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Peterson AB, Waltzman D, Daugherty J, Chen J, Breiding M. Sport and Recreation Related Concussion in Children: National Concussion Surveillance System. Am J Prev Med 2024; 67:370-379. [PMID: 38852098 PMCID: PMC11338698 DOI: 10.1016/j.amepre.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION Concussions sustained during sports and recreational activities are a concern for young athletes. The purpose of this study was to estimate past 12-month sport- and recreation-related (SRR) traumatic brain injuries (TBIs) among a sample of children. METHODS Pilot data from the Centers for Disease Control and Prevention's National Concussion Surveillance System were analyzed. National Concussion Surveillance System utilized a cross-sectional random-digit-dial telephone survey using computer-assisted telephone interviewing to collect self/proxy-reported data from 2018 to 2019. Adults with children aged 5-17 in the household were asked about head injuries sustained by their children. Estimates were stratified by sociodemographic and injury circumstance characteristics. Data analysis occurred from April 2022 to July 2023. RESULTS Utilizing a tiered case definition developed by the Centers for Disease Control and Prevention, an estimated 6.9% (95% confidence interval [CI], 6.0%-7.8%) of the sample's 5-17-year-old children sustained at least one probable or possible SRR-TBI in the previous 12 months; 3.3% (95% CI, 2.7%-4.0%) of the children sustained at least one probable SRR-TBI. An estimated 63.6% (95% CI, 58.1%-69.0%) of all reported TBIs were attributed to SRR activities. Of the SRR-TBIs reported, 41.1% (95% CI, 33.0%-49.2%) were experienced while playing contact sports. Symptoms did not resolve for 8 or more days or had not resolved at the time of the interview for 18.1% (95% CI, 13.0%-23.1%) of the children's most recent SRR-TBI. CONCLUSIONS Many proxy-reported TBIs among children aged 5-17 years were due to sports and recreational activities. Athletic trainers and healthcare providers can play a role in the prevention, identification, and management of SRR-TBIs in their respective environments.
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Affiliation(s)
- Alexis B Peterson
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia.
| | - Dana Waltzman
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia
| | - Jill Daugherty
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia
| | - Jufu Chen
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia
| | - Matthew Breiding
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia
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Tadmor DI, Chesson L, Till K, Phillips G, Fairbank L, Brown J, Cross M, Gardner AJ, Johnston RD, Owen C, Hendricks S, Stokes KA, Jones B. Non-reporting of sport-related concussion symptoms: a cross-sectional study of community rugby league players in the UK. Inj Prev 2024:ip-2023-045108. [PMID: 39060115 DOI: 10.1136/ip-2023-045108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
Recognising and removing players with suspected sport-related concussions is crucial for community sports. OBJECTIVES Quantify rates and factors associated with non-reporting of concussion symptoms in community rugby league. METHODS Overall, 484 community rugby league players aged ≥18 years and 965 parents of rugby league players aged <18 years completed an online survey, regarding concussion history, knowledge, prevalence and reasons for non-reporting of concussion, long-term implications and perceptions of concussion. RESULTS Thirty-five percent of players aged ≥18 years and 22% of parents of players aged <18 years reported at least one concussion in the last two seasons. Forty-three percent of players aged ≥18 years and 5% of parents of players aged<18 years surveyed stated they did not report concussion-related symptoms sustained during 2020 and 2021 seasons. The two most common reasons for non-reporting of concussion symptoms were 'didn't want to be ruled out of a match' and 'didn't want to let down the team'. Players aged ≥18 years who received external coaching pressures around concussion were more likely to not report concussion symptoms. Over 40% of parents and players were concerned about the potential long-term implications. Ten percent of players aged ≥18 years and 7% of parents of players aged <18 years would encourage their family members/children to not play rugby league. CONCLUSIONS Non-reporting rates of suspected concussion symptoms in adult community players were twice as high as in professional rugby league, with similar reasons (wanting to play and not letting the team down). Engaging coaches to prioritise brain health and providing broader and appropriate education on concussion should be focused on, given the concerns reported by community players and parents.
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Affiliation(s)
- Daniel Isaac Tadmor
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Lucy Chesson
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Hull Kingston Rovers, Hull, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Uno-X Mobility Professional Cycling, Oslo, Norway
| | - Laura Fairbank
- England Performance Unit, Rugby Football League, Manchester, UK
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Matt Cross
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Premiership Rugby, London, UK
| | - Andrew J Gardner
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rich D Johnston
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, Queensland, Australia
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Keith A Stokes
- Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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Abbott A, Ramos T, Smith WAR, Ierulli VK, Mulcahey MK. Concussion Education for Athletes: Symptom Reporting and Safe Return to Sport. JBJS Rev 2023; 11:01874474-202306000-00013. [PMID: 37327353 DOI: 10.2106/jbjs.rvw.23.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
» Educational programs on concussion have been demonstrated to improve knowledge for athletes, families, athletic trainers, and coaches about concussion, with the goal of reducing concussion incidence, duration, severity, and complications.» Despite the widespread availability and often mandatory concussion education provided to high school and collegiate athletes, there has not been an adequate change in knowledge, attitudes, and self-reporting behavior in this population.» Recently published studies suggest improving concussion education by emphasizing athletes' symptom reporting behavior, to contrast with current emphasis on knowledge-based outcomes.» Future educational programs about concussions for athletes, families, athletic trainers, and coaches should aim to emphasize cultural and behavioral changes that demonstrate outcome changes rather than solely evaluating knowledge improvements to determine effective programming.
