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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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Montalvo AM, Wallace JS, Nedimyer AK, Chandran A, Kossman MK, Gildner P, Register-Mihalik JK, Kerr ZY. Does the Association Between Concussion Measures and Social Context Factors Differ in Black and White Parents? J Athl Train 2024; 59:363-372. [PMID: 37681666 PMCID: PMC11064114 DOI: 10.4085/1062-6050-0193.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
CONTEXT Middle school (MS) parents may benefit from education supporting timely concussion identification and care-seeking in their young children (aged approximately 10 to 15 years). However, such education may not consider individual needs and different social context factors, including lower socioeconomic status, disadvantaged social determinants of health, and different racial and ethnic backgrounds. OBJECTIVES To examine the relationship between social context factors and concussion knowledge, attitudes, and communication in MS parents and to explore the possible role of race and ethnicity (Black or White) as an effect measure modifier. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A nationally representative sample of MS parents who completed an online survey (n = 1248). MAIN OUTCOME MEASURE(S) Parent outcomes were a history of concussion education, concussion symptom knowledge and attitudes, and communication with children about concussion. Main exposures were parental race and ethnicity (Black or White) and social context factors. Uni- and multivariable statistical analyses were performed to achieve the study aims. RESULTS Black parents were more likely than White parents to have received concussion education (69.5% versus 60.5%, P = .009), although median concussion knowledge scores were higher for White parents than for Black parents (40 versus 37, P < .001). Few associations were found for social context factors with concussion knowledge, attitudes, and communication in Black and White parents separately. CONCLUSIONS Among MS parents, race and ethnicity may not influence the association between social context factors and concussion-related knowledge, attitudes, or communication. However, differences were present by race and ethnicity regarding previous concussion education and other parental outcomes, concussion symptom knowledge in particular.
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Affiliation(s)
- Alicia M Montalvo
- College of Health Solutions, Arizona State University, Phoenix
- Emory Sports Performance and Research Center, Flowery Branch, GA
- Sports Medicine and Community Health Research Lab, University of Southern Mississippi, Hattiesburg
| | | | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Melissa K Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg
- Sports Medicine and Community Health Research Lab, University of Southern Mississippi, Hattiesburg
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
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Meyer CM, Mensch J, Battle N, Yeargin SW. Knowledge and Attitudes of Concussion Reporting Behavior Intentions in Parents of Youth Recreational Football Players. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:218-226. [PMID: 37040134 DOI: 10.1080/02701367.2023.2189444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/26/2023] [Indexed: 06/19/2023]
Abstract
Purpose: This study: (1) Described the knowledge, attitudes, and reported behavior intentions of young recreational football players' parents toward concussion. (2) Investigated associations of the previous variables with parent demographics. Materials and Methods: A cross-sectional design utilized an online platform to survey parents of children (8-14 yrs.) in three youth football leagues in the southern United States. Demographics collected included items such as sex or concussion history. Knowledge was assessed via true/false items, with higher scores (0-20) representing greater concussion understanding. 4-point Likert scales were used to describe parents attitudes (1 = not at all, 4 = very much), confidence in intended recognition/reporting (1 = not-confident, 4 = extremely confident), and agreement with intended reporting behaviors (1 = strong- disagreement, 4 = strong-agreement). Descriptive statistics were calculated for demographics. Mann-Whitney U test or Kruskal-Wallis Tests examined survey responses across demographics. Results: Respondents (n = 101) were primarily female (64.4%), white (81.2%), and participated in contact sport (83.2%). Parents averaged 15.9 ± 1.4 on concussion knowledge, with only 34.7% (n = 35) of parents scoring > 17/20. Statements that received the lowest average agreement (3.29/4) regarding reporting intent were related to emotional symptoms. Some parents (n = 42, 41.6%) reported low confidence in recognizing symptoms of a concussion in their child. Parent demographics did not have clinically significant associations with survey responses, with 6/7 demographic variables resulting in no statistical significance (p > .05). Conclusions: Although one-third of parents attained high knowledge scores, several reported low confidence in recognizing concussion symptoms in their children. Parents scored lower in agreement with removing their child from play when concussion symptoms were subjective. Youth sports organizations providing concussion education to parents should consider these results when revising their materials.
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Stewart SL, Withers A, Graham AA, Poss JW, Donnelly N. Examining the Biopsychosocial Factors Related to Lifetime History of Concussion in Children and Youth. Child Psychiatry Hum Dev 2024; 55:36-47. [PMID: 35729361 DOI: 10.1007/s10578-022-01384-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
This study investigated the prevalence of lifetime concussions, related psychosocial problems, and post-concussion recovery rates in a clinical sample of children and youth. Participants were 24,186 children and youth (M = 11.9 years, SD = 3.5) who completed an interRAI Child and Youth Mental Health Assessment at mental health agencies across Ontario, Canada. In addition to the expected physiological correlates, results found concussions to be more prevalent in children and youth with attention deficit hyperactivity disorders, anxiety disorders, disruptive behaviour disorders, mood disorders, and those involved in self-harm, harm to others, destructive aggression, and internalizing and externalizing symptoms. The results of this study add to our understanding of children and youth's experiences with concussions. Clinical implications and recommendations are discussed to maximize the effectiveness of evidence-based interventions related to concussion recovery.
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Affiliation(s)
- Shannon L Stewart
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Abigail Withers
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada.
| | - Alana A Graham
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Jeffrey W Poss
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G5, Canada
| | - Nicholas Donnelly
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
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Haarbauer-Krupa J, Thigpen S, Glang A, Eagan-Johnson B, McAvoy K, Brunken C, Chininis M, Kurowski BG, Suskauer S, Crowley M, Denslow P. Return to School After Traumatic Brain Injury: Description of Implementation Settings. J Head Trauma Rehabil 2023; 38:329-335. [PMID: 36727685 PMCID: PMC10481241 DOI: 10.1097/htr.0000000000000859] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Children who experience traumatic brain injury (TBI) of any severity may need accommodations when they return to school-the setting that manages academic achievement and learning. However, variations exist in current return to school (RTS) programs that address a child's transition to school following TBI. This article describes some of these return to school (RTS) programs and how they vary by setting. DESIGN This article provides insights from a modified evaluability assessment that examined RTS programs and their readiness for rigorous evaluation. A secondary analysis was conducted to better describe the types and location of programs examined. RESULTS Differences exist in program structure, access, and how care for children is monitored over time. RTS programs that serve children following TBI are located in healthcare settings, schools, and state agencies and vary in models of care due to their location and organizational structure. CONCLUSIONS Children who experience TBI benefit from a healthcare assessment and follow-up upon RTS that includes parental involvement. Models of care for this process vary based on program location and organizational structure. Further research and program evaluation are needed to better understand effectiveness and how to optimally monitor and care for children returning to school after a concussion or TBI.
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Affiliation(s)
- Juliet Haarbauer-Krupa
- Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Haarbauer-Krupa and Ms Thigpen); University of Oregon, Eugene (Dr Glang); BrainSTEPS Brain Injury School Consulting Program in Pennsylvania, Pittsburgh (Dr Eagan-Johnson); Brain Injury Educational Consulting Colorado LLC, Fort Collins (Dr McAvoy); Lincoln Public Schools and the Nebraska State Department of Education, Lincoln (Ms Brunken); Sports Medicine and Concussion Institute Community Outreach and Education Northside Hospital, Duluth, Georgia (Ms Chininis); Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Medical Center, Department of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Kurowski); Kennedy Krieger Institute and Departments of Physical Medicine & Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Suskauer); National Association of State Head Injury Administrators, Alabaster, Alabama (Ms Crowley); and Brain Links, Tennessee Disability Coalition, Nashville (Ms Denslow)
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Yue JK, Krishnan N, Andrews JP, Semonche AM, Deng H, Aabedi AA, Wang AS, Caldwell DJ, Park C, Hirschhorn M, Ghoussaini KT, Oh T, Sun PP. Update on Pediatric Mild Traumatic Brain Injury in Rural and Underserved Regions: A Global Perspective. J Clin Med 2023; 12:jcm12093309. [PMID: 37176749 PMCID: PMC10179657 DOI: 10.3390/jcm12093309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/29/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Mild traumatic brain injury (MTBI) causes morbidity and disability worldwide. Pediatric patients are uniquely vulnerable due to developmental and psychosocial factors. Reduced healthcare access in rural/underserved communities impair management and outcome. A knowledge update relevant to current gaps in care is critically needed to develop targeted solutions. METHODS The National Library of Medicine PubMed database was queried using comprehensive search terms (("mild traumatic brain injury" or "concussion") and ("rural" or "low-income" or "underserved") and ("pediatric" or "child/children")) in the title, abstract, and Medical Subject Headings through December 2022. Fifteen articles on rural/underserved pediatric MTBI/concussion not covered in prior reviews were examined and organized into four topical categories: epidemiology, care practices, socioeconomic factors, and telehealth. RESULTS Incidences are higher for Individuals in rural regions, minorities, and those aged 0-4 years compared to their counterparts, and are increasing over time. Rural healthcare utilization rates generally exceed urban rates, and favor emergency departments (vs. primary care) for initial injury assessment. Management guidelines require customization to resource-constrained settings for implementation and adoption. Decreased community recognition of the seriousness of injury is a consensus challenge to care provision by clinicians. Low parental education and income were correlated with decreased MTBI knowledge and worse outcome. Telehealth protocols for triage/consultation and rehabilitation were feasible in improving care delivery to rural and remote settings. CONCLUSIONS Pediatric MTBI/concussion patients in rural/underserved regions experience increased risks of injury, geographic and financial healthcare barriers, and poorer outcomes. Globally, under-reporting of injury has hindered epidemiological understanding. Ongoing MTBI education should be implemented for rural caregivers, schools, and low-income populations to improve community awareness. Telehealth can improve care delivery across acuity settings, and warrants judicious inclusion in triage and treatment protocols.
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Affiliation(s)
- John K Yue
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Nishanth Krishnan
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - John P Andrews
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Alexa M Semonche
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Hansen Deng
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Alexander A Aabedi
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Albert S Wang
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - David J Caldwell
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Christine Park
- Department of Neurosurgery, Duke University, Durham, NC 27708, USA
| | - Melessa Hirschhorn
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kristen T Ghoussaini
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Taemin Oh
- Department of Neurosurgery, University of Utah, Salt Lake City, UT 84132, USA
| | - Peter P Sun
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of California San Francisco, San Francisco, CA 94143, USA
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Henley S, Andrews K, Kabaliuk N, Draper N. Soft-shell headgear in rugby union: a systematic review of published studies. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-023-01058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Abstract
Objectives
To review the rate of soft-shell headgear use in rugby union, consumer knowledge of the protection potential of soft-shell headgear, incidence of concussion reported in rugby headgear studies, and the capacity of soft-shell headgear to reduce acceleration impact forces.
Design
A systematic search was conducted in July and August 2021 using the databases SPORT Discus, PubMed, MEDLINE, CINAHL (EBSCO), Scopus, and Science Direct. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol for this systematic review was registered on PROSPERO (registration number: CRD42021239595).
