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Kerr ZY, Ingram BM, Livingston S, Gildner P, Register-Mihalik JK. An initial assessment of an opinion leader-informed intervention to improve concussion-related outcomes among middle school parents: a randomized controlled trial. Ann Med 2024; 56:2393760. [PMID: 39183448 PMCID: PMC11348810 DOI: 10.1080/07853890.2024.2393760] [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] [Received: 09/02/2023] [Revised: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION There is a need for evidence-based prevention programming that can reduce head impacts and increase reporting and disclosure of concussion. This study assessed an intervention to decrease concussion risk and improve concussion management through improving concussion-related knowledge, attitudes, intentions, and self-efficacy among parents in the middle school (MS) sport setting. PATIENTS AND METHODS This randomized controlled trial (NCT04841473) examined parents of MS-aged children. Participants were randomized into one of two study arms: (1) CDC, which completed an education training module that compiled concussion education from the Centers for Disease Control and Prevention (CDC); and (2) TRAIN + CDC, which completed the CDC training module and an additional TRAIN educational module that provided strategies (originating from the Popular Opinion Leader framework) on communicating such information with one's personal peer networks and children. Validated measures of concussion-related knowledge, attitudes, intentions, and self-efficacy were collected before completing the training modules and one week following completion. Linear mixed model analyses examined differences in outcomes between study arms. RESULTS Overall, 103 parents completed the training modules and had valid pre- and post-intervention data (TRAIN + CDC n = 49; CDC n = 54). Analyses found that the study arms did not differ in the change scores from pre- to post-intervention across concussion-related outcomes. However, scores from pre- to post-intervention improved across both study arms for knowledge metrics, such as 'Concussions are less likely to happen when athletes play by the rules of the sport' (p < 0.001), and self-efficacy metrics, such as feeling confident in one's knowledge and recognition of concussion symptoms (p < 0.001 and p = 0.001, respectively). CONCLUSIONS Although study arms did not differ in change scores from pre- to post-intervention, beneficial increases were nonetheless found across both knowledge and self-efficacy. Additional research is needed to further examine the beneficial manners in which concussion education can be best delivered and the most effective.
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Affiliation(s)
- Zachary Yukio Kerr
- Department of Exercise and Sport Science, Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brittany M. Ingram
- Department of Exercise and Sport Science, Matthew Gfeller Center, Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samuel Livingston
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paula Gildner
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Johna K. Register-Mihalik
- Department of Exercise and Sport Science, STAR Heel Performance Laboratory, Matthew Gfeller Center and Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Shepherd HA, Galarneau JM, Neill M, Karmali S, Turcotte K, Williamson RA, Cowle S, Macpherson A, Reed N, Schneider KJ, Belton KL, Gagnon I, Black AM, Emery CA, Babul S. Concussion Awareness Training Tool for Youth: Impact on Concussion Knowledge, Beliefs, and Reporting Intentions. HEALTH EDUCATION & BEHAVIOR 2024:10901981241263577. [PMID: 39138808 DOI: 10.1177/10901981241263577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
BACKGROUND Concussion education is recommended to increase concussion knowledge, beliefs, and reporting intentions. The Concussion Awareness Training Tool for Youth (CATT-Youth) is a 40-minute e-Learning module developed for high school-aged youth. AIM The aim of the study was to evaluate changes in concussion knowledge, beliefs, and reporting intentions in high school youth from Calgary, Canada, following completion of the CATT-Youth. METHODS This study used a modified stepped-wedge trial design. High school classes were randomly assigned to an intervention (Ix) or delayed intervention (DIx) group. Ix group participants completed a pre-CATT survey immediately followed by the CATT-Youth, then a post-CATT survey 2 to 6 weeks later. DIx group participants completed two pre-CATT surveys 2 to 6 weeks apart, with the CATT-Youth completed immediately following the second pre-CATT, then a post-CATT survey 2 to 6 weeks later. The pre-/post-CATT survey encompassed 11 subtests evaluating concussion knowledge, beliefs, and reporting intentions. Independent mixed linear regression models were conducted to examine changes in scores for each subtest. RESULTS Participants included 454 high school students: five Ix schools (16 classes, n = 323) and two DIx schools (six classes, n = 131). The CATT-Youth significantly increased general concussion knowledge, Ix δ = 0.546/8 (95% confidence interval [CI] = [0.243, 0.849]), DIx δ = 0.728/8 (95% CI = [0.389, 1.106]), and beliefs about capabilities, Ix δ = 2.462/28 (95% CI = [1.086, 3.838]), DIx δ = 3.219/28 (95% CI = [1.594, 4.844]) for both groups. For some subtests, improvements were noted in the DIx group only. CONCLUSION The CATT-Youth module improved concussion knowledge and beliefs about capabilities for students in both groups. Future studies should explore the utility of the CATT-Youth in changing knowledge, beliefs, and reporting intentions in high school students.