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Affiliation(s)
| | - Tolulope Ramos
- Tulane University School of Medicine, New Orleans, Louisiana
| | - Wyatt A R Smith
- Tulane University School of Medicine, New Orleans, Louisiana
| | - Victoria K Ierulli
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
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Avery A, Takagi-Stewart J, Qiu Q, Philipson EB, Moore M, Kroshus E, Weiner BJ, Graves JM, Glang A, Jinguji T, Coppel DB, Sidhu M, Vavilala MS. Effect of RISE bundle implementation on school adoption of a student-centered return-to-learn program in Washington state. NeuroRehabilitation 2023:NRE220200. [PMID: 37125566 DOI: 10.3233/nre-220200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Appropriate concussion care in school is vital for full recovery, but school return-to-learn (RTL) programs are lacking and vary in quality. Establishing student-centered RTL programs may reduce disparities in RTL care. OBJECTIVE To examine the effect of RISE Bundle (Return to Learn Implementation Bundle for Schools) implementation on high school adoption of a student-centered RTL program. METHODS A convenience sample of fourteen (4 rural and 10 urban) small and large Washington (WA) State public high schools were enrolled in a stepped-wedge study with baseline, end of study, and monthly measures over the 2021-2022 academic year. Schools identified an RTL champion who led RISE Bundle implementation in 6-week steps. Concussion knowledge and impact of RTL program on concussion care were examined. RESULTS Ten schools (71.4%) successfully completed RISE Bundle implementation and established a functional RTL program. Self-reported concussion knowledge from RTL Champions increased post intervention. Establishing RTL programs facilitated provision of tailored accommodations, and perceived variation and inequities in RTL care were reduced. CONCLUSION RISE Bundle implementation proved feasible, supported the establishment of a functional RTL program, and perceived to reduce disparities in concussion care in rural and urban WA State public high schools of varying sizes.
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Affiliation(s)
- Aspen Avery
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Julian Takagi-Stewart
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Qian Qiu
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Erik B Philipson
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Megan Moore
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Emily Kroshus
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Janessa M Graves
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- College of Nursing, Washington State University, Spokane, WA, USA
| | - Ann Glang
- Department of Psychology, University of Oregon, Eugene, O, USA
| | - Thomas Jinguji
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - David B Coppel
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | - Monica S Vavilala
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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5
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International perspectives on trends in paediatric sports-related concussion: knowledge, management, unanswered questions. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-01014-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Purpose
In the last 20 years, concussion has received increased attention in the media, with distinct recognition of sports-related concussion (SRC). Much of this attention has centred on the paediatric population, due to concerns over adolescent brain development and the high numbers of teenagers playing contact sport. This qualitative study explored (1) what experts in the field of concussion perceive regarding trends in paediatric concussion awareness and management, and (2) how responses to these questions differ by country (US vs. NZ) and by discipline (research vs. sports coaching vs. sports medicine).
Methods
After the development of a semi-structured interview template, questions were coded for interviews of six (N = 6) experts in academia, medicine, and coaching: three in the United States (N = 3) and three in New Zealand (N = 3). Interviews were then transcribed and qualitatively analysed using a thematic narrative analysis. Emergent themes included concussion knowledge, management, and unanswered questions.
Results
Findings showed general commonalities on the importance of concussion education, the improvement of concussion awareness, compliance to concussion protocols, and the need to research long-term outcomes. Fewer commonalities were found regarding the level of concussion reporting, the impact of multiple concussions, whether paediatric and adult concussion should be treated similarly, and the utility of concussion tests.
Conclusions
Concussion experts agree on many areas; however, divergent opinions were apparent. Further original research is required within the paediatric population to analyse the efficacy of current concussion guidelines.
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Mallory KD, Saly L, Hickling A, Colquhoun H, Kroshus E, Reed N. Concussion Education in the School Setting: A Scoping Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:605-618. [PMID: 35259774 PMCID: PMC9311225 DOI: 10.1111/josh.13156] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Concussions are a prevalent injury among youth, and concussion education has the potential to promote positive concussion-related behaviors. Recent recommendations and legislation have increased concussion education provided in schools; however, little is known about the education context, delivery method, development, and evaluation. A scoping review was conducted to identify peer-reviewed literature on concussion education delivered in the school setting. METHODS Six databases were searched (MEDLINE, CINAHL, EMBASE, PsycINFO, SPORTDiscus, and ERIC) to identify published articles from 2002 to July 16, 2020 that delivered concussion education in the school setting. Included studies described the concussion education and were written in English. RESULTS A total of 11,373 articles were identified and screened, with 27 studies meeting eligibility criteria and therefore, included. The studies delivered education to various stakeholders including students (n = 12; 44.4%), coaches (n = 5; 18.5%), educators (n = 3; 11.1%), parents (n = 1; 3.7%), and a mixed audience (n = 6; 22.2%). The education format varied and six studies (22.2%) developed the education based on a theory, model, or framework. CONCLUSIONS This study found substantial variability in the context, delivery method, development, and evaluation of education delivered in schools and further evaluation of this education is needed to ensure it is best-suited for school-based stakeholders.