Outcome measures
Rates of headgear use, reports of estimated protection of headgear against head injury, incidence of concussion and magnitude of impact collisions with vs. without headgear, impact attenuation of headgear in lab studies.
Results
Eighteen studies were identified as eligible: qualitative (N = 4), field (N = 7), and lab (N = 7). Qualitative studies showed low rates of headgear use and varying understanding of the protection afforded by headgear. Field studies showed negligible association of headgear use with reduced impact magnitude in headgear vs. non-headgear cohorts. Lab studies showed increased energy attenuation for thicker headgear material, poorer performance of headgear after repetitive impacts and increased drop heights, and promising recent results with headgear composed of viscoelastic polymers.
Conclusions
Rates of adoption of soft-shell headgear remain low in rugby and any association between its use and reduction in acceleration impact forces remains unclear. Lab results indicating improved impact attenuation need to be validated in the field. Further headgear-related research is needed with youth and female rugby players.
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Johnson A, Van Tubbergen M, Hashikawa A, Ichesco I, Almeida A, Kolberg K, Larson J. Differences in concussion knowledge between parents and their children in a multidisciplinary concussion clinic sample. J Pediatr Rehabil Med 2023; 16:301-309. [PMID: 36847020 DOI: 10.3233/prm-210058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
PURPOSE This study assessed concussion knowledge in concussed youth and parents treated at a multi-disciplinary concussion center. METHODS Youth (n = 50) and parents (n = 36) were approached at the beginning of a clinical visit. Participants completed a 22-item, previously published concussion knowledge survey before the visit. RESULTS Responses were compared with previously collected, published data from adolescents in a high school setting (n = 500). The patient group was divided into those with one (n = 23) vs. two or more concussions (n = 27). Chi-square analyses compared total correct responses between youth, parents, and the high school sample. T-tests assessed differences in knowledge based on prior concussions, age, and gender. All groups showed high accuracy for return-to-play guidelines (>90%) and similar knowledge of concussion-related symptoms (72.3% vs. 68.6%). Significant knowledge gaps about diagnosis, neurological consequences, and long-term risks were present across groups (19% to 68% accuracy). The patient group more often misattributed neck symptoms to concussion (X2 < 0.005). Prior concussion and gender were not significant predictors of concussion knowledge (p > 0.5). CONCLUSION Community and clinically-based educational techniques may not be effectively communicating knowledge about concussion diagnosis, symptoms, long-term risks, and neurological implications of concussion. Educational tools need to be tailored to specific settings and populations.
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Affiliation(s)
- Abigail Johnson
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | | | | | - Ingrid Ichesco
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | - Andrea Almeida
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | | | - Jennifer Larson
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
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Kerr ZY, Gildner P, Parker SK, Kostogiannes V, Callahan CE, Nedimyer AK, Kossman MK, Chandran A, Register-Mihalik JK. Sport culture and communication among middle school athletes, parents, and staff: A qualitative study. PLoS One 2023; 18:e0282252. [PMID: 36920886 PMCID: PMC10016647 DOI: 10.1371/journal.pone.0282252] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/10/2023] [Indexed: 03/16/2023] Open
Abstract
Middle school (MS) is an intermediary level of education between elementary and secondary school that typically includes students aged 10-15 years. There is limited research within the MS sport setting, particularly related to sport-related injury prevention. This qualitative study aimed to better understand the sport culture within MS sports and the communication strategies used among invested groups (i.e., athletes, parents, staff inclusive of coaches and school nurses). Semi-structured interviews were conducted with 19 athletes, 20 parents, and 18 staff (e.g., coaches, school nurses) from seven MS in two school districts during the 2018/19 and 2019/20 school years. Topics focused on understanding school- and sport-related factors related to education, safety, and communication. Analysis used a consensual qualitative research tradition, in which the research team discussed individually developed themes and categories from transcribed interviews, with the goal of coming to a consensus and creating a codebook. Throughout the coding process, the research team would reconvene to discuss coding decisions until consensus was reached. This study focuses on the themes of sport culture and communication. Dominant categories identified within sport culture related to participants noting why they were interested in MS sports, and their struggles with their perceived roles and engagement (e.g., helping parents stay engaged, finding coaches, oversight of school nurses). Competitiveness and safety could have conflicting roles and priority. Dominant categories identified within communication centered around limited communication between coaches and parents. Technological assistance (e.g., phone apps, websites) was available, but often varied by school and sport. Concussions were seldom discussed unless during the preseason meeting or when one occurred. Findings highlight that the MS sport settings may struggle with incorporating primary prevention into their cultures and ensuring reliable communication among individuals. Novel and tailored approaches to injury prevention are needed to help ensure buy-in and proper implementation.
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Affiliation(s)
- Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Stephanie K. Parker
- Department of Physical Therapy, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, United States of America
| | - Vasiliki Kostogiannes
- Physician Assistant Program, University of Maryland-Baltimore, Baltimore, MD, United States of America
| | - Christine E. Callahan
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Aliza K. Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Melissa K. Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS, United States of America
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, United States of America
| | - Johna K. Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Kerr ZY, Chandran A, Nedimyer AK, Rothschild AE, Kay MC, Gildner P, Byrd KH, Haarbauer-Krupa JK, Register-Mihalik JK. Use of sport-related concussion information sources among parents of United States middle school children. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:716-724. [PMID: 32417468 PMCID: PMC9729916 DOI: 10.1016/j.jshs.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/14/2020] [Accepted: 03/16/2020] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Parents may use various information sources to obtain information about sport-related concussions (SRC). This study examined SRC-related information sources used by parents of United States middle school children (age: 10-15 years). METHODS A panel of 1083 randomly selected U.S. residents, aged ≥18 years and identifying as parents of middle school children, completed an online questionnaire capturing parental and child characteristics, and utilization and perceived trustworthiness of various sources of SRC-related information. Multivariable logistic regression models identified factors associated with utilizing each source. Adjusted odds ratios (OR) with 95% confidence intervals (95%CIs) excluding 1.00 were deemed significant. RESULTS Doctors/healthcare providers (49.9%) and other healthcare-related resources (e.g., Centers for Disease Control and Prevention, WebMD) (37.8%) were common SRC-related information sources; 64.0% of parents utilized ≥1 of these sources. Both sources were considered "very" or "extremely" trustworthy for SRC-related information among parents using these sources (doctors/healthcare providers: 89.8%; other healthcare-related resources: 70.9%). A 10-year increase in parental age was associated with higher odds of utilizing doctors/healthcare providers (adjusted odd ratio (ORadjusted) = 1.09, 95%CI: 1.02-1.16) and other healthcare-related resources (ORadjusted = 1.11, 95%CI: 1.03-1.19). The odds of utilizing doctors/healthcare providers (ORadjusted = 0.58, 95%CI: 0.40-0.84) and other healthcare-related resources (ORadjusted = 0.64, 95%CI: 0.44-0.93) were lower among parents whose middle school children had concussion histories versus the parents of children who did not have concussion histories. CONCLUSION One-third of parents did not report using doctors/healthcare providers or other healthcare-related resources for SRC-related information. Factors associated with underutilization of these sources may be targets for future intervention. Continuing education for healthcare providers and educational opportunities for parents should highlight accurate and up-to-date SRC-related information.
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Affiliation(s)
- Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA.
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC 27599-8700, USA
| | - Allison E Rothschild
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7400, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - K Hunter Byrd
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
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Sullivan K, Kinmond S, Singaravelu Jaganathan K. Postconcussion discharge advice does not improve concussion knowledge in a community sample. Inj Prev 2022; 28:507-512. [PMID: 35701109 DOI: 10.1136/injuryprev-2022-044593] [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: 03/29/2022] [Accepted: 05/18/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Poor concussion knowledge in the community has been linked to reduced injury identification. This study investigated if concussion knowledge could be improved by providing standard postinjury advice (written brochure). METHODS This study was a prospective, controlled study, with random allocation of 199 Australian adults to receive either a concussion information (CI, n=101), or non-CI (n=98). All participants completed the Rosenbaum Concussion Knowledge and Attitudes Survey on three occasions: pre-education and posteducation, and 1 week later. RESULTS A 2 (condition) × 3 (occasion) mixed analysis of variance with concussion knowledge as the dependent variable did not find a statistically significant interaction (p>0.05). This result was unchanged: (1) with the covariate addition of background education and; (2) in a subgroup analysis (individuals with initially 'low' self-rated knowledge). Some key misconceptions about concussion were identified. CONCLUSION The community knowledge of concussion was not significantly improved by the concussion advice. Since injury recognition relies ton an extent on community knowledge, the identified misconceptions should be addressed. This could occur via public health messaging. In clinical settings and for future research, the next steps should also include regular updating of concussion information to keep pace with advances in the field.
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Affiliation(s)
- Karen Sullivan
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Sally Kinmond
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Kannan Singaravelu Jaganathan
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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12
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Campbell A, Hartling L, Plourde V, Scott SD. Parental Knowledge, Self-confidence, and Usability Evaluation of a Web-Based Infographic for Pediatric Concussion: Multimethod Study. JMIR Pediatr Parent 2022; 5:e36317. [PMID: 35536631 PMCID: PMC9131137 DOI: 10.2196/36317] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Concussions, which are known as mild traumatic brain injuries, are complex injuries caused by direct or indirect blows to the head and are increasingly being recognized as a significant public health concern for children and their families. Previous research has identified few studies examining the efficacy of educational interventions on parental concussion knowledge. The aim of this research was to actively work together with children who have experienced a concussion and their parents to develop, refine, and evaluate the usability of a web-based infographic for pediatric concussion. OBJECTIVE The objective of this study was to report on the usability of the infographic, parental knowledge, and self-confidence in pediatric concussion knowledge before and after exposure to the infographic. METHODS A multiphase, multimethod research design using patient engagement techniques was used to develop a web-based infographic. For this phase of the research (usability, knowledge, and confidence evaluation), parents who could communicate in English were recruited via social media platforms and invited to complete web-based questionnaires. Electronic preintervention and postintervention questionnaires were administered to parents to assess changes to concussion knowledge and confidence after viewing the infographic. A usability questionnaire with 11 items was also completed. RESULTS A web-based, infographic was developed. The infographic is intended for parents and children and incorporates information that parents and children identified as both wants and needs about concussion alongside the best available research evidence on pediatric concussion. A total of 31 surveys were completed by parents. The mean scores for each item on the usability surveys ranged from 8.03 (SD 1.70) to 9.26 (SD 1.09) on a 10-point Likert scale, indicating that the usability components of the infographic were largely positive. There was no statistically significant difference between preintervention and postintervention knowledge scores (Z=-0.593; P=.55; both preintervention and postintervention knowledge scores had a median of 9 out of 10). In contrast, there was a statistically significant difference between preintervention (mean 3.9/5, SD 0.56) and postintervention (mean 4.4/5, SD 0.44) confidence in knowledge scores (t30=-5.083; P<.001). CONCLUSIONS Our results demonstrate that parents positively rated a web-based, infographic for pediatric concussion. In addition, although there was no statistically significant difference overall in parents' knowledge scores before and after viewing the infographic, their confidence in their knowledge did significantly increase. These results suggest that using a web-based infographic as a knowledge translation intervention may be useful in increasing parents' confidence in managing their child's concussion.