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Affiliation(s)
- Heather A Shepherd
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Michel Galarneau
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Matthew Neill
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Shazya Karmali
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Kate Turcotte
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Rylen A Williamson
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Nick Reed
- University of Toronto, Toronto, Ontario, Canada
| | - Kathryn J Schneider
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Amanda M Black
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A Emery
- The Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Shelina Babul
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
- The University of British Columbia, Vancouver, British Columbia, Canada
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Kelly LA, Caccese JB, Jain D, Master CL, Lempke L, Memmini AK, Buckley TA, Clugston JR, Mozel A, Eckner JT, Susmarski A, Ermer E, Cameron KL, Chrisman S, Pasquina P, Broglio SP, McAllister TW, McCrea M, Esopenko C. Sex Differences Across Concussion Characteristics in US Service Academy Cadets: A CARE Consortium Study. Sports Med 2024:10.1007/s40279-024-02068-3. [PMID: 38995598 DOI: 10.1007/s40279-024-02068-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To describe sex differences in concussion characteristics in US Service Academy cadets. DESIGN Descriptive epidemiology study. SETTING Four US service academies. PARTICIPANTS 2209 cadets (n = 867 females, n = 1342 males). INDEPENDENT VARIABLE Sex. OUTCOME MEASURES Injury proportion ratios (IPR) compared the proportion of injuries by sex (females referent) for injury situation, certainty of diagnosis, prolonged recovery, recurrent injuries, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and immediate reporting. MAIN RESULTS Concussions from varsity/intercollegiate sports [IPR of 1.73, 95% confidence interval (CI) 1.43-2.10] and intramurals (IPR of 1.53, 95% CI 1.02-2.32) accounted for a larger proportion in males, whereas concussions outside of sport and military activities accounted for a smaller proportion among males (IPR of 0.70, 95% CI 0.58-0.85). The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60-0.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09-1.38), LOC (IPR of 1.67, 95% CI 1.17-2.37), PTA (IPR of 1.94, 95% CI 1.43-2.62), and RGA (IPR of 2.14, 95% CI 1.38-3.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00-2.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes. CONCLUSIONS A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries.
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Affiliation(s)
- Louise A Kelly
- Department of Exercise Science, California Lutheran University, #3400, 60 W. Olsen Road, Thousand Oaks, CA, 91360, USA.
| | - J B Caccese
- College of Medicine School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - D Jain
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C L Master
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - L Lempke
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - A K Memmini
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - T A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - J R Clugston
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
| | - A Mozel
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - J T Eckner
- Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - A Susmarski
- Medical Associates Clinic, Loras College, Dubuque, IA, USA
| | - E Ermer
- Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - K L Cameron
- Orthopaedic and Sports Medicine, United States Military Academy, West Point, NY, 10996, USA
| | - S Chrisman
- Division of Adolescence Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, 98105, USA
| | - P Pasquina
- Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - S P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - T W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - C Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Shafik A, Bennett P, Rosenbloom C, Okholm Kryger K, Carmody S, Power J. Sport-related concussion attitudes and knowledge in elite English female footballers. SCI MED FOOTBALL 2024; 8:119-125. [PMID: 36541545 DOI: 10.1080/24733938.2022.2161613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Sport-related concussions (SRC) are more common and more severe in women's football than men's yet the knowledge and attitudes of SRC in the women's game are not well understood. The objective of this study was to assess the SRC knowledge and attitude in elite female footballers. METHODS An online questionnaire was sent to all registered players in the English Football Association Women's Super League (WSL) and Championship. Respondents completed an amended version of the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS). Concussion Knowledge Index (CKI) and Concussion Attitudes Index (CAI) scores were derived for all respondents. RESULTS One hundred and twenty-three players completed the survey with 111 fitting the inclusion criteria. The mean CKI score was 20.5 ± 2.3 and the mean CAI score was 63.3 ± 6.3. A weak positive correlation was shown between the CKI and CAI (r = 0.20; p = 0.03). Previous concussion education had a significant impact on increased knowledge (U = 1198; p = 0.04). There was no significant difference in concussion attitudes and knowledge between the WSL and Championship or in those with a previous concussion history and no previous concussion (p > 0.05). CONCLUSION Previous SRC education demonstrated an increased knowledge around concussion but a limited impact towards concussion attitudes. It is suggested that concussion education should be mandated across the professional game to enhance player welfare.