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Affiliation(s)
- Kylie D. Mallory
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160TorontoONCanadaM5G 1V7
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital 150 Kilgour RoadTorontoONM4G 1R8
| | - Lauren Saly
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour RoadTorontoONM4G 1R8
| | - Andrea Hickling
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital; Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto 150 Kilgour RoadTorontoONM4G 1R8
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto 160‐500 University Avenue, Room 924TorontoOntarioM5G 1V7
| | - Emily Kroshus
- Department of Pediatrics, University of Washington; Center for Health, Behavior and Development, Seattle Children's Research Institute 1920 Terry AvenueSeattleWA98101
| | - Nick Reed
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital 160‐500 University Avenue, Room 936TorontoOntarioM5G 1V7
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7
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Taylor MV, Stephenson PL. Sports Concussions: A Webliography. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2022.2045131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mary Virginia Taylor
- Retired, former Chief Librarian, Overton Brooks VA Medical Center, Shreveport, Louisiana, USA
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Beran KM, Scafide KN. Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:406-417. [PMID: 35075658 DOI: 10.1111/josh.13140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sport-related concussions are a major public health problem with only 50% of concussed teens reporting their symptoms. The purpose of this systematic review was to identify individual and institutional factors that contribute to concussion knowledge, attitude, and reporting behaviors among US high school athletes. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol was used to direct the process of this systematic review. A search for English, peer-reviewed, quantitative studies published between 2010 and 2020 was conducted in 5 scholarly databases. The Joanna Briggs Critical Appraisal Tools were used to assess study quality. RESULTS Twenty-two studies met criteria for inclusion in this systematic review. The study designs were mostly cross-sectional (N = 18). Synthesis revealed individual factors including gender, age, race/ethnicity, grade level, and concussion history were associated with differences in concussion knowledge, attitude, and/or reporting behaviors. Institutional factors identified included school location, concussion education, access to an athletic trainer, sport played, and team climate. Six studies found concussion education had a positive impact on knowledge and reporting behaviors. CONCLUSION This systematic review identified certain populations which may be more vulnerable to underreporting concussion symptoms; therefore, a targeted approach to education and management may be more effective.
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Affiliation(s)
- Krista M Beran
- Doctoral Candidate, , College of Health and Human Services, George Mason University, 4400 University Dr., Fairfax, VA 22030
| | - Katherine N Scafide
- Associate Professor, , College of Health and Human Services, George Mason University, 4400 University Dr., Fairfax, VA 22030
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Leeds DD, Zeng Y, Johnson BR, Foster CA, D'Lauro C. Beliefs affecting concussion reporting among military cadets: advanced observations through machine learning. Brain Inj 2022; 36:156-165. [PMID: 35133926 DOI: 10.1080/02699052.2022.2034945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Untreated concussions are an important health concern. The number of concussions sustained each year is difficult to pinpoint due to diverse reporting routes and many people not reporting. A growing body of literature investigates the motivations for concussion under-reporting, proposing ties with knowledge of concussion outcomes and concussion culture. The present work employs machine learning to identify trends in knowledge and willingness to self-report concussions. METHODS 2,204 cadets completed a survey addressing athletic and pilot status, concussion symptoms and outcome beliefs, ethical beliefs, demographics, and reporting willingness. RESULTS Clustering and non-negative matrix analysis identified connections to self-report willingness within: knowledge of symptoms, ethical beliefs, reporting requirements, and belief of long-term concussion outcomes. Support vector machine classification of cadet reporting likelihood reveals symptom and outcome knowledge may be inversely related to reporting among those rating ethics considerations as low, while heightened ethics may predict higher reporting likeliness overall. CONCLUSIONS Machine-learning analysis bolsters prior theories on the importance of concussion culture in reporting and indicate more symptom knowledge may decrease willingness to report. Uniquely, our analysis indicated importance of ethical behavior may be associated with general concussion reporting willingness, inviting further consideration from healthcare practitioners seeking increased reporting.
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Affiliation(s)
- Daniel D Leeds
- Computer and Information Science Department, Fordham University, Bronx, New York, USA
| | - Yue Zeng
- Computer and Information Science Department, Fordham University, Bronx, New York, USA
| | - Brian R Johnson
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Marry Land, USA
| | - Craig A Foster
- Psychology Department for SUNY Cortland, State University of New York College at Cortland, Cortland, New York, USA
| | - Christopher D'Lauro
- Department of Behavioral Science and Leadership, United States Air Force Academy, USAF, Colorado Springs, CO, USA
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10
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Complexity of concussion management in youth ice hockey: Context matters. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Falla KA, Randall S, DeMatteo C. Brain smart – Let's play safely: Evaluation of a concussion education program in schools. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211024447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives There are two objectives for this paper. First, to determine effects of a concussion education program in a local school board in terms of concussion-specific knowledge in children and confidence in identifying and managing concussion in adults. Second, to identify differences and similarities in concussion knowledge between children who participate in sports and those who do not and between children with a history of one or more concussions and those without. Design A cross sectional survey regarding concussion knowledge was distributed randomly to students and adults at both pre- and posteducation timepoints. A concussion education program was disseminated across the school board for students between the distribution survey timepoints. Following the education program, adults and students completed their respective post-test surveys. Chi-squared tests in SPSS determined the significance of between-group differences. Results All 17 adults (100.0%) who had received concussion education recently reported confidence in their knowledge of concussion management, compared to 35.7% adults who had not received education for over a year (p = 0.020). For students, all of whom completed the concussion education training between the pre- and post-tests, there were no significant differences in concussion knowledge scores between athletes and non-athletes (either in or outside of school) or between those with a history of concussion and those without. There were no significant changes in concussion knowledge between the pre- and post-tests, except for one question. Conclusion Concussion education programs increase confidence of concussion management protocols in adults involved in sport, but they require improvements to better support knowledge amelioration, particularly for target groups that are at high risk of sustaining another injury.