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Affiliation(s)
- Alyson Campbell
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vickie Plourde
- École de Psychologie, Faculté des sciences de la santé et des services communautaires, Université de Moncton, Moncton, NB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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13
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Memmini AK, Van Pelt KL, Wicklund A, Breedlove KM, Broglio SP. Evaluating Adult Decision-Making Modifiers in Support of Youth Contact-Sport Participation. J Athl Train 2022; 57:44-50. [PMID: 35040986 PMCID: PMC8775283 DOI: 10.4085/1062-6050-0125.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT Nearly 44 million youth participate in organized youth sports programs in the United States each year. However, approximately 25% of parents have considered removing their children from sports due to the fear of concussion. OBJECTIVE To determine which adult decision-making modifiers (eg, gender, educational attainment, career type) influenced support for youth contact-sports participation. DESIGN Cross-sectional study. SETTING Midwestern university and medical center. PATIENTS OR OTHER PARTICIPANTS Convenience sample of staff and faculty (N = 5761; 73.9% female) from 2017 to 2018. MAIN OUTCOME MEASURE(S) Support for youth contact-sports participation using multivariate binary logistic regression to calculate odds ratios and 95% CIs. RESULTS The sample was split between adults with children (AWCs; n = 3465, age = 45.39 ± 13.27 years, 76.72% female) and adults without children (AWOCs; n = 2296, age = 30.84 ± 9.01 years, 70.26% female). Among AWCs, those who obtained a bachelor's degree or higher were more likely to support contact-sports participation. Females were more inclined to allow all contact sports, specifically football (odds ratio [OR] = 2.22; 95% CI = 1.64, 3.01) and ice hockey (OR = 1.98; 95% CI = 1.42, 2.78). Overall, previous adult sport participation, increasing number of children, and child gender were significant modifying variables in greater support of youth contact-sports participation among AWCs (P < .001). Among AWOCs, previous sport participation in football (OR = 3.27; 95% CI = 2.14, 4.87), ice hockey (OR = 4.26; 95% CI = 2.23, 8.17), or soccer (OR = 2.29; 95% CI = 1.48, 3.54) increased the likelihood of an adult supporting contact-sports participation. Lastly, all adults were less inclined to support a daughter participating in any contact sport than a son. CONCLUSIONS These results reveal adult- and child-specific variables that may influence youth contact-sports participation. These decisions may be developed through the lens of certain gender role beliefs and may lead adults to perceive certain sports as more appropriate for sons than daughters.
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Affiliation(s)
| | | | | | - Katherine M. Breedlove
- Department of Radiology, Harvard Medical School, Boston, MA
,Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA
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Moser RS, Friedman S, Hensel GL, Dubnov-Raz G, Schatz P. A Cross-Cultural Examination of Parental Knowledge of Concussion in Three Countries. Dev Neuropsychol 2021; 46:588-597. [PMID: 34844487 DOI: 10.1080/87565641.2021.2005600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the present study was to examine and compare knowledge regarding concussion among parents of youth soccer players, ages 5-17, from the United States, Israel, and Sicily. Results revealed parents from the United States were more knowledgeable than Israeli and Sicilian parents and were more likely to have a previous history of concussion in their children, themselves, and their social contacts. The success of concussion education, programming, and legislation in the US may account for the greater knowledge of US parents and is reason to advocate for similar resources for youth athletes internationally.
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Affiliation(s)
| | - Sarah Friedman
- Sports Concussion Center of New Jersey, Princeton, New Jersey, USA
| | - Gustav Luke Hensel
- Lehigh Valley Health Network-Scranton Orthopedics, Newfoundland, Pennsylvania, USA
| | - Gal Dubnov-Raz
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Philip Schatz
- Department of Psychology, Saint Joseph University, Philadelphia, Pennsylvania, USA
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15
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Roberts SD, Schatz P, Register-Mihalik J, Wojtowicz M. Parent knowledge of and attitudes towards youth sport-related concussion and associations with child and parent factors. Concussion 2021; 6:CNC93. [PMID: 35433025 PMCID: PMC9008503 DOI: 10.2217/cnc-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
Aim: This cross-sectional study aimed to better understand parental knowledge and attitudes regarding pediatric sport-related concussions, and association with parent/child biopsychosocial factors. Methods: A community sample of ninety families (n = 140 children) were included. Parental concussion knowledge and attitudes, concussion history, sport participation and social risk status score (SRS) were collected. Results: Parents scored an average of 76% accuracy on factual concussion knowledge, with 74% confidence in responses. Parents endorsed a favorable attitude toward concussion reporting and management. Low SRS had higher perceived accuracy of knowledge than medium or high SRS (p = 0.003). SRS influenced over-and-underestimations of factual knowledge (p = .04). Age at first sport and sport contact level influenced factual and perceived concussion knowledge. Conclusion: These findings identify common gaps in concussion knowledge in parents.
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Affiliation(s)
| | - Phillip Schatz
- Department of Psychology, Saint Joseph's University, Philadelphia, PA 19131, USA
| | - Johna Register-Mihalik
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27514, USA
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16
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Reporting of Concussion Symptoms by a Nationwide Survey of United States Parents of Middle School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212070. [PMID: 34831822 PMCID: PMC8622026 DOI: 10.3390/ijerph182212070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
This cross-sectional study assessed concussion symptom knowledge of parents of middle school (MS) children (aged 10-15 years) through a free-response item that solicited concussion symptoms and compared findings to a pre-validated scale-based measure. A self-administered online questionnaire was sent to a panel of randomly selected United States residents who were recruited by a third-party company, aged ≥ 18 years, and identified as parents of MS children. Via a free-response item, parents listed what they believed were concussion symptoms. Multiple sections later, parents identified potential concussion symptoms via a scale measure, which featured 25 items (22 actual symptoms, three distractor symptoms) with three response options: yes, no, maybe. Free-response item responses were coded into specific symptoms. The 1062 eligible parents that provided complete data commonly identified the symptoms of dizziness (90.2%), blurred vision (87.4%), and balance problems (86.4%) on the scale-based measure. However, these and other symptoms were less commonly identified via the free-response item (dizziness: 44.4%; blurred vision: 16.5%; balance problems: 3.5%). Concussion symptoms commonly reported via the scale-based measure were reported less frequently within the free-response item. Future research must explore strategies to help clinicians working with parents and their children to measure and assess concussion symptom reporting and knowledge.
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17
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Haarbauer-Krupa JK, Register-Mihalik JK, Nedimyer AK, Chandran A, Kay MC, Gildner P, Kerr ZY. Factors associated with concussion symptom knowledge and attitudes towards concussion care-seeking among parents of children aged 5-10 years. JOURNAL OF SAFETY RESEARCH 2021; 78:203-209. [PMID: 34399916 PMCID: PMC9139453 DOI: 10.1016/j.jsr.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/26/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Understanding parents' concussion-related knowledge and attitudes will contribute to the development of strategies that aim to improve concussion prevention and sport safety for elementary school children. This study investigated the association between parent- and child-related factors and concussion symptom knowledge and care-seeking attitudes among parents of elementary school children (aged 5-10 years). METHODS Four hundred parents of elementary school children completed an online questionnaire capturing parental and child characteristics; concussion symptom knowledge (25 items, range = 0-50; higher = better knowledge); and concussion care-seeking attitudes (five 7-point scale items, range = 5-35; higher = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher score levels. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) excluding 1.00 were deemed statistically significant. RESULTS Select parent and child characteristics were associated with higher score levels for both outcomes. For example, odds of better knowledge level in parents were higher with increased age (10-year increase aOR = 1.59; 95% CI = 1.10-2.28), among females (aOR = 3.90; 95% CI = 2.27-6.70), and among white/non-Hispanics (aOR = 1.79; 95%CI = 1.07-2.99). Odds of more positive concussion care-seeking attitude levels were higher among parents with a college degree (aOR = 1.98; 95%CI = 1.09-3.60). Child sports participation was not associated with higher score levels for either outcome. CONCLUSIONS Certain elementary school parent characteristics were associated with parents' concussion symptom knowledge and care-seeking attitudes. While the findings suggest providing parents with culturally and demographically relevant concussion education might be helpful, they also emphasize the importance of ensuring education/prevention regardless of their children's sports participation. Practical Applications: Pediatric healthcare providers and elementary schools offer an optimal community-centered location to reach parents with this information within various communities.
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Affiliation(s)
- Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Aliza K Nedimyer
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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18
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Chizuk HM, Haider MN, Solomito M, Kostyun R, Willer BS, Leddy JJ, Wang D. Concussion reporting behaviors in student athletes across sexes and levels of contact. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211015093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Context Sport-related concussions (SRC) are common in student athletes. However, current literature suggests that many athletes do not accurately report their symptoms. The under-reporting of concussion symptoms can result in an increased risk of further injury and an underestimation of concussion prevalence. Objective This study aims to identify perspectives on concussion reporting behaviors in student athletes across levels of contact and by sex. Design Cross-sectional study. Setting Elementary and high school, college. Patients or other participants: 1126 female (52%) and male (48%) athletes, mean age 16.6 years. Main outcome measure(s): Standardized questionnaire on concussion reporting during a series of hypothetical scenarios. Results Student athletes participating in sports with higher levels of contact had more education about concussions, yet professed they were less likely to report a concussion. The most common reasons athletes chose not to report were ‘not wanting to miss the game’ and ‘not wanting to let the coach down.’ Minimal differences were found between sexes, with females being just as unlikely, or sometimes more unlikely, to report a concussion than males. Lastly, females playing contact and non-contact sports appear to be more concerned about not wanting to let their coach down than males. Conclusions Although perspective on concussion reporting behavior varied across sports of different levels of contact, we did not find any conclusive evidence of differences in willingness to report a concussion between sexes when compared within the same level of contact.
