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Knowles P, Schneider K, Bugwadia AK, Sorcar P, Pea RD, Daneshvar DH, Baugh CM. The importance of language in describing concussions: A qualitative analysis. PM R 2024. [PMID: 39189352 DOI: 10.1002/pmrj.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 06/02/2024] [Accepted: 06/20/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Concussions are mild traumatic brain injuries that are often undiagnosed due to difficulties in identifying symptoms. To minimize the negative sequelae associated with undiagnosed concussion, efforts have targeted improving concussion reporting. However, knowing more about concussions does not indicate how likely an athlete is to report their concussion. Alternatively, the attitudes and beliefs of athletes and surrounding stakeholders have shown to be a better indication of whether an athlete intends to report their concussion. Prior research has shown that athletes report concussions less often when the injury is described using language that minimizes their severity, such as when it is referred to as a "ding." This study evaluated whether describing concussions using the word "brain" was associated with individuals' underlying attitudes and beliefs about the injury's severity. OBJECTIVE To measure the relationship between perceived concussion severity and the language used to describe concussions, specifically whether participants used the word "brain" in describing the injury. METHODS One-on-one semi-structured telephone interviews were conducted, and a cross sectional secondary qualitative analysis was performed to assess participants' perceived concussion severity and their use of the word "brain" to describe concussions. DESIGN Cross-sectional secondary qualitative analysis. SETTING One-on-one semistructured telephone interviews. PARTICIPANTS In 2017, 94 individuals involved in high school sports, including athletes, coaches, educators, parents of athletes, and athletic directors were recruited via convenience sampling. MAIN OUTCOME MEASURES Respondents' perceived severity of concussions. RESULTS Individuals who used a brain phrase to describe concussion also perceived concussions as more severe (p < .001). Specifically, those who described concussions with maximum severity had higher odds of using brain phrases than those who described concussions as having minimum (odds ratio [OR] = 0.05, 95% confidence interval [CI] = 0.002-0.299, p < .001) or moderate severity (OR = 0.24, 95% CI = 0.086-0.647, p = .003), with the most significant relationship found among coaches. CONCLUSIONS These findings demonstrate the relationship between medical terminology and perceived severity of concussions. This relationship may play a role in concussion reporting behavior for coaches, athletes, and parents. Education programs using similar medical terminology may promote concussion reporting behaviors.
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Affiliation(s)
- Peter Knowles
- Department of Psychology, Stanford University, Stanford, California, USA
- TeachAids, Institute for Brain Research and Innovation, Palo Alto, California, USA
| | - Katherine Schneider
- TeachAids, Institute for Brain Research and Innovation, Palo Alto, California, USA
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Amy K Bugwadia
- TeachAids, Institute for Brain Research and Innovation, Palo Alto, California, USA
- Stanford University School of Medicine, Stanford, California, USA
| | - Piya Sorcar
- TeachAids, Institute for Brain Research and Innovation, Palo Alto, California, USA
- Stanford University School of Medicine, Stanford, California, USA
- Stanford Center for Innovation in Global Health, Stanford University, Stanford, California, USA
- Stanford University Graduate School of Education, Stanford University, Stanford, California, USA
| | - Roy D Pea
- TeachAids, Institute for Brain Research and Innovation, Palo Alto, California, USA
- Stanford University Graduate School of Education, Stanford University, Stanford, California, USA
| | - Daniel H Daneshvar
- TeachAids, Institute for Brain Research and Innovation, Palo Alto, California, USA
- Spaulding Rehabilitation Network, Division of Brain Injury Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Rehabilitation Outcomes Center at Spaulding, Spaulding Rehabilitation Network, Boston, Massachusetts, USA
| | - Christine M Baugh
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Drattell JD, Kroshus E, Register-Mihalik JK, D’Lauro C, Schmidt JD. Improving Concussion Education: Do Athletic Trainers' Opinions Match Expert Consensus? J Athl Train 2024; 59:801-808. [PMID: 38243731 PMCID: PMC11340673 DOI: 10.4085/1062-6050-0486.23] [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: 01/21/2024]