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Affiliation(s)
- Katie Alison Falla
- CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada Canada
| | - Sarah Randall
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Carol DeMatteo
- CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Tjønndal A, Austmo Wågan F. Athletes' and Coaches' Attitudes Toward Protective Headgear as Concussion and Head Injury Prevention: A Scoping Review. Front Sports Act Living 2021; 3:680773. [PMID: 34113846 PMCID: PMC8185014 DOI: 10.3389/fspor.2021.680773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/26/2021] [Indexed: 01/04/2023] Open
Abstract
The purpose of this article is to map existing research literature on athletes and coaches' attitudes toward protective headgear in sport in relation to concussion and head injury prevention, and to identify and analyse knowledge gaps in the field. A scoping review was conducted in three databases; PubMed, Scopus, SportDiscus, and reference lists were searched to identify relevant grey literature. This process lead to an in-depth analysis of 18 peer-reviewed journal articles. Of the 18 studies identified, the majority focused on athletes (n = 14), only two studies focused on coaches, and two studies included a sample of both athletes and coaches. The findings in this scoping review suggests that there is a discrepancy between attitudes and beliefs about the protective effects of headgear, athletes' behaviour as far as wearing protective headgear, and coaches' behaviour in terms of recommending use of protective headgear to their athletes. The majority of athletes in most of the reviewed literature believed that headgear had protective effects against concussion and other head injuries, however relatively few athletes report wearing this protective headgear unless it was mandatory by competition rules.
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Affiliation(s)
- Anne Tjønndal
- Faculty of Social Sciences, Nord University, Bodø, Norway
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13
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Beidler E, Wallace J, Alghwiri AA, O'Connor S. Collegiate Athletes' Concussion Awareness, Understanding, and -Reporting Behaviors in Different Countries With Varying Concussion Publicity. J Athl Train 2021; 56:77-84. [PMID: 33259602 PMCID: PMC7863604 DOI: 10.4085/1062-6050-0575.19] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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. Greater percentages 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 and 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.
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Affiliation(s)
- Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, PA
| | - Jessica Wallace
- Department of Health Science, University of Alabama, Tuscaloosa
| | | | - Siobhan O'Connor
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Ireland
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Sarmiento K, Waltzman D, Borradaile K, Hurwitz A, Conroy K, Grazi J. A Qualitative Study of Youth Football Coaches' Perception of Concussion Safety in American Youth Football and Their Experiences With Implementing Tackling Interventions. INTERNATIONAL SPORT COACHING JOURNAL 2021; 1:10.1123/iscj.2020-0004. [PMID: 33598504 PMCID: PMC7884092 DOI: 10.1123/iscj.2020-0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Due in part to concern about the potential long-term effects of concussion and repetitive head injuries in football, some programs have implemented tackling interventions. This paper explores youth football coaches' perception of football safety and their experiences implementing these interventions aimed at athlete safety. Using a qualitative approach, coaches were interviewed by means of a semi-structured protocol that covered: (a) demographics; (b) background and experiences; (c) personal relevance risks, safety, and benefits of youth football; (d) experiences with tackling technique; (e) experiences with mouth guard sensors; and (f) opinions on disseminating information on football safety. Most coaches felt that learning tackling at a young age helped prepare them for their playing later in life and believed that youth should begin playing tackle football at a young age. Coaches were mixed regarding their concerns about the risk for concussion and subconcussive head impacts. Still, most were receptive to changes in rules and policies aimed at making football safer. Findings from this study demonstrate that youth football coaches are important stakeholders to consider when implementing changes to youth football. Understanding coach perceptions and experiences may inform future efforts aimed to educate coaches on rules and policies to make the game safer for youth athletes.
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Affiliation(s)
- Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Is It Time to Give Athletes a Voice in the Dissemination Strategies of Concussion-Related Information? Exploratory Examination of 2444 Adolescent Athletes. Clin J Sport Med 2020; 30:562-567. [PMID: 30119086 DOI: 10.1097/jsm.0000000000000653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of the research was to screen male and female adolescent athletes on their concussion educational histories and preferred future methods of education in terms of educational messenger, modality, and concussion-related areas of interest. DESIGN Cross-sectional survey. SETTING Examination setting within the classroom. PARTICIPANTS Adolescent male (n = 1854) and female (n = 590) athletes aged 12 to 18 years. MAIN OUTCOME MEASURES To explore the concussion educational histories and preferred future methods of education in Irish male and female adolescent athletes. RESULTS 19.7% (n = 482) of the sample received education in the past 12 months. Male athletes had a significantly higher rate of previous education than female athletes (41% vs 17%). The methods used in previous educational interventions are failing to match the interests of the athletes. Sex played a significant role in the preferred educational methods, as male and female athletes had significant differences in their choice of educational messenger, modality, and concussion-related areas of interest. CONCLUSIONS The current disparity in previous concussion education rates between male and female adolescent athletes should be addressed. Forthcoming research should explore the efficacy of tailoring knowledge translation strategies to match the specific needs of the recipient.
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Daugherty J, DePadilla L, Sarmiento K. Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers. JOURNAL OF SAFETY RESEARCH 2020; 74:133-141. [PMID: 32951774 PMCID: PMC7644176 DOI: 10.1016/j.jsr.2020.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course. METHOD Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted. RESULTS The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test. CONCLUSION SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs.