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Affiliation(s)
- Haley M Chizuk
- UBMD Orthopedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, USA
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, USA
| | - Mohammad N Haider
- UBMD Orthopedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, USA
| | - Matthew Solomito
- The Bone and Joint Institute, Hartford Health Care, Hartford, USA
| | - Regina Kostyun
- The Bone and Joint Institute, Hartford Health Care, Hartford, USA
| | - Barry S Willer
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, USA
| | - John J Leddy
- UBMD Orthopedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, USA
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, USA
| | - David Wang
- Department of Orthopedics, UConn Health Farmington, Farmington, USA
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Wallace JS, Mannix RC. Racial Disparities in Diagnosis of Concussion and Minor Head Trauma and Mechanism of Injury in Pediatric Patients Visiting the Emergency Department. J Pediatr 2021; 233:249-254.e1. [PMID: 33524386 DOI: 10.1016/j.jpeds.2021.01.057] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine if racial/ethnic differences exist in the diagnosis and mechanism of injury among children and adolescents visiting the emergency department (ED) for concussion and minor head trauma (MHT). STUDY DESIGN A retrospective, cross-sectional study of patient (age ≤19 years) visits to the ED for concussion between 2010-2015, using the National Hospital Ambulatory Medical Care Survey, was completed. The primary study exposure was race/ethnicity. Outcome measures included ED visits that resulted in a concussion/MHT diagnosis and mechanism of injury. Mechanism categories included sport, motor vehicle collision, fall, assault, and other mechanism. A multivariable logistic regression and multinomial logistic regression were conducted to assess relationships between race/ethnicity and outcomes. Findings were weighted to reflect population estimates. RESULTS In total, 1263 child/adolescent visits for concussion/MHT were identified, representing an estimated 6.6 million child/adolescent visits nationwide. Compared with non-Hispanic White pediatric patients, non-Hispanic Black patients were least likely to have an ED visit for a concussion/MHT (P < .001; OR, 0.66; 95% CI, 0.52-0.83) The odds of non-Hispanic Black children/adolescents (OR, 3.80; 95% CI, 1.68-8.55) and children/adolescents of other race/ethnicity (OR, 4.93; 95% CI, 1.09-22.23) sustaining a concussion/MHT resulting from assault vs sport was higher. CONCLUSIONS Amid the emerging focus on sport-related concussion, these ethnic/racial differences in ED diagnosis of concussion/MHT demonstrate sociodemographic differences that warrant further attention. Assault may be a more common mechanism of concussion among children/adolescents of a racial minority.
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Affiliation(s)
- Jessica S Wallace
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA; Department of Health Science, University of Alabama, Tuscaloosa, AL.
| | - Rebekah C Mannix
- Departments of Pediatrics & Emergency Medicine, Harvard Medical School, Boston, MA; Division of Emergency Medicine, Boston Children's Hospital, Boston, MA
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LaBond V, Liebsch K, West B, Caputo D, Barber K. A Longitudinal Observation of the Influence of Michigan Sports Concussion Law on Parents' Knowledge and Perception of Sport-Related Concussion. Spartan Med Res J 2021; 6:22067. [PMID: 33870006 PMCID: PMC8043906 DOI: 10.51894/001c.22067] [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: 02/15/2021] [Accepted: 04/05/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION In 2013, Michigan enacted legislation requiring parents and athletes to receive educational material concerning sport-related concussion (SRC). The aim of this study was to examine trends in concussion knowledge of parents from one community following implementation of Michigan's Sports Concussion Laws (MSCL). METHODS A convenience sample of parents of students from a suburban school district were surveyed via district email at one year and five years post MSCL implementation. Results were compared to an equivalent 33-item survey obtained prior to the law. Individual questions were compared between the three surveys using Chi-square analysis with statistical significance observed at p < 0.05. RESULTS A total of 381 responses were obtained from the one-year post-MSCL (1yMSCL) and 178 in the five-year post-MSCL (5yMSCL) survey. Awareness of district policy regarding concussion was significantly higher after implementation of the MSCL (i.e., 77% at 1yMSCL and 71% at 5yMSCL) compared to prior 18% pre-MSCL (p < 0.0001). Respondents to the 5yMSCL survey were also significantly more aware of medical guidelines surrounding "return to play" after SRC compared to 1yMSCL (84.8% v 78.7%, p = 0.01). At 5yMSCL, significantly more respondents agreed that head injuries could cause more brain damage to children than adults (86.5% v 78.7% at 1yMSCL, p = 0.03). Finally, most parents at both survey periods rated the concussion educational material as the most helpful information source regarding SRC. CONCLUSIONS Based on these results, parental knowledge awareness appears to have increased concerning awareness of medical guidelines for SRC and potential brain damage risks to children after enactment of the MSCL.
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An Examination of Perceived Pressure From Stakeholders on Concussion Reporting Intentions and Behavior in Ice Hockey Athletes. J Head Trauma Rehabil 2021; 37:79-88. [PMID: 33782349 DOI: 10.1097/htr.0000000000000679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to assess whether perceived pressure predicts concussion reporting intentions and behavior in youth, high school, and collegiate ice hockey athletes, and, secondarily, whether perceived pressure from stakeholders differed between sex or level of play. SETTING Online survey. PARTICIPANTS One hundred fifty-two ice hockey athletes (males: n = 96, 63.2%; females: n = 55, 36.2%; missing: n = 1, 0.7%; age = 14.04 ± 3.6 years). DESIGN Cross-sectional. MAIN MEASURES Respondents answered a survey that elicited information about demography, perceived pressure from 6 stakeholders, and concussion reporting intentions and behavior. For the first aim, we used a generalized linear model to determine whether perceived pressure from any stakeholder predicted intention (symptom reporting, concussion reporting, and intention beliefs) or behavior ("all concussions," "not obvious concussions"; α < .05) while controlling for level of play. To determine whether pressure from any stakeholder predicted symptom reporting behavior, we used logistic regression while controlling for level of play. For the second aim, to examine sex differences in perceived pressure from each stakeholder, we employed Mann-Whitney tests and to examine level of play differences, we used Kruskal-Wallis tests. RESULTS Controlling for level of play, a 1-point increase in perceived pressure from parents and athletic administrators decreased concussion reporting intentions by 0.92 (P = .004) and 1.09 (P = .005) points, respectively. Perceived pressure from a sports medicine professional decreased intention beliefs by 0.17 (P = .029) points. Perceived pressure from stakeholders did not predict symptom reporting (P = .440) or "not obvious concussion" reporting (P = .655) behavior. We observed no difference in perceived pressure across stakeholders (all P values >.05); however, collegiate ice hockey respondents perceived greater pressure from coaches than youth or high school athletes (P < .001). We noted no other differences in perceived pressure across levels of play (all P values >.05). CONCLUSIONS Concussion reporting intentions were negatively influenced by perceived pressure from parents, athletic administrators, and sports medicine professionals, but these findings did not translate to reporting behavior.
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Kerr ZY, Nedimyer AK, Kay MC, Chandran A, Gildner P, Byrd KH, Haarbauer-Krupa JK, Register-Mihalik JK. Factors associated with concussion-symptom knowledge and attitudes toward concussion care seeking in a national survey of parents of middle-school children in the US. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:113-121. [PMID: 32919064 PMCID: PMC7987565 DOI: 10.1016/j.jshs.2020.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/18/2020] [Accepted: 08/04/2020] [Indexed: 06/06/2023]
Abstract
BACKGROUND Developing appropriate concussion prevention and management paradigms in middle school (MS) settings requires understanding parents' general levels of concussion-related knowledge and attitudes. This study examined factors associated with concussion-symptom knowledge and care-seeking attitudes among parents of MS children (aged 10-15 years). METHODS A panel of 1224 randomly selected U.S. residents, aged ≥ 18 years and identifying as parents of MS children, completed an online questionnaire capturing parental and child characteristics. The parents' concussion-symptom knowledge was measured using 25 questions, with possible answers being "yes", "maybe", and "no". Correct answers earned 2 points, "maybe" answers earned 1 point, and incorrect answers earned 0 point (range: 0-50; higher scores = better knowledge). Concussion care-seeking attitudes were also collected using five 7-point scale items (range: 5-35; higher scores = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher scores. Models met proportional odds assumptions. Adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs) (excluding 1.00) were deemed statistically significant. RESULTS Median scores were 39 (interquartile range: 32-44) for symptom knowledge and 32 (interquartile range: 28-35) for care-seeking attitude. In multivariable models, odds of better symptom knowledge were higher in women vs. men (aOR = 2.28; 95%CI: 1.71-3.05), white/non-Hispanics vs. other racial or ethnic groups (aOR = 1.88; 95%CI: 1.42-2.49), higher parental age (10-year-increase aOR = 1.47; 95%CI: 1.26-1.71), and greater competitiveness (10%-scale-increase aOR = 1.24; 95%CI: 1.13-1.36). Odds of more positive care-seeking attitudes were higher in white/non-Hispanics vs. other racial or ethnic groups (aOR = 1.45; 95%CI: 1.06-1.99) and in older parental age (10-year-increase aOR = 1.24; 95%CI: 1.05-1.47). CONCLUSION Characteristics of middle school children's parents (e.g., sex, race or ethnicity, age) are associated with their concussion-symptom knowledge and care-seeking attitudes. Parents' variations in concussion knowledge and attitudes warrant tailored concussion education and prevention.
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Affiliation(s)
- Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA.
| | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC 27599-8700, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN 46202, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - K Hunter Byrd
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
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What Do Parents Need to Know About Concussion? Developing Consensus Using the Delphi Method. Clin J Sport Med 2021; 31:139-144. [PMID: 30475245 DOI: 10.1097/jsm.0000000000000702] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/13/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Many schools and sports leagues provide preseason concussion education to parents/guardians, and in some jurisdictions, it is required for interscholastic sports participation. However, directives about content are absent or vague. The purpose of this study was to obtain expert consensus about what parents/guardians need to know to about concussion. DESIGN A modified Delphi process with nationally recognized expert panel members was used to obtain consensus about parent/guardian behaviors relevant to concussion prevention, identification, and management and knowledge domains relevant to performance of those behaviors. RESULTS Sixteen parent/guardian behaviors and 24 knowledge domains were identified. However, consensus was not achieved regarding whether it is realistic to expect parents/guardians to perform approximately one-third of the behaviors that experts agreed mattered. This variability may reflect underlying uncertainty about the capacities of some parents/guardians to put knowledge into action or the belief that there are other barriers to action. Furthermore, for most knowledge domains, there was a lack of agreement about whether or not there could be a "correct" answer on the basis of current scientific knowledge. CONCLUSIONS These findings raise practical and ethical questions: how can we expect parents/guardians to help prevent, identify, or manage concussion if they cannot have all the information required to engage in these behaviors due to lack of scientific consensus? This issue is not unique to concussion. Best practices for risk communication and shared decision-making can inform how we think about educating parents/guardians about concussion inside and outside of the health care setting.
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Ajayi PT, Garavito DM, Reyna VF. Socioeconomic status and concussion reporting: The distinct and mediating roles of gist processing, knowledge, and attitudes. JOURNAL OF BEHAVIORAL DECISION MAKING 2021. [DOI: 10.1002/bdm.2235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Peter T. Ajayi
- Department of Human Development, Human Neuroscience Institute Cornell University Ithaca New York USA
| | - David M.N. Garavito
- Department of Human Development, Human Neuroscience Institute Cornell University Ithaca New York USA
| | - Valerie F. Reyna
- Department of Human Development, Human Neuroscience Institute Cornell University Ithaca New York USA
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Pietz K, Graves J, Weybright E, Pinkleton B, Klein T. Original Research: Concussions at School: The Experiences and Knowledge of School Nurses. Am J Nurs 2021; 121:28-38. [PMID: 33470615 DOI: 10.1097/01.naj.0000733428.67589.5e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND School nurses' knowledge about and confidence in managing concussions are important to ensure continuity of care between a student's school and home environments. This mixed-methods study explored concussion-related knowledge, confidence, and management experiences among urban and rural school nurses in Washington State. METHODS Public school nurses, identified via state educational service district websites and recruited by e-mail, completed an online survey assessing their concussion knowledge and confidence levels. Following the survey, a subset of respondents participated in semistructured interviews aimed at exploring their confidence in managing concussions. RESULTS Of the 945 school nurses to whom the survey was sent, 315 responded (33% response rate). Most survey respondents held an RN license (89.6%) and were from urban areas (90.8%). Overall, the respondents exhibited accurate concussion knowledge; only one significant difference was noted based on rural-urban status. Correct responses were given for most questions (67.4% to 98.7% correct responses). In interviews with a subset of six school nurses, emergent themes pertained to communication, assessment, and monitoring, and the nurse's role in postconcussion management. Barriers can include a lack of relevant school policies, low concussion awareness among teachers and parents, and limited resources. CONCLUSIONS The study findings suggest that school nurses possess high levels of concussion knowledge and confidence in managing concussions. Continuing education remains important to ensure that current research and evidence inform practice regarding ongoing concussion management among school-age children.