Abstract
CONTEXT The National Collegiate Athletic Association and Department of Defense (NCAA-DoD) Mind Matters Challenge created "useful and feasible" consensus recommendations to improve concussion care-seeking behavior in collegiate athletes and military cadets. Given athletic trainers' (ATs') role as providers of concussion education and medical care, it is important to understand if they agree with the expert panel that the recommendations are useful and feasible. OBJECTIVE To describe and compare the perceptions of ATs in the secondary school (SS) and collegiate settings of the utility and feasibility of the NCAA-DoD Mind Matters Challenge recommendations on improving concussion education. DESIGN Cross-sectional study. SETTING Electronic survey. PATIENTS OR OTHER PARTICIPANTS Five hundred fifteen (515) ATs (age = 40.7 ± 12.4 years, 53.1% female gender) practicing in the SS (60.6%) or collegiate (38.4%) setting. MAIN OUTCOME MEASURE(S) An online survey asked participants about their awareness of the statement followed by 17 pairs of Likert-item questions regarding each recommendation's utility and feasibility with responses ranging from no (1) to yes (9). Mimicking the consensus process, we defined consensus as a mean rating of ≥7.00. We compared utility and feasibility rating responses between SS and collegiate setting participants using Mann-Whitney U tests with α = .05. RESULTS Two-thirds (66.6%) of participants were unaware of the consensus statement. Participants felt all recommendations were useful (all means ≥ 7.0); however, 4 recommendations related to collaborating with stakeholders did not meet the feasibility cutoff (mean range = 6.66-6.84). Secondary school ATs rated lower feasibility related to educational content (P value range = .001-.014), providing patient education throughout recovery (P = .002), and promoting peer intervention (P = .019) but higher utility (P = .007) and feasibility (P = .002) for providing parent education than collegiate ATs. CONCLUSIONS The NCAA-DoD Mind Matters Challenge recommendations require further dissemination. Athletic trainers rated collaboration with stakeholders as a feasibility barrier. Secondary school ATs require more resources for educational content, messaging, and promoting peer intervention but find educating athletes' parents more useful and feasible than collegiate ATs.
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Affiliation(s)
- Julia D. Drattell
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle
| | | | - Christopher D’Lauro
- Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs
| | - Julianne D. Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
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Olanrewaju O, Rashid H, Dobbin N. A cross-sectional study examining Nigerian footballers' knowledge and attitudes towards sport-related concussion and associated contextual factors. BRAIN IMPAIR 2023; 24:424-440. [PMID: 38167186 DOI: 10.1017/brimp.2022.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To examine Nigerian footballers' knowledge and attitudes towards sport-related concussion (SRC) and associated contextual factors. METHODS A cross-sectional study design was used with an online questionnaire distributed to Nigerian footballers affiliated with a registered team. The questionnaire included demographic information and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS-ST). The concussion knowledge index (CKI, 0-25) and attitude index (CAI, 15-75) were calculated. The association between various contextual factors with "high" knowledge and attitude were determined. RESULTS A total of 331 participants completed the questionnaire from 10 football clubs. Mean CKI and CAI scores were 14.0 ± 3.0 (56.2 ± 13.2%) and 54.5 ± 9.4 (72.6 ± 12.5%), respectively, and the association between scores was considered large (r = 0.530; 28%). A small proportion (n = 25; 7.6%) of participants reported a previous diagnosis of an SRC, with a further 40 (12.1%) suspecting they have suffered SRC. Thirty-five participants (10.6%) reported sustaining a SRC but did not seek medical help. Results indicated that men were at 4.8 times greater odds of having a "high[er]" CKI than women, and that those with 5-10 years playing experience had lower odds of a "high" CKI than those with >10 years' experience. Men had 7 times greater odds of having a "high" CAI than women. CONCLUSION The results of this study suggest that Nigerian footballers have a moderate level of SRC knowledge, satisfactory symptom recognition, and high SRC attitudes. Those working with Nigerian football may consider these findings when seeking strategies to improve concussion knowledge, potentially by improving attitudes and considering sex and playing experience.