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Affiliation(s)
- Andrew Shafik
- Sport and Exercise Medicine, University of Leeds, Leeds, UK
- Millwall Football Club Medical Department, London, UK
| | - Pippa Bennett
- The Football Association, Technical Directorate, Burton-Upon-Trent, UK
| | - Craig Rosenbloom
- The Football Association, Technical Directorate, Burton-Upon-Trent, UK
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
- Tottenham Hotspur Football Club Medical Department, London, UK
| | - Katrine Okholm Kryger
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
- Health and Applied Science, St Mary's University Twickenham, London, UK
| | - Sean Carmody
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC,University of Amsterdam, Amsterdam, The Netherlands
| | - Jonathan Power
- Sport and Exercise Medicine, University of Leeds, Leeds, UK
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Almalki SF, Zakaria OM, Almousa AS, Alwadany MM. Knowledge, Attitude, and Behavior of Medical Students with Regard to Concussions: A Cross-Sectional Study. Cureus 2023; 15:e47112. [PMID: 38022325 PMCID: PMC10646687 DOI: 10.7759/cureus.47112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Concussions, categorized as mild traumatic brain injuries, result from traumatic events and present a significant concern within the field of traumatic brain injuries. Understanding the multifaceted pathophysiology of concussions, their diverse symptomatology, and their appropriate management strategies is crucial for healthcare professionals. This study explores the knowledge, attitudes, and behaviors of medical students at King Faisal University in the Eastern Province of Saudi Arabia regarding concussions. METHODS A cross-sectional study design was employed to assess a diverse group of medical students at King Faisal University in the Eastern Province of Saudi Arabia. Participants were surveyed using a questionnaire covering socio-demographic information, knowledge assessment, attitude assessment, and behavior assessment. RESULTS Of the 315 participants, 68.3% demonstrated good knowledge about concussions. Participants generally recognized concussions as a type of traumatic brain injury (68.9%) and believed it was necessary to report concussion symptoms to a doctor (80.3%). However, certain misconceptions existed, such as the belief that all patients with concussion should rest for seven days (31.7%). Participants primarily obtained information from teachers (100%) and the internet and social media (81.6%). CONCLUSION While medical students at King Faisal University in the Eastern Province of Saudi Arabia generally exhibited good knowledge about concussions, specific knowledge gaps and misconceptions were seen to exist. To ensure comprehensive understanding and promote appropriate management, continuous education, and awareness campaigns are essential, with healthcare providers playing a pivotal role in knowledge dissemination.
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6
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Musko PA, Demetriades AK. Are Sex Differences in Collegiate and High School Sports-Related Concussion Reflected in the Guidelines? A Scoping Review. Brain Sci 2023; 13:1310. [PMID: 37759911 PMCID: PMC10526868 DOI: 10.3390/brainsci13091310] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Background: Sport-related concussion (SRC) is a common sport injury. Females are participating in sports at increasing rates, and there is growing awareness that female athletes may be more vulnerable to SRC. Objectives: We aimed to identify sex differences in epidemiology, clinical manifestation and assessment of SRC and examine how these relate to the 6th International Conference on Concussion in Sport (ICCS). Methods: We conducted a scoping review of the Medline database and identified 58 studies examining the effects of sex on SRC in collegiate and high school athletes that were written in English and published in a peer-reviewed journal between March 2012 and March 2022. Results: We found that female athletes suffer higher rates of concussion in sex-comparable sports, in particular soccer. Female athletes experience more somatic symptoms-headache/migraine/sleep disturbance-and may take longer to recover from concussion. Sex differences were also identified regarding some aspects of sideline concussion assessment with the Sport Concussion Assessment Tool. Conclusions: Females are at greater risk and experience SRC differently than males; this is mostly likely due to a combination of biomechanical factors, differences in neck musculature and hormonal and social factors. Sex differences are not widely addressed by the 6th ICSS, which informs many sports' concussion protocols.