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Affiliation(s)
- Katy Pietz
- Katy Pietz is an instructor and the clinical coordinator of the Athletic Training Program at the College of Education, Washington State University (WSU), Pullman Campus. Janessa Graves is an associate professor at the College of Nursing, WSU, Spokane Campus. Elizabeth Weybright is an associate professor in the Department of Human Development, College of Agricultural, Human, and Natural Resource Sciences at WSU, Pullman Campus. Bruce Pinkleton is a professor and dean of the Edward R. Murrow College of Communication at WSU, Pullman Campus. Tracy Klein is an associate professor in the College of Nursing, WSU, Vancouver Campus. Graves, Weybright, Pinkleton, and Klein are on the faculty of WSU's interdisciplinary Prevention Science program. Contact author: Katy Pietz, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Youth Soccer Parents' Attitudes and Perceptions About Concussions. J Adolesc Health 2021; 68:184-190. [PMID: 32636138 DOI: 10.1016/j.jadohealth.2020.04.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Parents are important figures in properly managing youth sport concussions. Although media attention has predominantly centered on concussions in contact/collision sports, evidence suggests that the concussion rate in soccer is comparable to those found in contact/collision sports. Given the high rate of concussions in youth soccer, this study aimed to examine parents of youth soccer athletes' attitudes and perceptions about concussions and associated factors. METHODS A cross-sectional study was conducted by surveying parents of youth soccer athletes from the five largest organized youth soccer programs across the U.S. The researchers developed a questionnaire after an extensive literature review and by modifying previously used instruments. RESULTS Overall, 419 parents completed the survey. The vast majority (85%) agreed that a concussion is a serious injury, but only 27.9% believed that their child could suffer a concussion during the next season. Parents were most concerned about permanent brain damage when their child suffers a concussion. The vast majority (4.37 ± .89) perceived concussion reporting as an important injury prevention strategy. Greater appreciation and perceived risk about concussions was found particularly among parents who received concussion education and those who had witnessed or heard about a concussive incidence(s). CONCLUSIONS Findings suggest that youth soccer parents have high appreciation and perceived risk about concussions. However, the need for more targeted education was noted, as improvements to better manage and reduce concussions can be made. Future research should continue examining youth sport parents' belief and understanding about concussions as well as factors affecting them.
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Wallace J, Affagato R, Brooke M, McAllister-Deitrick J, Moran RN, Covassin T. Racial disparities in parent knowledge of concussion and recognition of signs and symptoms. JOURNAL OF SAFETY RESEARCH 2020; 75:166-172. [PMID: 33334474 DOI: 10.1016/j.jsr.2020.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/08/2020] [Accepted: 09/16/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Concussion is a type of traumatic brain injury that can be sustained through participation in different sports. It is important that a parent be able to identify common and uncommon symptoms of a concussion to ensure the safety and good health of their child. The purpose of this study was to compare knowledge of concussion scores among White and African American parents and guardians. METHODOLOGY This cross-sectional study consisted of a single survey of 53 questions that was given to parents/guardians of high school athletes at a preseason parent meeting. Parent and guardian knowledge of concussion was assessed through a series of 45 questions. Participants were asked to correctly identify signs and symptoms of concussion, answer questions regarding the anatomy of a concussion (i.e. a concussion is an injury to the brain), answer true/false questions about general concussion knowledge, select from a list the consequences of multiple concussions and select from a list the consequences of returning to play too soon from a concussion. Knowledge of concussion was calculated by summing correct responses for the 45 knowledge questions. Racial differences were calculated using an ANCOVA, controlling for socioeconomic school type. The statistical significance level was set a priori p ≤ 0.05 for all analyses. RESULTS Participants of this study consisted of 176 [115 (65.3%) White, 61 (34.7%) African American] parents/guardians of high school athletes. Significant differences in knowledge of concussion scores between White parents/guardians [38.50 ± 4.55 (85.6% correct)], and African American parents/guardians [35.15 ± 4.97, 78.1% correct)] were identified (F(1,172) = 4.82, p = 0.03). CONCLUSION Knowledge of concussion disparities exist between African American and White parents/guardians. This disparity could cause complications from concussion to surface among children and adolescents participating in sport as their parents/guardians may not be able to correctly identify the signs and symptoms in order to seek proper medical care. Practical Application: Findings from this study highlight quantitative differences in concussion knowledge of parents from different demographics. These findings underline disparities and inequities in access to concussion-health resources that need to be addressed.
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Affiliation(s)
- Jessica Wallace
- The University of Alabama, Department of Health Science, Tuscaloosa, AL 35401, United States.
| | - Rachel Affagato
- Youngstown State University, Department of Kinesiology & Sport Science, Youngstown, OH 44555, United States
| | - Maxwell Brooke
- Youngstown State University, Department of Kinesiology & Sport Science, Youngstown, OH 44555, United States.
| | | | - Ryan N Moran
- The University of Alabama, Department of Health Science, Tuscaloosa, AL 35401, United States.
| | - Tracey Covassin
- Athletic Training Program, Michigan State University, 105 IM Circle, East Lansing, MI 48840, United States.
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Moser RS, Schatz P. A Cross-Cultural Examination of Parental Knowledge of Concussion in Sicily, Italy. Dev Neuropsychol 2020; 45:330-340. [PMID: 32627601 DOI: 10.1080/87565641.2020.1789644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Forty parents of youth soccer players of ages 5-17 years, in Sicily, Italy completed a survey measuring knowledge of concussion symptoms and facts. Parents averaged 16 out of 23 correct responses (69.5%) on the survey, with no significant correlation between parental age and education and knowledge. Italian parents were more familiar with somatic symptoms (92.5%-100% correct) than emotional/behavioral (27.5%-57.5% correct) and sleep symptoms (45.0%). Comparisons to U.S. and Australian research showed general agreement on knowledge of concussion symptoms, but less awareness of other concussion facts among Italian parents. More research on cross-cultural concussion education and barriers to concussion resources is warranted.
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Feiss RS, Lutz M, Moody JR, Pangelinan MM. A systematic review of coach and parent knowledge of concussion. JOURNAL OF CONCUSSION 2020. [DOI: 10.1177/2059700219900053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Robyn S Feiss
- School of Kinesiology, Auburn University, Auburn, USA
| | - Molly Lutz
- Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, USA
| | - Justin R Moody
- School of Health Professions, Samford University, Birmingham, USA
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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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Rice T, Curtis R. Parental knowledge of concussion: Evaluation of the CDC's "Heads up to parents" educational initiative. JOURNAL OF SAFETY RESEARCH 2019; 69:85-93. [PMID: 31235239 DOI: 10.1016/j.jsr.2019.02.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 01/16/2019] [Accepted: 02/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Potential negative outcomes associated with sport-related concussion drive the need for resources to educate parents about prevention, recognition, and management of concussion in the youth athlete. Parents play a critical role in the recognition and management of concussion for their child. PURPOSE This study aims to (a) investigate current knowledge of concussion among parents whose children age 5-18 years play a club sport and (b) identify effects of an online video versus online print educational intervention on concussion knowledge change and learning. METHODS 140 parents whose children played a club sport answered questions regarding their knowledge of sport-related concussion pre- and post-random assignment to an educational intervention: CDC Concussion Awareness video or CDC Concussion Fact Sheet for Parents. RESULTS Participating parents demonstrated a moderate level of pre-intervention knowledge, but critical gaps in knowledge were identified. Knowledge of concussion improved slightly following intervention regardless of intervention type. CONCLUSIONS This study confirms the presence of gaps in knowledge of concussion in parents whose children play club sports. Without the protection of concussion legislation, those athletes who participate in club sports are at particular risk due to lack of concussion knowledge and education. This study confirms that education can have a positive impact on parental knowledge of concussion. Practical applications: Pre-knowledge of concussion is the greatest predictor of post-knowledge of concussion, therefore pre-assessment of target audience knowledge followed by a custom educational intervention taking into account principles of adult learning, would be the most beneficial to increasing concussion knowledge.
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Affiliation(s)
- Tracy Rice
- School of Medicine, Division of Physical Therapy, West Virginia University, P.O. Box 9226, Morgantown, WV 26506, United States.
| | - Reagan Curtis
- Department of Learning Sciences & Human Development, College of Education and Human Services, West Virginia University, Allen Hall 507D, Morgantown, WV, United States
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Halstead ME, Walter KD, Moffatt K, LaBella CR, Brooks MA, Canty G, Diamond AB, Hennrikus W, Logan K, Nemeth BA, Pengel KB, Peterson AR, Stricker PR. Sport-Related Concussion in Children and Adolescents. Pediatrics 2018; 142:peds.2018-3074. [PMID: 30420472 DOI: 10.1542/peds.2018-3074] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Sport-related concussion is an important topic in nearly all sports and at all levels of sport for children and adolescents. Concussion knowledge and approaches to management have progressed since the American Academy of Pediatrics published its first clinical report on the subject in 2010. Concussion's definition, signs, and symptoms must be understood to diagnose it and rule out more severe intracranial injury. Pediatric health care providers should have a good understanding of diagnostic evaluation and initial management strategies. Effective management can aid recovery and potentially reduce the risk of long-term symptoms and complications. Because concussion symptoms often interfere with school, social life, family relationships, and athletics, a concussion may affect the emotional well-being of the injured athlete. Because every concussion has its own unique spectrum and severity of symptoms, individualized management is appropriate. The reduction, not necessarily elimination, of physical and cognitive activity is the mainstay of treatment. A full return to activity and/or sport is accomplished by using a stepwise program while evaluating for a return of symptoms. An understanding of prolonged symptoms and complications will help the pediatric health care provider know when to refer to a specialist. Additional research is needed in nearly all aspects of concussion in the young athlete. This report provides education on the current state of sport-related concussion knowledge, diagnosis, and management in children and adolescents.