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Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Lara DePadilla
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
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Waltzman D, Daugherty J, Snedaker K, Bouton J, Wang D. Concussion reporting, return to learn, and return to play experiences in a sample of private preparatory high school students. Brain Inj 2020; 34:1193-1201. [PMID: 32697613 DOI: 10.1080/02699052.2020.1793388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The objective of this study is to describe concussion reporting and return to learn and play among high school students. METHODS Self-reported survey data of 1,999 New England private preparatory high school students who played sports or engaged in recreational activities were collected in 2018. Descriptive and bivariate statistics are presented. RESULTS Three in ten respondents (31.4%) reported ever sustaining a concussion and 22.0% did not report at least one concussion to an adult. The most common reasons for not reporting included wanting to keep playing their sport (58.0%) and not thinking the injury was that serious (53.6%). Girls and students in higher grades took longer to return to school and sports. A quarter of students reported pretending to have a faster recovery in order to return to school or sports. CONCLUSION Private school students who play sports or engage in recreational activity may be at risk of sustaining concussions and may not report their symptoms due to a lack of understanding the seriousness of concussion, not wanting to fall behind in school, or out of desire to continue playing their sport. Teachers, coaches, and parents can stress reporting as the first step in recovery.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention , Atlanta, GA, USA
| | - Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention , Atlanta, GA, USA
| | | | - Jason Bouton
- PINK Concussions , Norwalk, CT, USA.,King School , Stamford, CT, USA
| | - David Wang
- Elite Sports Medicine, Connecticut Children's Medical Center , Hartford, CT, USA.,Sports Medicine, Quinnipiac University, Hamden, CT, USA
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Zanin AC, Kamrath JK, Ruston SW, Posteher KA, Corman SR. Labeling Avoidance in Healthcare Decision-Making: How Stakeholders Make Sense of Concussion Events through Sport Narratives. HEALTH COMMUNICATION 2020; 35:935-945. [PMID: 31007073 DOI: 10.1080/10410236.2019.1598742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study documents how cultural sport narratives influence athletic team member sensemaking during concussion events. Analysis of macro-level sport culture narratives and interviews (N = 93) with collegiate athletes and athletic trainers from eleven large universities within the United States revealed that participants utilized five cultural sport narratives when making sense of a concussion event (i.e., Play-through-pain, Commodification, Big leagues, Masculine-Warrior, and Need-for-safety). These narratives functioned in two specific ways as athletic team members made sense of concussion events (i.e., as extracted cues and identity defenses). The study presents the concept of labeling avoidance (e.g., avoiding a formal concussion diagnosis) to describe how athletes retrospectively rationalized their non-disclosure of a severe head impact. Theoretical and practical implications of the study findings are discussed.
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Affiliation(s)
- Alaina C Zanin
- The Hugh Downs School of Human Communication, Arizona State University
| | - Jessica K Kamrath
- Department of Human Communication Studies, California State University, Fullerton
| | - Scott W Ruston
- The Hugh Downs School of Human Communication, Arizona State University
| | - Karlee A Posteher
- The Hugh Downs School of Human Communication, Arizona State University
| | - Steven R Corman
- The Hugh Downs School of Human Communication, Arizona State University
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Daugherty J, Waltzman D, Snedaker KP, Bouton J, Zhang X, Wang D. Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities. THE JOURNAL OF SCHOOL HEALTH 2020; 90:527-537. [PMID: 32369871 PMCID: PMC7393617 DOI: 10.1111/josh.12899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/03/2019] [Accepted: 01/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Sports- and recreation-related (SRR) activities are a major cause of adolescent concussions. Most adolescent SRR concussion research has been conducted among public school students. As private schools are qualitatively different from public schools (eg, location, socioeconomic status, sports played), this study explores the concussion experiences of a large group of private high school students. METHODS We surveyed 2047 New England private preparatory high school students who played sports or engaged in a recreational activity in 2018 about the sports they played, and their self-reported concussion experiences (eg, age at first concussion, if concussions were sports- or recreation-related). Descriptive, bivariate, and multivariate statistics are presented. RESULTS One-third (33.0%) of students who reported engaging in sport- or recreation-related activities self-reported experiencing a concussion in their lifetime. A higher percentage of boys, students who played contact sports, and those who played multiple seasons of school sports reported a concussion. Sex, contact level of primary sport played, and age of first concussion were also significantly associated with reporting a sports- or recreation-related concussion. CONCLUSIONS A sizeable proportion of private preparatory high school students reported experiencing a concussion, with some students at higher risk. Private preparatory high school-specific concussion prevention strategies may be needed.
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Affiliation(s)
- Jill Daugherty
- Epidemiologist, , National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Dana Waltzman
- Behavioral Scientist, , National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Katherine P Snedaker
- Founder and Executive Director, , PINK Concussions, 15 Shorefront Park, Norwalk, CT, 06854, USA
| | - Jason Bouton
- Head Athletic Trainer, , NEPSAC District 4 SMAC Representative, Founding Chair, FAA Athletic Trainers Organization, Adjunct Faculty, Sacred Heart University, 1450 Newfield Avenue, Stamford, CT, 06905, USA
| | - Xinjian Zhang
- Statistician, , National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - David Wang
- Clinical Director, , Elite Sports Medicine, Connecticut Children's Medical Center, 399 Farmington Ave, Farmington, CT, 06032, USA
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20
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Wicklund A, Coatsworth JD. Concussion disclosure in middle and high school youth: Who gets the message and are they trained to receive it? JOURNAL OF CONCUSSION 2020. [DOI: 10.1177/2059700220924499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Disclosure of concussion is vital for proper diagnosis and treatment. Youth have many stakeholders to whom they may disclose concussion, including parents, peers, coaches, and school personnel. We examined whom high school and middle school youth report concussion and the level of concussion education of the recipients of the disclosure. Methods Data were analyzed from 2362 students, 680 parents, and 150 school personnel who completed an online survey about concussion reporting, education, and training. Results Youth were most likely to disclose concussions to parents, particularly mothers, and their peer group. Middle school youth reported to teachers and school nurses at higher rates than high school youth. High school youth were more likely to disclose concussion to coaches and athletic trainers than middle school youth. While mothers were the most likely recipient of youths’ reporting, they were least likely to have received concussion education. Conclusions Recipients of youth concussion disclosure differs by school level. Parents are the most common recipients of disclosure. The role of school personnel and coaches changes as youth enter high school. Youth primarily report concussions to parents, yet parents receive the least amount of concussion training. These findings highlight the need for targeted concussion training for stakeholder groups as their role in disclosure may differ by school age.