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Affiliation(s)
- Patryk A. Musko
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH16 4SB, UK;
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7
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Heck SJ, Acord-Vira A, Davis DR. Sex differences in college students' knowledge of concussion and concussion education sources. Concussion 2023; 8:CNC108. [PMID: 37691852 PMCID: PMC10488458 DOI: 10.2217/cnc-2023-0001] [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: 02/05/2023] [Accepted: 04/21/2023] [Indexed: 09/12/2023] Open
Abstract
Aim To understand sex differences and sources of concussion education for college students. The literature for college students primarily focuses on sports concussions and general knowledge. Understanding how non-students-athletes learn is critical to developing interventions to improve concussion knowledge. Participants A random sample of 208 students from four-year institutions. Methods A 22-question online survey explored postsecondary students' current knowledge and education regarding concussions. Results Findings indicated that sex differences emerged with concussion knowledge and sources of concussion knowledge (e.g., leaflets, pamphlets, parents, and television). The top choices for where they wanted to learn about concussions were health educators, health centers, and campus peer educators. Conclusion This study provides an initial evaluation and implications for future research on providing concussion education.
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Affiliation(s)
- Stephen J Heck
- Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Amanda Acord-Vira
- Division of Occupational Therapy, West Virginia University, Morgantown, WV 26506, USA
| | - Diana R Davis
- Division of Occupational Therapy, West Virginia University, Morgantown, WV 26506, USA
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Ryan L, Daly E, Blackett AD. Sport-related concussion disclosure in women's rugby-A social identity approach. Front Sports Act Living 2023; 5:1058305. [PMID: 37090816 PMCID: PMC10114594 DOI: 10.3389/fspor.2023.1058305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/15/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Sport-related concussion (SRC) is a risk of collision sports such as women's rugby. To support appropriate SRC diagnosis and management, an understanding of the factors that encourage SRC disclosure is necessary. To date, research has focused on ascertaining individual player knowledge and attitudes towards SRC disclosure. Methods We chose to investigate the potential influence of group identification effects by examining the role of social identity on SRC disclosure in elite women's rugby. Seventeen elite players from the United Kingdom and Ireland were interviewed and their transcripts thematically analysed. Results The data highlighted that the players shared a very strong social identity as women in rugby and were acutely aware that their experiences were different to their male counterparts. The shared social identity had both positive and negative implications for SRC disclosure. The players interviewed did not feel comfortable disclosing their symptoms to their coach and often felt that medical staff either did not listen to them or were unavailable to them. Mediators such as communication, trust in medical teams, perceived pressure, positive injury management experience, and player role models were identified. Discussion This research could be utilised to inform sport psychology interventions to enhance SRC disclosure in elite women's rugby.
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Affiliation(s)
- Lisa Ryan
- Department of Sport, Exercise and Nutrition, Atlantic Technological University, Galway, Ireland
- Correspondence: Lisa Ryan
| | - Ed Daly
- Department of Sport, Exercise and Nutrition, Atlantic Technological University, Galway, Ireland
| | - Alexander D. Blackett
- Department of Sport and Exercise, School of Health Science & Wellbeing, Staffordshire University, Stoke-on-Trent, United Kingdom
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Germann D, Cancelliere C, Kazemi M, Marshall C, Hogg-Johnson S. Characteristics of adolescent athletes seeking early versus late care for sport-related concussion. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2021; 65:260-274. [PMID: 35197643 PMCID: PMC8791547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES 1) To determine which characteristics of adolescent athletes with SRC are associated with 'early' versus 'late' presentation for multimodal treatment; 2) to build a propensity score to investigate the effects of treatment timing during the management of SRCs. METHODS Associations between early (0-7 days) versus late (8-28 days) presentation for treatment and pre-specified sociodemographic, pre-injury and injury characteristics were investigated in a historical cohort study of 2949 multi-sport athletes across Canada aged 12-18 years diagnosed with a SRC in community-based healthcare clinics. RESULTS Early presentation was associated with being male, completing a pre-injury baseline assessment, and responding 'yes' or 'no' to having a diagnosed learning disability. Older athletes who reported previous SRCs were less likely to present early. The propensity score demonstrated an area under the curve of 0.71 (95% CI, 0.69 to 0.73). CONCLUSIONS Male athletes with a completed baseline assessment were more likely to seek early treatment following a SRC, and older athletes who reported a greater number of previous SRCs were less likely to present early. External validation of the propensity score is needed before examining the impact of treatment timing on adolescent athlete recovery outcomes.