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Affiliation(s)
- Oluwaseyi Olanrewaju
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Haroon Rashid
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
- Department of Emergency Medicine, Manchester Royal Infirmary, Manchester, UK
| | - Nick Dobbin
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Jacobi J, Wasserman EB, D Mack C, Heinzelmann M, Cárdenas J, Rehberg R, Solomon G, Sills A, Vargas B. The National Football League Concussion Protocol: A Review. HSS J 2023; 19:269-276. [PMID: 37435134 PMCID: PMC10331260 DOI: 10.1177/15563316231177207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/30/2023] [Indexed: 07/13/2023]
Abstract
Sport-related concussion remains an area of high concern for contact sport athletes and their families, as well as for the medical and scientific communities. The National Football League (NFL), along with the NFL Players Association and experts in the field, has developed protocols for the detection and management of sport-related concussions. This article reviews the NFL's most recent concussion protocol including preseason education and baseline testing for players, concussion surveillance by gameday medical teams and neurotrauma consultants and athletic trainers, gameday concussion protocol and procedures, and return to participation guidelines.
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Affiliation(s)
| | | | | | | | - Javier Cárdenas
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Robb Rehberg
- William Paterson University, Wayne, NJ, USA
- Player Health & Safety Department, National Football League, New York, NY, USA
| | - Gary Solomon
- Player Health & Safety Department, National Football League, New York, NY, USA
| | - Allen Sills
- Player Health & Safety Department, National Football League, New York, NY, USA
| | - Bert Vargas
- Global Medical Response, Indianapolis, IN, USA
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Li Y, Tang J, Zhang X, Cao D, Lyu T. Investigation of concussion knowledge and attitudes of Chinese amateur adolescent soccer athletes. Medicine (Baltimore) 2023; 102:e33972. [PMID: 37335627 DOI: 10.1097/md.0000000000033972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Concussions are a common traumatic brain injury in soccer games but are often ignored by coaches and athletes. The purpose of our study is to assess the concussion knowledge and attitudes among amateur adolescent soccer athletes in China. Data was collected from questionnaire surveying (Rosenbaum Concussion Knowledge and Attitudes Survey (Student Version)) and semi-structured interviews completed by 69 amateur adolescent soccer athletes who participated in the U17 and U15 male groups of the 2022 China Youth Soccer League. The study followed a mixed methodology cross sectional study design. The concussion knowledge index (0-25) and concussion attitude index (15-75) scores were derived from the questionnaire and descriptive statistics were used for data analysis. The mean score of concussion knowledge is 16.8 ± 2.4 (range 10-22), and the mean score of concussion attitude is 61.3 ± 8.8 (range 45-77). Thematic analysis was used to categorize the participant's responses of the semi-structured interview and the results were compared with their survey answers of questionnaire. Interestingly, the interviews revealed the inconsistencies between the questionnaire responses and intended behaviors, and multiple factors (injury severity, the importance of the game and substitution rules) influencing concussion-reporting behaviors were identified. In addition, athletes hope to acquire concussion knowledge through formal education. Our study lay the foundation for educational interventions to potentially improve concussion-reporting behaviors among amateur adolescent soccer athletes.
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Affiliation(s)
- Yue Li
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Jiaxing Tang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Xiaomin Zhang
- School of Electronic and Information Engineering, Huaibei Institute of Technology, Huaibei, China
| | - Dawei Cao
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Teng Lyu
- Graduate School, University of Perpetual Help System Dalta, Manila, Philippines
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Mallory KD, Saly L, Hickling A, Colquhoun H, Kroshus E, Reed N. Concussion Education in the School Setting: A Scoping Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:605-618. [PMID: 35259774 PMCID: PMC9311225 DOI: 10.1111/josh.13156] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Concussions are a prevalent injury among youth, and concussion education has the potential to promote positive concussion-related behaviors. Recent recommendations and legislation have increased concussion education provided in schools; however, little is known about the education context, delivery method, development, and evaluation. A scoping review was conducted to identify peer-reviewed literature on concussion education delivered in the school setting. METHODS Six databases were searched (MEDLINE, CINAHL, EMBASE, PsycINFO, SPORTDiscus, and ERIC) to identify published articles from 2002 to July 16, 2020 that delivered concussion education in the school setting. Included studies described the concussion education and were written in English. RESULTS A total of 11,373 articles were identified and screened, with 27 studies meeting eligibility criteria and therefore, included. The studies delivered education to various stakeholders including students (n = 12; 44.4%), coaches (n = 5; 18.5%), educators (n = 3; 11.1%), parents (n = 1; 3.7%), and a mixed audience (n = 6; 22.2%). The education format varied and six studies (22.2%) developed the education based on a theory, model, or framework. CONCLUSIONS This study found substantial variability in the context, delivery method, development, and evaluation of education delivered in schools and further evaluation of this education is needed to ensure it is best-suited for school-based stakeholders.