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Affiliation(s)
| | - J Douglas Coatsworth
- Human Development and Family Studies, Colorado State University, Fort Collins, USA
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21
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Waltzman D, Hoffman R, Donnell Z, Bell E, Sarmiento K. US Centers for Disease Control and Prevention's HEADS UP Branding and Evaluation Process. HEALTH EDUCATION JOURNAL 2020; 79:180-194. [PMID: 31768074 PMCID: PMC6876128 DOI: 10.1177/0017896919873931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background For 15 years, the US Centers for Disease Control and Prevention's (CDC) HEADS UP education campaign has focused on increasing awareness of concussion among children to reduce adverse outcomes from this injury. Objective To keep pace with the rapid expansion in media coverage, research, state laws and education efforts on concussion, the CDC embarked on a comprehensive evaluation effort to assess the campaign's brand. Method The CDC conducted a multi-step process to evaluate HEADS UP. This included surveying partner organisations and focus groups targeting key audiences. Results The analysis demonstrated that most (70%) partner organisations have used the materials for 4 years or longer and more than half (51%) found the materials very useful or extremely useful. Focus groups with the campaign's target audiences yielded insights and opportunities to refresh the CDC HEADS UP brand. The need for more compelling images, prevention facts and use of eye-catching colours was signaled by all the campaign's target audiences. Updates focused on the use of data visualisation, more emotionally compelling images, and more engaging colours. The CDC also created a new tagline to focus on concussion prevention that encourages children and young people to think about protecting their brains from concussion so they can have a safer future. Conclusion This paper describes the process used to update the branding of an educational health promotion campaign in order to meet the needs of key audiences. Findings can help others working to keep their educational campaigns relevant and aligned with an expanding and changing public health problems.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention
| | - Rosanne Hoffman
- ICF International, Strategic Communications & Marketing Division, USA
| | - Zoe Donnell
- ICF International, Strategic Communications & Marketing Division, USA
| | - Elizabeth Bell
- ICF International, Strategic Communications & Marketing Division, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention
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Anderson MN, Lempke LB, Bell DH, Lynall RC, Schmidt JD. The ability of CNS vital signs to detect coached sandbagging performance during concussion baseline testing: a randomized control trial. Brain Inj 2020; 34:369-374. [DOI: 10.1080/02699052.2020.1724332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M. N. Anderson
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - L. B. Lempke
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - D. H. Bell
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - R. C. Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - J. D. Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
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Sarmiento K, Gioia GA, Kirkwood MW, Wade SL, Yeates KO. A commentary for neuropsychologists on CDC's guideline on the diagnosis and management of mild traumatic brain injury among children. Clin Neuropsychol 2020; 34:259-277. [PMID: 31530221 PMCID: PMC7039321 DOI: 10.1080/13854046.2019.1660806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/28/2019] [Accepted: 08/18/2019] [Indexed: 12/27/2022]
Abstract
Objective: In 2018, the Centers for Disease Control Prevention (CDC) published an evidence-based guideline on the diagnosis and management of mild traumatic brain injury (mTBI) among children. This commentary summarizes the key recommendations in the CDC Pediatric mTBI Guideline most relevant for neuropsychologists and discusses research gaps and topics that should receive attention in future iterations of the Guideline.Method: We described the methods used to develop the Guideline, which included a comprehensive Systematic Review. We also distilled and presented key practice strategies reflected in Guideline.Results: To optimize care of pediatric patients with mTBI, neuropsychologists should: use validated, age-appropriate symptom scales, assess evidence-based risk factors for prolonged recovery, provide patients with instructions on return to activity customized to their symptoms, and counsel patients to return gradually to nonsports activities after a short period of rest. Future iterations of the Guideline should encompass a review and guidance on care of patients with psychiatric and psychological difficulties, as well as the potential use of imaging to assess patients with persistent symptoms. Expanded research on mTBI among girls, children age 8 and under, and effective treatments for pediatric mTBI will be beneficial to inform care practices.Conclusions: Recommendations in the CDC Pediatric mTBI Guideline highlight multiple opportunities for neuropsychologists to take action to improve the care of young patients with mTBI and to advance research in the field. Multiple resources and tools are available to support implementation of these recommendations into clinical practice.
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Affiliation(s)
- Kelly Sarmiento
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gerard A. Gioia
- Division of Pediatric Neuropsychology, Children’s National Health System, George Washington University School of Medicine, Washington, DC, USA
| | - Michael W. Kirkwood
- Department of Physical Medicine and Rehabilitation, Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA
| | - Shari L. Wade
- Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Keith O. Yeates
- Departments of Psychology and Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
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Daugherty J, DePadilla L, Sarmiento K. Effectiveness of the US Centers for Disease Control and Prevention HEADS UP coaches' online training as an educational intervention. HEALTH EDUCATION JOURNAL 2019; 78:784-797. [PMID: 31530957 PMCID: PMC6747698 DOI: 10.1177/0017896919846185] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Concussions are common among youth athletes. Responsibility for the recognition and management of concussion is often put on coaches. To equip coaches with appropriate knowledge and skills, the US Centers for Disease Control and Prevention (CDC) launched the HEADS UP: Concussion in Youth Sports online training. OBJECTIVES To determine whether HEADS UP coaches' training improves knowledge, attitudes and behavioural intentions. METHODS Knowledge questions were grouped into scales by level of difficulty. Differences between pre-and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score and effect sizes were interpreted. RESULTS Coaches displayed a high level of knowledge in the pre-test. While lower difficulty questions did not show improvement from pre- to post-test, moderate and high difficulty questions did. Use of the training was associated with improved knowledge about symptom resolution, return-to-play recommendations and under-reporting of incidents of concussion. Coaches demonstrated improvement in five of the seven concussion-related attitude and behavioural intention items post training. CONCLUSION HEADS UP training improved coaches' knowledge on select topics and helped them feel more comfortable about responding to concussion among their athletes. This study provides insight into how to better focus future HEADS UP concussion health education efforts to fit coaches' informational needs.