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Affiliation(s)
- Darrin Germann
- Department of Graduate Studies, Canadian Memorial Chiropractic College
| | - Carol Cancelliere
- Faculty of Health Sciences, Ontario Tech University
- Institute for Disability and Rehabilitation Research, Ontario Tech University and Canadian Memorial Chiropractic College
| | - Mohsen Kazemi
- Department of Graduate Studies, Canadian Memorial Chiropractic College
| | | | - Sheilah Hogg-Johnson
- Faculty of Health Sciences, Ontario Tech University
- Institute for Disability and Rehabilitation Research, Ontario Tech University and Canadian Memorial Chiropractic College
- Department of Research and Innovation, Canadian Memorial Chiropractic College
- Dalla Lana School of Public Health, University of Toronto
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10
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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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11
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Biegon A. Considering Biological Sex in Traumatic Brain Injury. Front Neurol 2021; 12:576366. [PMID: 33643182 PMCID: PMC7902907 DOI: 10.3389/fneur.2021.576366] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/08/2021] [Indexed: 11/23/2022] Open
Abstract
Published epidemiological studies of traumatic brain injury (TBI) of all severities consistently report higher incidence in men. Recent increases in the participation of women in sports and active military service as well as increasing awareness of the very large number of women who sustain but do not report TBI as a result of intimate partner violence (IPV) suggest that the number of women with TBI is significantly larger than previously believed. Women are also grossly under-represented in clinical and natural history studies of TBI, most of which include relatively small numbers of women, ignore the role of sex- and age-related gonadal hormone levels, and report conflicting results. The emerging picture from recent studies powered to detect effects of biological sex as well as age (as a surrogate of hormonal status) suggest young (i.e., premenopausal) women are more likely to die from TBI relative to men of the same age group, but this is reversed in the 6th and 7th decades of life, coinciding with postmenopausal status in women. New data from concussion studies in young male and female athletes extend this finding to mild TBI, since female athletes who sustained mild TBI are significantly more likely to report more symptoms than males. Studies including information on gonadal hormone status at the time of injury are still too scarce and small to draw reliable conclusions, so there is an urgent need to include biological sex and gonadal hormone status in the design and analysis of future studies of TBI.
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Affiliation(s)
- Anat Biegon
- Department of Radiology and Neurology, Stony Brook University School of Medicine, Stony Brook, NY, United States
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12
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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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O’Connor S, Moran K, Burke C, Whyte E. Sports-Related Concussion in Adolescent Gaelic Games Players. Sports Health 2019; 11:498-506. [PMID: 31592720 PMCID: PMC6822212 DOI: 10.1177/1941738119875978] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Gaelic games are some of the most popular sports played by Irish adolescents, and the Gaelic Athletic Association has undertaken educational initiatives to improve awareness of a sports-related concussion (SRC). However, SRC underreporting is common among adolescent athletes internationally, potentially due to poor knowledge or attitudes toward SRC. This study aimed to examine previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future education in adolescent Gaelic games players and their parents. HYPOTHESES The hypotheses were as follows: (1) A significant number of adolescent Gaelic games players will have experienced an SRC, (2) nondisclosure of SRCs will be common, and (3) adolescents will display poorer attitudes toward reporting than parents. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Adolescent male and female Gaelic games players (n = 113) and parents (n = 151) completed an anonymous questionnaire examining previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future SRC education initiatives. RESULTS Overall, 57.5% of adolescent Gaelic games players suspected they had suffered an SRC previously, and a greater number of suspected SRCs were reported than were medically diagnosed. Adolescent players (mean score, 11.4/14) and their parents (mean score, 11.8) displayed good knowledge of SRC signs and symptoms. However, adolescents were less likely to report an SRC during an important game or if an important game was coming up. Both adolescents and their parents would like more SRC education, particularly in the format of online videos or medical professional-led workshops. CONCLUSION Underreporting of SRC occurs in adolescent players, despite good knowledge of SRC signs and symptoms. Education is required to highlight the importance of completing a return-to-play program after an SRC regardless of match importance. CLINICAL RELEVANCE A multifaceted educational strategy that targets the wider Gaelic games community in the preferred formats identified by key stakeholders is required.
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Affiliation(s)
- Siobhán O’Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Kieran Moran
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Cian Burke
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Enda Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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