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Affiliation(s)
- Kylie D. Mallory
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160TorontoONCanadaM5G 1V7
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital 150 Kilgour RoadTorontoONM4G 1R8
| | - Lauren Saly
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour RoadTorontoONM4G 1R8
| | - Andrea Hickling
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital; Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto 150 Kilgour RoadTorontoONM4G 1R8
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto 160‐500 University Avenue, Room 924TorontoOntarioM5G 1V7
| | - Emily Kroshus
- Department of Pediatrics, University of Washington; Center for Health, Behavior and Development, Seattle Children's Research Institute 1920 Terry AvenueSeattleWA98101
| | - Nick Reed
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital 160‐500 University Avenue, Room 936TorontoOntarioM5G 1V7
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7
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Ziminski D, Szlyk HS, Baiden P, Okine L, Onyeaka HK, Muoghalu C, Cavazos-Rehg P. Sports- and physical activity-related concussion and mental health among adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey. Psychiatry Res 2022; 312:114542. [PMID: 35461119 PMCID: PMC9531575 DOI: 10.1016/j.psychres.2022.114542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/28/2022]
Abstract
This study examined the association between self-reported sports- or physical activity-related concussion and symptoms of depression and suicidal behaviors (suicidal ideation, having a suicide plan, and suicide attempts). This study used data from the 2017 and 2019 Youth Risk Behavior Survey (YRBS), a biennial, school-based, nationally representative survey of U.S. students in grade levels 9 to 12 (N = 14,496). Multivariate logistical regression models assessed the association between self-reported sports-or physical activity-related concussions and suicidal behaviors among students, controlling for a range of demographic and psychosocial variables. Altogether, 13.6% of students reported a sports-or physical activity related concussion in the past 12 months. Among youth, sports-or physical activity related concussions were significantly associated with greater odds of symptoms of depression, suicidal ideation, making a suicide plan, and suicide attempts compared to other youth who did not experience sports- or physical activity-related concussion. Findings highlight increased risk for adverse mental health outcomes among students with sports-or physical activity related concussions. Providing resources for students to engage in physical activity and sports teams may help prevent the onset of depression and suicidal behaviors; however, resources must also be available to monitor any concussions related to these activities to provide support for student emotional well-being.
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Affiliation(s)
- Devon Ziminski
- Rutgers, The State University of New Jersey, School of Social Work, 120 Albany St, New Brunswick, NJ 08901
| | - Hannah S. Szlyk
- Rutgers, The State University of New Jersey, School of Social Work, 120 Albany St, New Brunswick, NJ 08901,Corresponding author: Dr. Hannah S. Szlyk, PhD, LCSW Social Work, Rutgers University: Rutgers The State University of New Jersey, 390 George Street, Rm. 807, New Brunswick, NJ 08901, United States, (H.S. Szlyk)
| | - Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019
| | - Lucinda Okine
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work, 669 W 34th St. Los Angeles, CA 90089
| | - Henry K. Onyeaka
- Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital/McLean Hospital, Boston, MA, USA, 02115
| | - Chioma Muoghalu
- Plains Regional Medical Center, Clovis, New Mexico, NM 88101,Duke University School of Medicine, Master of Management in Clinical Informatics, NC 27710
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110
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Daneshvar DH, Baugh CM, Lama RD, Yutsis M, Pea RD, Goldman S, Grant GA, Cantu RC, Sanders LM, Zafonte RD, Hainline B, Sorcar P. Participating in Two Video Concussion Education Programs Sequentially Improves Concussion-Reporting Intention. Neurotrauma Rep 2022; 2:581-591. [PMID: 35018360 PMCID: PMC8742279 DOI: 10.1089/neur.2021.0033] [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] [Indexed: 11/26/2022] Open
Abstract