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Affiliation(s)
| | - Kevin D. Walter
- Department of Orthopaedic Surgery, Pediatric Sports Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; and
| | - Kody Moffatt
- Creighton University School of Medicine, Omaha, Nebraska
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Taranto E, Fishman M, Garvey K, Perlman M, Benjamin HJ, Ross LF. Public Attitudes and Knowledge About Youth Sports Participation and Concussion Risk in an Urban Area. J Natl Med Assoc 2018; 110:635-643. [PMID: 30376961 DOI: 10.1016/j.jnma.2018.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 06/13/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Every year, millions of children in the United States participate in youth full-contact sports, which carry concussion risks-the long-term sequelae of which are not well understood. We examined the attitudes and knowledge of adults in Chicago about youth sports participation, concussion risk, and whether physicians should counsel against youth participation in full-contact sports. METHODS An anonymous paper survey featuring 13 attitudinal, 13 demographic, and 9 knowledge questions was distributed to a convenience sample of adults ≥18 years in hospital waiting areas and four Chicago parks. Participants were asked to hypothetically consider themselves the parent of a 10-year-old child regarding attitudes towards full-contact sports participation. RESULTS Between June 13 and July 27, 2016, 1091 partial or complete valid surveys were collected. Almost half (46%) of respondents would not allow a hypothetical 10-year-old son to play tackle football. The majority (74%) of respondents agreed that it was appropriate for physicians to counsel against youth participation in full-contact sports. Respondents obtained information about concussions from, on average, 2-3 sources, although only 34% received information from physicians. Respondents demonstrated a high concussion knowledge level (average: 6.75 of 9 questions). However, only 39% of respondents correctly answered that the following statement was false: "After a mild concussion, there are usually visible changes on medical imaging". CONCLUSIONS Overall, respondents are well-informed about concussions. They are divided about the participation of youth in full-contact sports and are amenable to physician counseling against youth participation in full-contact sports.
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Affiliation(s)
- Eleanor Taranto
- Pritzker School of Medicine, University of Chicago 924 E 57th St., Chicago, IL, 60637, USA
| | - Michael Fishman
- Pritzker School of Medicine, University of Chicago 924 E 57th St., Chicago, IL, 60637, USA
| | - Katherine Garvey
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Meryl Perlman
- Massachusetts General Hospital for Children, Department of Pediatric Gastroenterology & Nutrition, 55 Fruit Street, 6B, Boston, MA, 02114, USA
| | - Holly J Benjamin
- Department of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA; Department of Pediatrics, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA
| | - Lainie Friedman Ross
- Department of Pediatrics, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA; MacLean Center for Clinical Medical Ethics, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
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Register-Mihalik JK, Williams RM, Marshall SW, Linnan LA, Mihalik JP, Guskiewicz KM, McLeod TCV. Demographic, Parental, and Personal Factors and Youth Athletes' Concussion-Related Knowledge and Beliefs. J Athl Train 2018; 53:768-775. [PMID: 30198745 DOI: 10.4085/1062-6050-223-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT: Currently, significant attention is focused on improving care for patients with concussions through legislative mandates that include educational interventions. Few researchers have examined young athletes' concussion knowledge and the factors that may influence their knowledge. OBJECTIVE: To use the socioecological model to examine demographic, parental, and personal factors associated with youth athletes' knowledge of concussion. Our ultimate goal is to inform the planning and implementation of youth sport concussion-related interventions. DESIGN: Cross-sectional survey. SETTING: Gymnasium and classroom. PATIENTS OR OTHER PARTICIPANTS: North Carolina and Arizona youth athletes (n = 225; age = 8 to 15 years) active in football, boys' or girls' soccer, boys' or girls' ice hockey, or boys' or girls' lacrosse in 2012-2013. MAIN OUTCOME MEASURE(S): Participants completed a validated, self-administered survey. The intention and belief measures were guided by the theory of planned behavior. Perceptions of concussion and intention to seek care were examined using descriptive statistics. Athletes' concussion knowledge was modeled using linear regressions and generalized estimating equations, with child demographic and personal factors and parental knowledge and attitudes about concussion as predictors. RESULTS: Geography, sport, parental attitudes toward concussion, and athlete age were associated with athlete knowledge in the univariable analyses ( P < .10). In the multivariable model, geographic location (North Carolina versus Arizona, mean difference [MD] = 2.2, 95% confidence interval [CI] = 1.1, 3.2), sport (girls' soccer versus girls' lacrosse, MD = 2.2, 95% CI = 0.7, 3.6), more favorable parental attitudes toward concussion (MD = 1.2 for a 2-standard deviation shift; 95% CI = 0.3, 2.1), and older age (>12 years, MD = 1.6; 95% CI = 0.5, 2.6) were associated with better knowledge about concussion. CONCLUSIONS: Geographic location, sport, parental attitudes about concussion, and athlete's age influenced athletes' concussion-related perceptions, indicating the need to address multiple levels of the socioecological model when targeting youth sport interventions. Parental interventions that translate to an improved culture of youth sport by improving youth athletes' perceptions and experiences are key areas for future work.
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Affiliation(s)
- Johna K Register-Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.,Injury Prevention Research Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | | | - Stephen W Marshall
- Injury Prevention Research Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Laura A Linnan
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Jason P Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Kevin M Guskiewicz
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Tamara C Valovich McLeod
- Athletic Training Programs, A.T. Still University, Mesa.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa
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35
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Using Community Detection Analysis to Elucidate Caregivers’ Mental Models of Pediatric Concussion Symptoms. SAFETY 2018. [DOI: 10.3390/safety4030035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Due to a culture of resistance around concussion reporting, novel methods are needed to reveal implicit beliefs that could affect symptom reporting. The goal of this study was to elucidate caregivers’ mental models of pediatric concussion symptoms using an exploratory community detection analysis (CDA). Caregivers (n = 76) of adolescents 10–15 years old participated in a survey that assessed their intentions of seeking medical treatment for 12 injury symptoms following their child’s involvement in three hypothetical injury scenarios. We used a series of analyses of variance (ANOVAs) to compare injury symptoms across these scenarios and CDA to determine if caregivers implicitly group symptoms together. We then used logistic regressions to further explore associations between the CDA-identified symptom indices and known factors of injury risk. There were no differences in the likelihood to seek treatment for symptoms across injury scenarios; however, the CDA revealed distinct symptom clusters that were characterized by the degree of risk for non-treatment and symptom type. We observed associations between injury risk factors and intentions of seeking medical treatment for the higher-risk indices. Results indicate that caregivers’ mental models of concussion symptoms are nuanced, not monolithic. Therefore, it is inaccurate to measure intentions to seek treatment for concussion without taking these nuances into consideration.
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Kerr ZY, Register-Mihalik JK, Haarbauer-Krupa J, Kroshus E, Go V, Gildner P, Byrd KH, Marshall SW. Using opinion leaders to address intervention gaps in concussion prevention in youth sports: key concepts and foundational theory. Inj Epidemiol 2018; 5:28. [PMID: 29984386 PMCID: PMC6035905 DOI: 10.1186/s40621-018-0158-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/30/2018] [Indexed: 12/04/2022] Open
Abstract
Behavioral interventions to increase disclosure and proper management of concussion in youth sports have unrealized potential when it comes to preventing concussion. Interventions have focused on changing individual athlete behavior and have fallen short of the potential for sustained systemic behavioral change. One potentially critical reason for this shortfall is that other key determinants of risk behaviors at all levels of the socio-ecological model (e.g. interpersonal, community, policy) are not addressed in extant programming. There is a critical need for theory-driven interventions that address concussion prevention and education at the community level and target sustainable culture change. The Popular Opinion Leader (POL) intervention, a multi-level intervention model previously successfully employed in multiple public health contexts, is theoretically well positioned to affect such change. POL is based on the Diffusion of Innovations framework and involves identifying, recruiting, and training well-respected and trusted individuals to personally endorse prevention and risk-reduction within their social networks. Critical behavioral changes related to concussion disclosure and management have been shown to diffuse to others if enough opinion leaders endorse and support the behaviors. This article summarizes the concepts and principles of POL and describes how it could be adapted for and implemented in youth sport settings. For optimal impact, POL needs to adapt to several factors unique to youth sports settings and culture. First, adult involvement may be important, given their direct involvement in the athlete's medical care. However, parents and coaches' opinions on injury care-seeking, competition, and safety may affect their perceptions of POL. Second, youth sports are structured settings both physically and socioculturally. Games and practices may provide opportunities for the informal interactions that are critical to the success of POL. However, youth sport setting membership is transient as players get older and move to other sport settings; POL approaches need to be self-sustaining despite this turnover. Moreover, stakeholder value placed on athlete development and competition, alongside safety, must be considered. Formative research is needed to ensure that POL principles are translated into the youth sport setting while maintaining fidelity to the concepts and principles that have made POL successful for other health outcomes.
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Affiliation(s)
- Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina, 313 Woollen Gym CB#8700, Chapel Hill, NC 27599-8700 USA
- Injury Prevention Research Center, University of North Carolina, CVS Plaza, Suite 500, 137 East Franklin Street, CB#7505, Chapel Hill, NC 27599-7505 USA
| | - Johna K. Register-Mihalik
- Injury Prevention Research Center, University of North Carolina, CVS Plaza, Suite 500, 137 East Franklin Street, CB#7505, Chapel Hill, NC 27599-7505 USA
- Department of Exercise and Sport Science, University of North Carolina, 125 Fetzer Hall CB#8700, Chapel Hill, NC 27599-8700 USA
| | - Juliet Haarbauer-Krupa
- Division of Unintentional Injury, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4700 Buford Highway, MS F-62, Atlanta, GA 30341 USA
| | - Emily Kroshus
- Department of Pediatrics, University of Washington, 2001 Eighth Ave, Seattle, WA 98121 USA
- Seattle Children’s Research Institute; Child Health, Behavior and Development, 2001 Eighth Ave, Suite 400, Seattle, WA 98121 USA
| | - Vivian Go
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 361 Rosenau Hall CB#7440, Chapel Hill, NC 27599-7440 USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina, CVS Plaza, Suite 500, 137 East Franklin Street, CB#7505, Chapel Hill, NC 27599-7505 USA
| | - K. Hunter Byrd
- Injury Prevention Research Center, University of North Carolina, CVS Plaza, Suite 500, 137 East Franklin Street, CB#7505, Chapel Hill, NC 27599-7505 USA
| | - Stephen W. Marshall
- Injury Prevention Research Center, University of North Carolina, CVS Plaza, Suite 500, 137 East Franklin Street, CB#7505, Chapel Hill, NC 27599-7505 USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, CVS Plaza, Suite 500, 137 East Franklin Street, CB#7505, Chapel Hill, NC 27599-7505 USA
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Lystad RP, Strotmeyer SJ. Concussion knowledge, attitudes and reporting intention among adult competitive Muay Thai kickboxing athletes: a cross-sectional study. Inj Epidemiol 2018; 5:25. [PMID: 29888376 PMCID: PMC5994390 DOI: 10.1186/s40621-018-0155-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Muay Thai kickboxing is a full-contact combat sport with a high incidence of head trauma, yet little is known about these athletes' concussion knowledge and attitudes. This study aims to describe and quantify concussion knowledge, attitudes, and reporting intention among adult competitive Muay Thai kickboxing athletes. RESULTS This cross-sectional study comprised 193 competitive Muay Thai kickboxing athletes aged ≥18 years registered with the Thai Boxing Association Sanctioning Authority. The mean concussion knowledge score was 19.5 (SD 2.3) out of 25, the mean concussion attitudes score was 62.7 (SD 7.4) out of 75, and 134 (69.4%) of respondents indicated that they were likely to report concussion symptoms. No significant predictors of concussion knowledge, attitudes, or reporting intention were revealed. CONCLUSIONS Competitive Muay Thai kickboxing athletes appear to have reasonably good concussion knowledge, attitudes, and reporting intention; however, there is still room for further improvement. It is recommended that concussion education programs based on current best evidence are made available to all kickboxing athletes and coaches.
