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Sarmiento K, Miller GF, Jones SE. Sports-Related Concussions and Adverse Health Behaviors Among Middle and High School Students. Am J Sports Med 2023; 51:503-510. [PMID: 36637145 PMCID: PMC9932634 DOI: 10.1177/03635465221141440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Concussions affect millions of youths in the United States each year, and there is concern about long-term health effects from this injury. PURPOSE To examine the association between sports- or physical activity-related concussion and health risk behaviors among middle and high school students in 9 states. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Data from the 2019 middle school and high school Youth Risk Behavior Survey were used for this analysis. Nine states were identified that included the same question on concussion and similar questions on health risk behaviors in their 2019 Youth Risk Behavior Survey. Students were asked to self-report whether they had ≥1 sports- or physical activity-related concussions during the 12 months preceding the survey. Self-reported concussion was the primary outcome of interest. Other variables included sex, race/ethnicity, played on a sports team, were physically active 5 or more days/week, ever tried cigarette smoking, ever used an electronic vapor product, academic grades, drank alcohol, were in a physical fight, seriously considered attempting suicide, made a suicide plan, and attempted suicide. RESULTS Among the 9 states, 18.2% of middle school students and 14.3% of high school students self-reported ≥1 sports- or physical activity-related concussions. Among both middle school and high school students, the prevalence of ≥1 sports- or physical activity-related concussions was higher among students who played on a sports team, were physically active 5 or more days per week, had ever tried cigarette smoking, had ever used an electronic vapor product, had seriously considered attempting suicide, had made a suicide plan, and had attempted suicide compared with those who had not engaged in those behaviors. The prevalence of sports- or physical activity-related concussion was consistently higher among middle school students than high school students across sex, race/ethnicity, and adverse health behaviors. CONCLUSION Middle school students with a history of concussion warrant attention as an at-risk population for concussions and adverse health behaviors. Health care providers may consider screening students for adverse health behaviors during preparticipation examinations and concussion evaluations.
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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, Atlanta, Georgia, USA
| | - Gabrielle F. Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sherry Everett Jones
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Callahan CE, Kossman MK, Mihalik JP, Marshall SW, Gildner P, Kerr ZY, Cameron KL, Houston MN, Mrazik M, Register-Mihalik JK. Association between Sensation-Seeking Behaviors and Concussion-Related Knowledge, Attitudes, Perceived Norms, and Care-Seeking Behaviors among Collegiate Student-Athletes. J Sports Sci Med 2022; 21:33-42. [PMID: 35250331 PMCID: PMC8851124 DOI: 10.52082/jssm.2022.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/27/2021] [Indexed: 06/14/2023]
Abstract
There are limited data connecting personality and behavioral tendencies and traits related to concussion care-seeking/disclosure behaviors and minimal research exists surrounding the relationship between risky behaviors, sensation-seeking, and concussion-related outcomes. This study examined the association between sensation-seeking and a student-athlete's concussion-related knowledge, attitudes, perceived social norms, and concussion care-seeking/disclosure behaviors (intention to disclose concussion symptoms, perceived control over symptom disclosure, self-removal from play due to concussion symptoms, continued play with concussion symptoms, and disclosure of all concussions at the time of injury). The current study utilized a retrospective cohort of collegiate student-athletes at a single National Collegiate Athletic Association Division I institution. Separate multivariable linear regression models estimating mean differences (MD) and 95% Confidence Intervals (CI) estimated the association between sensation-seeking and concussion knowledge, concussion attitudes, and perceived social norms. Separate multivariable binomial regression models estimating adjusted prevalence ratios (PR) and 95%CI estimated the association between sensation-seeking and intention to disclose concussion symptoms, perceived control over symptom disclosure, self-removal from play due to concussion symptoms, continued play with concussion symptoms, and disclosure of all concussions at the time of injury. All models were adjusted for sex, sport participation, and concussion history. Higher sensation-seeking was significantly associated with less favorable concussion attitudes (adjusted MD = -1.93; 95%CI = -3.04,-0.83), less favorable perceived social norms surrounding concussion (adjusted MD = -1.39; 95%CI = -2.06,-0.72), and continuing to play while experiencing concussion symptoms (adjusted PR = 1.50; 95%CI = 1.10, 2.06). Student-athletes with increased sensation-seeking could be at risk for failing to disclose a concussion, decreasing athlete safety and resulting in less optimal care post-injury. Results will inform future theory-based concussion education programs which consider behavioral tendencies and traits as well as sport culture to promote concussion care-seeking/disclosure and individualized interventions based on risky behavior engagement.