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Affiliation(s)
- Jill Daugherty
- Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lara DePadilla
- Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kelly Sarmiento
- Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Foster CA, D’Lauro C, Johnson BR. A social dilemma model of information self-disclosure, applied to the concussion domain. JOURNAL OF CONCUSSION 2019. [DOI: 10.1177/2059700219882876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Under-reporting of concussions is a well-known public health problem. Unfortunately, concussion researchers and practitioners do not have an explicit theoretical foundation for understanding the psychology of concussion non-disclosure. We used interdependence theory, a theory based on the structure of social relationships, to develop a social dilemma model of personal information non-disclosure and apply it to the concussion domain. Self-disclosure becomes problematic when individuals perceive a need to report their concussions but also perceive that disclosure could be detrimental in some way. Individuals who experience these disclosure dilemmas can evaluate the value of concussion self-disclosure using direct outcomes (e.g. losing scholarships, improved recovery), self-concept outcomes (e.g. viewing disclosure as “weak” or “sensible”), and social status outcomes (e.g. being perceived poorly or favorably by teammates). These immediate, personal outcomes are integrated with relationship-specific motives and ethical considerations ultimately leading to disclosure or non-disclosure. Providing an explicit theoretical basis for self-disclosure dilemmas is critical for understanding concussion non-disclosure and mitigating its corresponding harm. Our social dilemma model highlights (a) the foundational psychological basis for concussion non-disclosure, (b) possible reasons that initiatives designed to increase concussion disclosure have been ineffective, and (c) the need to consider the decision-making autonomy of concussed individuals. Although we explain our social dilemma model using concussion self-reporting, we believe that this model is applicable to any domain where individuals are reluctant to disclose personal information to others who need it.
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Affiliation(s)
| | | | - Brian R Johnson
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
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26
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Sarmiento K, Donnell Z, Bell E, Tennant B, Hoffman R. A qualitative study of barriers and opportunities for concussion communication and management among parents of youth sports athletes. JOURNAL OF CONCUSSION 2019; 3. [PMID: 32328293 PMCID: PMC7177182 DOI: 10.1177/2059700219861863] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Concussion, a commonly reported injury among young athletes, can lead to short- and long-term physical, cognitive, emotional, and sleep-related symptoms. Parents are in a unique position to help identify a possible concussion and to support an athlete’s recovery. Methods: This qualitative study used a focus group methodology to explore five research questions focused on two main topics: (1) parents’ perception of concussion and (2) parent–athlete communication. Two authors independently reviewed notes from each of the focus groups and then generated a list of emerging themes related to five research questions. Results: Parents in this study valued and were interested in discussing concussion with their athletes. However, parents were uncertain about their role in promoting concussion safety and often rely on coaches to communicate with athletes about concussion reporting and recovery. Participants described barriers their athletes may face in concussion reporting and suggested strategies to improve communication about both reporting and recovery. Conclusion: Concussion education efforts may benefit from promoting specific actions parents can take to prevent concussion and how to communicate effectively with their child about reporting a possible concussion.
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Affiliation(s)
- Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, USA
| | - Zoe Donnell
- ICF International, Strategic Communications & Marketing Division, Fairfax, USA
| | - Elizabeth Bell
- ICF International, Strategic Communications & Marketing Division, Fairfax, USA
| | - Bethany Tennant
- ICF International, Strategic Communications & Marketing Division, Fairfax, USA
| | - Rosanne Hoffman
- ICF International, Strategic Communications & Marketing Division, Fairfax, USA
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Shendell DG, Gonzalez L, Listwan TA, Pancella J, Blackborow M, Boyd J. Developing and Piloting a School-Based Online Adolescent Student-Athlete Concussion Surveillance System. THE JOURNAL OF SCHOOL HEALTH 2019; 89:527-535. [PMID: 31016753 DOI: 10.1111/josh.12775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 05/03/2018] [Accepted: 05/12/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Despite increased awareness of concussions, epidemiologic surveillance efforts have been scarce, especially among adolescents. This project, which was developed with school stakeholders (certified athletic trainers [ATCs], nurses, athletic directors), piloted a public secondary school-based online surveillance tool for interscholastic and intramural sports and physical education-related concussions in New Jersey during 2014-2017 school years (SY). METHODS Participating public high schools (5 within 4 districts) and career-technical-vocational education districts (2 with 5 campuses) completed forms anonymously online via PsychData within 5 days. RESULTS There were 208 concussions reported, 115 in 2015-2016 SY and 93 in 2016-2017 SY. In fall 2015, 86 concussions were reported, including 16 from summer preseason. In fall 2016, 56 concussions were reported; 3 occurred during preseason. There were 7 concussions reported in winter 2016 and 16 in winter 2017. Twenty-two concussions were reported in spring of both 2016 and 2017. Most online forms were completed in <10 minutes, usually using either desktop computers or tablets/iPads. School nurses followed by ATCs were primary sources of data entered online, usually by ATCs. CONCLUSIONS Cooperation of nurses and ATCs at participating schools suggested online surveillance was valued and viable. Data inform future concussion prevention education and ongoing injury surveillance.