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Affiliation(s)
- Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road NSW, Sydney, 2109, Australia.
| | - Stephen J Strotmeyer
- Division of General Surgery and Trauma, Department of Surgery, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
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Waltzman D, Daugherty J. Concussion knowledge and experience among a sample of American adults. JOURNAL OF CONCUSSION 2018; 2:1-11. [PMID: 30370060 PMCID: PMC6198821 DOI: 10.1177/2059700218769218] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Recently, there has been a strong emphasis on educating athletes, parents, coaches, and health care providers about concussions. However, not much is known about whether these efforts are affecting the general public’s level of concussion knowledge. Purpose: To determine what is currently known among the public about concussions and where education campaigns may be targeted in order to fill in the gaps. Methods: In order to achieve the project’s objective, CDC analyzed self-reported data from Porter Novelli’s 2017 SummerStyles survey, an annual survey of American adults aged 18 and older across the United States. The questions focused on personal concussion experiences, basic concussion knowledge, knowledge of prevention strategies, and perceived best sources of information about concussion. Results: Analysis of the data showed that approximately 18% of respondents reported that they had personally experienced a concussion in their lifetime, and about two-thirds of these respondents were evaluated by a health care provider after their injury. In terms of concussion knowledge, the majority were aware of common causes of concussion. While 94% knew that headache was a symptom of concussion, just over half were aware that sleep problems were as well. Most respondents (>78%) correctly identified that wearing seat-belts, preventing falls, and reducing participation in contact sports were ways to prevent a concussion, while installing baby-gates across stairs was less frequently known (65.5%) as a prevention technique. Nearly all of the respondents believed that a doctor or other health professional was a good source of information about concussions. These results varied by age, sex, race/ethnicity, and education. Conclusion: The results demonstrate that even though the public has a relatively high knowledge level of concussion, targeted education is needed to teach American adults about the symptoms and ways of getting a concussion.
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Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Daugherty J, Miles I, Sarmiento K, Sansone C, Kroshus E, Bethea B. A Description and Evaluation of the Concussion Education Application HEADS UP Rocket Blades. Health Promot Pract 2018; 20:22-30. [PMID: 29597872 DOI: 10.1177/1524839918764670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Concussions are responsible for numerous emergency department visits and hospitalizations among children annually. However, there remains a great deal of confusion about how to prevent and manage concussions in youth. To teach children aged 6 to 8 years about concussion safety, the Centers for Disease Control and Prevention (CDC) created a mobile gaming application called HEADS UP Rocket Blades. This report introduces the game and presents findings on its evaluation. METHODS The aim of the game is to teach children what a concussion is, its commons signs and symptoms, how to prevent one, and what to do if one occurs. An early version of the game went through two rounds of usability testing with children and parents to obtain initial impressions and make improvements. RESULTS The first round of usability testing focused on the mechanics of the game. Based on feedback from this session, CDC and the developers simplified the messaging and adjusted the game's level of difficulty. The second round focused on the gaming experience. The children indicated that they enjoyed playing, and nearly all were able to relay at least one learning objective. CONCLUSIONS Parents and children rated Rocket Blades as a good learning tool and indicated that they would download it for personal use.
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Affiliation(s)
- Jill Daugherty
- 1 Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Isa Miles
- 2 Banyan Communications, Atlanta, GA, USA
| | - Kelly Sarmiento
- 1 Centers for Disease Control and Prevention, Atlanta, GA, USA
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Knowledge, Attitudes and Concussion Information Sources Among First Nations in Ontario. Can J Neurol Sci 2018; 45:283-289. [PMID: 29552994 DOI: 10.1017/cjn.2017.299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Hockey is a popular sport played by many First Nation youth. Concussion frequently goes unrecognized and unreported in youth hockey. Unintentional injuries among Indigenous youth occur at rates three to four times the national Canadian average. The study sought to examine knowledge, attitudes and sources of concussion information among First Nations people attending a provincial hockey tournament. METHODS A cross-sectional survey was undertaken. The survey by Mzazik et al. were modified to use in this study. Participants included youth (6-18 years) hockey players (n=75), parents (n=248) and coaches (n=68). The main outcome measure was total knowledge index (TKI) which consisted of the sum of correct responses to 15 multiple choice questions. Additional data gathered included demographics, concussion history, attitudes toward concussion and sources of information. Descriptive statistics included proportion comparisons. Variables were tested using χ 2 and analysis of variance. RESULTS Overall TKI scores (out of a total of 15) were low; players (5.9±2.8), parents (7.5±2.6) and coaches (7.9±2.6). Participants with higher knowledge scores reported more appreciation of the seriousness of concussion. Sources of information about concussion differed by study group, suggesting the need for multiple knowledge translation strategies to reach youth, parents and coaches. CONCLUSIONS Future initiatives are urgently needed to improve education and prevention of concussion in First Nations youth hockey. Collaborating and engaging with communities can help to ensure an Indigenous lens for culturally safe interventions.
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Rieger B, Lewandowski L, Potts H, Potter K, Chin LS. Parent Knowledge and Perceptions of Concussion Related to Youth Football. Cureus 2018; 10:e2268. [PMID: 29736353 PMCID: PMC5935436 DOI: 10.7759/cureus.2268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction There is increased concern about concussion in youth athletes, yet there is little research on parent knowledge of concussion. Purpose The purpose of the current study was to investigate attitudes to and knowledge of concussion among parents of youth football players. Methods We surveyed 180 parents/guardians of youth football players, ages 5-12, regarding their knowledge and beliefs concerning concussion. Results We found that the vast majority of respondents (86%) had confidence in their ability to recognize concussions. Yet, a significant number also held misconceptions about concussions, such as ‘too much sleep’ (48%) or ‘eating certain foods’ (26%) make concussion symptoms worse. Most (82%) had not heard of the Zurich guidelines, and less than half (44%) were aware that sustained mental activity could worsen symptoms. Parents were concerned about their child sustaining a concussion, but a substantial minority also reported ‘serious concern’ about their children losing playing time or their position. Discussion Results are somewhat positive in terms of parents’ general knowledge of concussions; yet, response variability and misconceptions point to a continued need for concussion education for parents. Medical professionals can play an important role in informing families about concussion symptoms, management, and recovery.
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Affiliation(s)
- Brian Rieger
- Physical Medicine and Rehabilitation, SUNY Upstate Medical University
| | | | | | - Kyle Potter
- Department of Psychology, Syracuse University
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Beno S, Ackery A, Colaco K, Boutis K. Parental Knowledge of Trampoline Safety in Children. Acad Pediatr 2018; 18:166-171. [PMID: 28414102 DOI: 10.1016/j.acap.2017.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/20/2017] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Recreational trampoline use is increasing in popularity, with a resulting increase in significant trampoline-related injuries in children. Parents are the best advocates for the safety of their children during recreational trampoline use. Our primary objective was to determine the proportion of parents who were aware of 5 key recommendations for safer recreational trampoline use in children. METHODS This was a cross-sectional survey of parents whose children presented to a tertiary care pediatric emergency department with an extremity injury. Survey questions were derived and validated using expert opinion, available literature, and pre- and pilot testing of questions on the target audience. RESULTS Of the 1415 enrolled parents, 654 (46.2%) had regular access to a trampoline and 125 (8.8%) of their children had a history of trampoline injury. A total of 116 (8.2%; 95% confidence interval, 6.8-9.6) parents were aware of all 5 key safety recommendations for home trampoline use. Specifically, the proportion of parents who reported knowledge of the requirement for active supervision, regularly inspected safety equipment, avoiding stunts, multiple jumpers, and use by children 6 years of age and older was 89.0%, 77.2%, 44.3%, 41.6%, and 18.3%, respectively. CONCLUSIONS Trampoline safety knowledge of the 5 key recommendations among parents was low, specifically with respect to recommended age, number of jumpers, and stunts. Because it is unlikely that use of recreational trampolines will decrease, a harm reduction approach that includes a public knowledge translation strategy of recommendations for safer home use of trampolines is necessary.
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Affiliation(s)
- Suzanne Beno
- Division of Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
| | - Alun Ackery
- Division of Emergency Medicine, Department of Medicine, St Michael's Hospital, University of Toronto, Ontario, Canada
| | - Keith Colaco
- Division of Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Kathy Boutis
- Division of Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada
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Kroshus E, Sonnen AJ, Chrisman SP, Rivara FP. Association between community socioeconomic characteristics and access to youth flag football. Inj Prev 2018; 25:278-282. [PMID: 29330199 DOI: 10.1136/injuryprev-2017-042677] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 12/22/2017] [Accepted: 12/27/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND The American Academy of Pediatrics has recommended that opportunities for non-tackling American football (e.g., flag football) be expanded, given concerns about the risks of brain trauma from tackle football. This study tested the hypothesis that flag football would be more accessible in communities characterised by higher socioeconomic status residents. METHODS In July 2017, the locations of community-based organisations offering youth flag and tackle football for youth between the ages of 6 and 13 in two US states (Georgia and Washington) were aggregated (n=440). Organisations were coded in terms of the availability of tackle and/or flag football teams for youth at each year of age between 6 and 13. Multivariate logistic regression analyses were used to assess the odds of a community-based football organisation offering flag football, by community socioeconomic and demographic characteristics. RESULTS In both states, communities with more educated residents were more likely to offer flag football for youth aged 6-12. For example, among 6 year-olds every 10% increase in the number of adult residents with a college education was associated with 1.51 times the odds of flag football availability (95% CI 1.22 to 1.86, P<0.001). CONCLUSION These results suggest that youth living in communities characterised by low educational attainment are less likely than other youth to have the option of a lower contact alternative to tackle football. Relying on voluntary community-level adoption of lower contact alternatives to tackle football may result in inequitable access to such sport options. This may contribute to an inequitable burden of brain trauma from youth sport.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle, Washington, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Aly J Sonnen
- University of Notre Dame, South Bend, Indiana, USA
| | - Sara Pd Chrisman
- Division of Adolescent Medicine, University of Washington, Seattle, Washington, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Frederick P Rivara
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
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Kay MC, Register-Mihalik JK, Ford CB, Williams RM, Valovich McLeod TC. Parents' and Child's Concussion History as Predictors of Parental Attitudes and Knowledge of Concussion Recognition and Response. Orthop J Sports Med 2017; 5:2325967117742370. [PMID: 29242807 PMCID: PMC5724649 DOI: 10.1177/2325967117742370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Parents’ knowledge of and attitudes toward concussions are often vital factors that affect care for injured adolescent athletes. It is important to understand the role that parents’ personal experiences with concussions play with regard to current concussion knowledge and attitudes so that clinicians may tailor their educational approaches. Purpose/Hypothesis: The purpose of this study was to determine an association between parents’ personal experiences and their child’s experiences with concussions as well as parental concussion knowledge and attitudes. We hypothesized that parents who have personally experienced symptoms or have a child who has experienced symptoms would have better knowledge and more favorable attitudes toward concussions. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Parents of youth sport athletes (N = 234 [82 male, 144 female, 8 unreported]; mean age, 44.0 ± 6.3 years) completed a prevalidated survey for concussion knowledge (maximum score possible, 29) and attitudes (maximum score possible, 49). Higher scores indicated better knowledge and more favorable attitudes toward concussive injuries. Parents reported the frequency of concussion diagnoses and/or experiences of concussion-related symptoms and whether their child had suffered a diagnosed concussion or experienced concussion symptoms (yes/no). Spearman rank correlation and multivariable regression were used to examine the association between experience of symptom clusters (self or child) and concussion knowledge and attitudes. Results: Knowledge was moderate (mean, 23.3 ± 2.5 of 29), while attitudes prioritized disclosure (mean, 46.3 ± 3.7 of 49). Parents’ experience of the sleep-arousal symptom cluster was positively associated with concussion attitudes (r = 0.22, P = .002; β = –3.301, P = .011). Parents with children who experienced sleep-arousal and vestibular-somatic symptom clusters were weakly associated with parental concussion knowledge (sleep-arousal: r = 0.15, P = .041; vestibular-somatic: r = 0.17, P = .020; β = 0.540, P = .012). Conclusion: Our findings suggest that parents’ personal experiences with concussion-related symptoms have little effect on parental knowledge and attitudes as a whole. However, clinicians should consider particular symptom clusters that may provide insight into targets for future concussion education. According to these findings, parents of youth sport participants would benefit from increased concussion education focusing on the types of symptoms as well as the consequences of suffering a concussion.