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Affiliation(s)
- Christine E Callahan
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
| | - Melissa K Kossman
- School of Health Professions, University of Southern Mississippi, MS, USA
| | - Jason P Mihalik
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
| | - Stephen W Marshall
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
| | - Paula Gildner
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
| | - Zachary Y Kerr
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
| | - Kenneth L Cameron
- John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, NY, USA
- Departments of Physical Medicine and Rehabilitation and Surgery, Uniformed Services University of the Health Sciences, MD, USA
| | - Megan N Houston
- John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, NY, USA
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, AB, Canada
| | - Johna K Register-Mihalik
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
- STAR Heel Performance Laboratory, The University of North Carolina at Chapel Hill, NC, USA
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Baiden P, Morgan MA, Logan MW. Sports- and Physical Activity-Related Concussions, Binge Drinking and Marijuana Use among Adolescents: The Mediating Role of Depression and Suicidal Ideation. Subst Use Misuse 2022; 57:504-515. [PMID: 34967277 DOI: 10.1080/10826084.2021.2019779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although past studies have examined the adverse impact of sports- and physical activity-related concussions (SPACs) on health and mental health outcomes, there is a dearth of research investigating the association between SPACs and binge drinking and marijuana use. OBJECTIVE The objective of this study is to examine the cross-sectional association between SPACs and binge drinking and marijuana use among adolescents and whether symptoms of depression and suicidal ideation mediate this association. METHODS Data for this study came from the 2017 and 2019 National Youth Risk Behavior Survey. An analytic sample of 17,175 adolescents aged 14-18 years (50.2% male) was analyzed using binary logistic regression. RESULTS Of the 17,175 adolescents, 13.7% engaged in binge drinking and 19.3% used marijuana 30 days preceding the survey date. Approximately one in seven (14.1%) adolescents had SPACs during the past year. Upon controlling for the effects of other factors, adolescents who had SPACs had 1.74 times higher odds of engaging in binge drinking (AOR = 1.74, p<.001, 95% CI = 1.47-2.06) and 1.42 times higher odds of using marijuana (AOR = 1.42, p<.001, 95% CI = 1.24-1.62) than those who did not have SPACs. Symptoms of depression and suicidal ideation explained 12% of the association between SPACs and binge drinking, and 19% of the association between SPACs and marijuana use. CONCLUSIONS Understanding the association between SPACs and substance use and mental health could contribute to early identification of adolescents who may engage in substance use.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Mark A Morgan
- Department of Criminal Justice & Security Studies, University of Dayton, Dayton, Ohio, USA
| | - Matthew W Logan
- School of Criminal Justice & Criminology, Texas State University, San Marcos, Texas, USA
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Nguyen NN. The Significance of School-based Programs, School-based Activities, and Community-Based Activities Against Marijuana Use Among Adolescents. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211037272] [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]
Abstract
Background: Marijuana use among adolescents is concerning in the United States, meanwhile, the effectiveness of school-based programs is inconclusive. This study examines the impact of school-based programs, school-based activities, and community-based activities on marijuana use among adolescents. Methods: A binary logistic regression analysis was conducted, using a sample of 16,509 adolescents (age = 12 to 17, male = 51.3%, White = 60.1%, Hispanic = 21.4%, African American = 14.7%, and Asian American = 3.9%) from the 2013 National Survey on Drug Use and Health (NSDUH). Results: Results of the main effects revealed that school-based programs, school-based activities, and community-based activities were deterrent factors against marijuana use among adolescents. Adolescents are less likely to use marijuana if they participate in school-based programs, school-based activities, and community-based activities. Conclusion: The findings of this study have implications for schools and those making educational policy.
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