletic training staff in order to provide the best care possible for their athletes. Having this relationship also allows the coaches to tell the athletic training staff everything that they are seeing when it comes to their athletes because they are around them a whole lot more, they know when something is off or when the player is acting differently compared to their normal self and these are key things when it comes to dealing with concussion protocols. When I become an athletic trainer I plan on advocating that coaches get educated on concussion protocols in order to not only educate their players, but to also be able to handle a concussion situation when I may not be on site do to other sporting events. Having coaches know the protocols allows them to pick up on the signs and symptoms, how to manage/care, and how to report when an incident occurs, which will then lead to more communication between coaches and AT staff, and will help prevent the injury from getting worse.