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Affiliation(s)
- Melissa C Kay
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Cassie B Ford
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Griffin SA, Ranson C, Moore I, Mathema P. Concussion knowledge and experience among Welsh amateur rugby union coaches and referees. BMJ Open Sport Exerc Med 2017; 3:e000174. [PMID: 29259806 PMCID: PMC5731226 DOI: 10.1136/bmjsem-2016-000174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 11/08/2022] Open
Abstract
Background Rugby union is a collision sport where participants are at high risk of sustaining a concussion. In settings where there is little qualified medical supervision, certain stakeholders (eg, coaches and officials) should possess sufficient knowledge in regard to the recognition and management of concussion. Aim The aim of this study was to assess the knowledge and experience of various aspects of concussion among coaches and referees involved in Welsh amateur rugby union. Methods A questionnaire was distributed to 1843 coaches and 420 referees. Results A total of 333 coaches and 283 referees completed the questionnaire (18% and 68% response rates, respectively). Participants exhibited greater knowledge of concussion symptom recognition relative to knowledge of both the consequences of concussion and associated return-to-play protocols, both of which could be considered poor. There were no differences in knowledge levels between coaches and referees or between participants with or without a history of concussion. Two-thirds of participants incorrectly believed that headgear could prevent concussion, and nearly 30% of coaches reported having witnessed other coaches allowing a potentially concussed player to continue playing. Conclusions Identification of several misconceptions indicates that concussion management within Welsh amateur rugby union needs to be improved, warranting a multi-faceted educational intervention.
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Affiliation(s)
| | - Craig Ranson
- Sports injury Research Group, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Isabel Moore
- Sports injury Research Group, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
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Kroshus E, Gillard D, Haarbauer-Krupa J, Goldman RE, Bickham DS. Talking with young children about concussions: an exploratory study. Child Care Health Dev 2017; 43:758-767. [PMID: 28019016 PMCID: PMC6029694 DOI: 10.1111/cch.12433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 11/12/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Concussion education for children early in their participation in organized sport may help shape lasting attitudes about concussion safety. However, existing programming and research focus on older ages. METHODS Qualitative interviews about concussions were conducted with twenty children between the ages of six and eight. Structural, descriptive and pattern coding were used to organize the transcribed interviews and identify emergent themes. RESULTS Eighteen of the participants indicated that they had heard of the word concussion, with 12 describing the injury as related to the brain or head. The most frequently described mechanisms of injury were impacts to the head or falls, and symptoms tended to be somatic, such as generalized pain. The most frequently endorsed strategy to avoid sustaining a concussion was to 'follow the rules.' Multiple participants referenced parents as an informal source of information about concussions. CONCLUSIONS While most participants demonstrated some awareness about concussions, there were clear knowledge gaps that can be addressed with developmentally appropriate concussion education programming. Consistent with their developmental stage, interventions targeted at children in this age range may be most successful if they use basic logic, concrete ideas, provide rules to be followed and engage parents in dissemination.
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Affiliation(s)
- E. Kroshus
- University of Washington, Department of Pediatrics, Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Seattle, WA, USA
| | - D. Gillard
- Medical Student, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - J. Haarbauer-Krupa
- Health Scientist, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - R. E. Goldman
- Alpert Medical School of Brown University, Department of Family Medicine, Brown University Center for Primary Care and Prevention, Pawtucket, RI, USA
| | - D. S. Bickham
- Research Scientist, Boston Children’s Hospital, Center for Media and Child Health, Boston, MA, USA
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Speirs JN, Lyons MI, Johansson BE. Emergency Medical Service Personnel Recognize Pediatric Concussions. Glob Pediatr Health 2017; 4:2333794X17719187. [PMID: 28812053 PMCID: PMC5528916 DOI: 10.1177/2333794x17719187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 05/30/2017] [Indexed: 11/15/2022] Open
Abstract
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed. This first of its kind pilot study was designed to assess EMS personnel’s ability to recognize and triage pediatric concussions. Our findings show EMS providers are statistically identical in their ability to recognize and triage concussions to physicians. The performance of our MD participants was lower than expected. Larger studies are needed to further investigate EMS providers’ ability to recognize a concussion.
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Affiliation(s)
- Joshua N. Speirs
- Texas Tech University Health Sciences Center, El Paso, TX, USA
- Joshua Speirs, Department of Orthopaedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 213, Loma Linda, CA 92354, USA.
| | | | - Bert E. Johansson
- Texas Tech University Health Sciences Center, El Paso, TX, USA
- El Paso Children’s Hospital El Paso, TX, USA
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Register-Mihalik J, Baugh C, Kroshus E, Y Kerr Z, Valovich McLeod TC. A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework. J Athl Train 2017; 52:195-205. [PMID: 28387550 DOI: 10.4085/1062-6050-51.12.02] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To offer an overview of sport-related concussion (SRC) prevention and education strategies in the context of the socioecological framework (SEF). Athletic trainers (ATs) will understand the many factors that interact to influence SRC prevention and the implications of these interactions for effective SRC education. BACKGROUND Concussion is a complex injury that is challenging to identify and manage, particularly when athletes fail to disclose symptoms to their health care providers. Education is 1 strategy for increasing disclosure. However, limited information addresses how ATs can integrate the many factors that may influence the effectiveness of SRC education into their specific settings. Public health models provide an example through the SEF, which highlights the interplay among various levels of society and sport that can facilitate SRC prevention strategies, including education. DESCRIPTION For ATs to develop appropriate SRC prevention strategies, a framework for application is needed. A growing body of information concerning SRC prevention indicates that knowledge alone is insufficient to change concussion-related behaviors. The SEF allows this information to be considered at levels such as policy and societal, community, interpersonal (relationships), and intrapersonal (athlete). The use of such a framework will facilitate more comprehensive SRC prevention efforts that can be applied in all athletic training practice settings. Clinical Applications: Athletic trainers can use this information as they plan SRC prevention strategies in their specific settings. This approach will aid in addressing the layers of complexity that exist when developing a concussion-management policy and plan.
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Turner RW, Lucas JW, Margolis LH, Corwell BN. A preliminary study of youth sport concussions: Parents' health literacy and knowledge of return-to-play protocol criteria. Brain Inj 2017; 31:1124-1130. [PMID: 28506094 DOI: 10.1080/02699052.2017.1298003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE To preliminarily explore parents' health literacy and knowledge of youth sport league rules involving concussion education and training, and return-to-play protocols. RESEARCH DESIGN AND METHODS This study was guided by the Knowledge, Attitude and Practice (KAP) model of health knowledge to examine parents' concussion literacy, and understanding of concussion education and training, and return-to-play protocols in youth sports. The mixed-method design involved 119 participants; that included in-person (n=8) and telephone (n=4) interviews, and web-based surveys administered through Mechanical Turk via Qualtrics (n=98). MAIN OUTCOMES AND RESULTS Most respondents were not familiar with concussion protocols, but trusted coaches' knowledge in return-to-play rules. More than half of the respondents report that the return-to-play concussion criteria have not been clearly explained to them. The majority of respondents were not familiar with the CDC's 'Heads Up' online concussion training programme, nor were they familiar with any other educational/training tool. About one-fifth of the parents had conversations with a coach or medical staff about youth sport concussions. CONCLUSION Parents have a general understanding of how to identify concussion symptoms, but lack knowledge of immediate steps to take following an incident other than seeking medical help.
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Affiliation(s)
- Robert W Turner
- a Center on Biobehavioral Health Disparities Research , Social Science Research Institute, Duke University , Durham , NC , USA
| | - Jeffery W Lucas
- b Department of Sociology , University of Maryland , College Park , MD , USA
| | - Lewis H Margolis
- c Department of Maternal and Child Health, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA
| | - Brian N Corwell
- d Emergency Medicine , University of Maryland School of Medicine , Baltimore , MD , USA
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Kroshus E, Kerr ZY, Lee JGL. Community-Level Inequalities in Concussion Education of Youth Football Coaches. Am J Prev Med 2017; 52:476-482. [PMID: 28209280 DOI: 10.1016/j.amepre.2016.12.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/30/2016] [Accepted: 12/15/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION USA Football has made the Heads Up Football (HUF) concussion education program available for coaches of youth football players. Existing evidence about the effectiveness of the HUF coach education program is equivocal. For HUF and other programs, there is growing concern that even effective interventions can increase inequalities if there is different uptake or impact by SES or other demographic factors. Understanding how adoption is patterned along these lines is important for understanding equity issues in youth football. This study tested the hypothesis that there will be lower adoption of HUF among coaches of youth football players in lower-SES communities. METHODS The authors conducted a cross-sectional study of the association between community-level characteristics and number of USA Football youth league coaches who have completed HUF. Data were collected in 2014 and analyzed in 2015-2016. RESULTS Implementation of the HUF program was patterned by community-level socioeconomic characteristics. Leagues located in communities with a higher percentage of families with children aged <18 years living below the poverty line and a smaller percentage of non-Hispanic white residents tended to have leagues with smaller percentages of HUF-certified coaches. CONCLUSIONS As interventions are developed that reduce the risks of youth football, it is important to consider not just the effectiveness of these interventions, but also whether they reduce or exacerbate health inequities. These results suggest that relying on voluntary adoption of coach education may result in inequitable implementation. Further study is required to identify and remedy organizational and contextual barriers to implementation of coach education in youth sport.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington; Harborview Injury Prevention and Research Center, Seattle, Washington.
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina
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