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Affiliation(s)
- Derek G Shendell
- Department of Environmental and Occupational Health, Rutgers School of Public Health, 683 Hoes Lane West, 3rd Floor SPH Building, Suite 399, Piscataway, NJ 08854-8020
- NJ Safe Schools Program, Rutgers School of Public Health, Piscataway, NJ
| | - Lauren Gonzalez
- NJ Safe Schools Program, Rutgers School of Public Health, Piscataway, NJ
| | - Tracy A Listwan
- Department of Environmental and Occupational Health, Rutgers School of Public Health, Piscataway, NJ
| | - Joseph Pancella
- West Deptford High School Athletic Department, West Deptford, NJ
| | - Mary Blackborow
- Brain Injury Alliance of NJ-Concussion in Youth Sports Committee, North Brunswick, NJ
- North Brunswick High School, North Brunswick, NJ
| | - Joanna Boyd
- Brain Injury Alliance of NJ-Concussion in Youth Sports Committee, North Brunswick, NJ
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Foster CA, D’Lauro C, Johnson BR. Pilots and athletes: Different concerns, similar concussion non-disclosure. PLoS One 2019; 14:e0215030. [PMID: 31042725 PMCID: PMC6493720 DOI: 10.1371/journal.pone.0215030] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/25/2019] [Indexed: 12/18/2022] Open
Abstract
Objectives Concussion non-disclosure research has focused almost exclusively on athletes. The focus on athletic populations has been sensible considering athletes’ demonstrated susceptibility to sustaining and concealing concussions. Nevertheless, the habitual use of athletic populations has allowed researchers and practitioners to omit the development of generalized perceived costs and perceived rewards as critical determinants of concussion self-disclosure. We hypothesized that perceiving concussion disclosure as generally more costly than rewarding would predict negative attitudes towards disclosure and decreased intent to disclose. We also hypothesized that generalized perceived costs and rewards could explain concussion non-disclosure in different populations, athletes and future pilots specifically, even when those populations perceive concussion self-disclosure as costly for different specific reasons. Methods We examined concussion disclosure using 2,504 cadets at the United States Air Force Academy. Cadets completed anonymous surveys assessing their intention to self-disclose undiagnosed concussions (Anticipated Concussion Disclosure) as well as several variables potentially related to concussion self-disclosure: perceived cost, perceived reward, personal identity, attitudes, normative behavior, social support, and self-efficacy. Results The results demonstrate that concussion non-disclosure develops when a population perceives disclosure as more costly (i.e. directly or emotionally) and less rewarding. Perceived Cost and Perceived Reward variables alone accounted for 50% of the variance in Anticipated Conclusion Disclosure (Adjusted R2= 0.50, F(2,2312) = 1,145.31, p < 0.001). As expected, Anticipated Conclusion Disclosure developed for different reasons within different sub-populations. Consistent with existing research, cadet intercollegiate athletes reported being primarily concerned that concussion self-disclosure would cause them to miss practice or game time (t (736.7) = 14.20, p < .001, Cohen’s d = 0.96). In contrast, cadet future pilots reported being primarily concerned that concussion self-disclosure would have negative United States Air Force career repercussions (t (1828) = 10.25, p < .001, Cohen’s d = 0.50). Conclusions These results suggest that cultures of concussion non-disclosure can develop in any population where disclosure is perceived as having undesirable consequences, not just athletic populations. Concussion researchers and practitioners should devote more attention to the perceived cost-benefit structures that create concussion non-disclosure to address this crucial public health issue more effectively.
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Affiliation(s)
- Craig A. Foster
- Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs, Colorado, United States of America
| | - Christopher D’Lauro
- Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs, Colorado, United States of America
- * E-mail:
| | - Brian R. Johnson
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
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DeBarr KA, Pettit ML. Concussion! Friday Night Lights and Informed Consent-A Commentary. THE JOURNAL OF SCHOOL HEALTH 2019; 89:341-344. [PMID: 30883754 DOI: 10.1111/josh.12744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/12/2018] [Accepted: 08/21/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Kathy A DeBarr
- Department of Public Health, University of Illinois Springfield, University Plaza, PAC 332, Springfield, IL 62703-5407
| | - Michele L Pettit
- Department of Health Education and Health Promotion, University of Wisconsin-La Crosse, 1725 State Street, 207 Mitchell Hall, La Crosse, WI 54601
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Waltzman D, Sarmiento K. What the research says about concussion risk factors and prevention strategies for youth sports: A scoping review of six commonly played sports. JOURNAL OF SAFETY RESEARCH 2019; 68:157-172. [PMID: 30876507 PMCID: PMC6615041 DOI: 10.1016/j.jsr.2018.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/29/2018] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Given the growing research on potential adverse outcomes related to concussion and other serious brain injuries and the increased susceptibility for concussion among youth athletes, primary prevention is vital to protect the health and safety of this population. The purpose of this study is to summarize the current research on risk factors and primary concussion prevention strategies focused on specific youth sports, and to identify research gaps. METHODS A literature search was conducted using six electronic databases. A scoping review method was used to identify studies that addressed risk factors or primary concussion prevention strategies focused on youth athletes (ages 5-18 years) in six sports (football, ice hockey, soccer, lacrosse, basketball, and wrestling). RESULTS Of the 18 publications identified, the publications focused on risk factors (N = 11), policy (N = 1), rule changes (N = 3), education (N = 2), equipment (N = 2), and playing technique (N = 0). Some articles had information related to multiple topics. CONCLUSIONS Current research on concussion prevention has primarily been focused on risk factors. There are a dearth of studies that examine primary concussion prevention in sports. When studies do exist, most focus on football and ice hockey. Only a small number of studies focus solely on risk factors or primary prevention in soccer, lacrosse, basketball, and wrestling-all sports in which concussions are common. Practical applications: This scoping review summarizes current research on concussion risk factors and primary prevention strategies in specific sports focused on youth athletes and identifies research gaps to help inform future efforts.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA 30341, USA.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA 30341, USA
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