Undiagnosed concussions increase the risk of additional concussion and persistent symptoms from concussion. Because there are no reliable objective markers of concussion, self-reporting of subjective and non-visible symptoms are critical to ensuring proper concussion management. For this reason, educational interventions target concussion reporting, but the majority of studies have examined the efficacy of single educational interventions or compared interventions to one another. This randomized crossover study sought to identify whether there was benefit to administering multiple concussion education programs in tandem, back to back. The study randomized 313 male high school football players to first receive CrashCourse concussion education (CC) or Centers for Disease Control and Prevention video concussion education (CDC) followed by crossover with the other education. Athlete concussion-reporting intention, attitudes, subjective norms, perceived behavioral control, and enjoyment of education were assessed at baseline and after each intervention. There were statistically significant improvements across all measures, both after single intervention and crossover (all p < 0.001). Secondary analyses examining differences between education found that athletes reported higher enjoyment of concussion education immediately after participating in CC, as compared to CDC (p < 0.001). These findings demonstrate an additive benefit to implementing CC and CDC education in tandem, without decrement in enjoyment of concussion education after experiencing dual educations; in fact, enjoyment of concussion education improved after receiving education programs back to back. These educational programs appear to complement one another, and the results support the use of multi-modal concussion education to differentially target and maximize concussion reporting.
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Affiliation(s)
- Daniel H Daneshvar
- Department of Physical Medicine and Rehabilitation, Harvard Medical School; Boston, Massachusetts, USA; Massachusetts General Hospital; Boston, Massachusetts, USA; Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.,Chronic Traumatic Encephalopathy Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Christine M Baugh
- Center for Bioethics and Humanities, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA; Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Roberto D Lama
- School of Engineering, Stanford University, Stanford, California, USA
| | - Maya Yutsis
- Department of Neurology, Stanford School of Medicine, Palo Alto, California, USA
| | - Roy D Pea
- Graduate School of Education, Stanford University, Stanford, California, USA
| | - Shelley Goldman
- Graduate School of Education, Stanford University, Stanford, California, USA
| | - Gerald A Grant
- Department of Neurosurgery, Stanford School of Medicine, Palo Alto, California, USA
| | - Robert C Cantu
- Chronic Traumatic Encephalopathy Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Cantu Concussion Center, Emerson Hospital, Concord, Massachusetts, USA
| | - Lee M Sanders
- Department of Pediatrics, Stanford School of Medicine, Palo Alto, California, USA
| | - Ross D Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School; Boston, Massachusetts, USA; Massachusetts General Hospital; Boston, Massachusetts, USA; Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.,Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Brian Hainline
- Indiana University School of Medicine, Indianapolis, Indiana, USA; New York University Langone Medical Center, New York, New York, USA
| | - Piya Sorcar
- Stanford Center for Innovation in Global Health, Stanford School of Medicine, Palo Alto, California, USA
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Daneshvar DH, Baugh CM, Yutsis M, Pea RD, Goldman S, Grant GA, Cantu RC, Sanders LM, Chen CL, Lama RD, Zafonte RD, Sorcar P. Athlete Enjoyment of Prior Education Moderates change in Concussion-Reporting Intention after Interactive Education. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211022641. [PMID: 34053328 PMCID: PMC8170270 DOI: 10.1177/00469580211022641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Undiagnosed concussions increase risk of additional injuries and can prolong recovery. Because of the difficulties recognizing concussive symptoms, concussion education must specifically target improving athlete concussion reporting. Many concussion education programs are designed without significant input from athletes, resulting in a less enjoyable athlete experience, with potential implications on program efficacy. Athlete enjoyment of previous concussion education programs moderates the improvement in concussion-reporting intention after experiencing the research version of CrashCourse (CC) concussion education. Prospective cohort study. Level of evidence: Level IV. Quantitative assessment utilizing ANOVA with moderation analysis of 173 male high school football players, aged 13 to 17, who completed baseline assessments of concussion knowledge, concussion reporting, and attitudes about prior educational interventions. Athletes were subsequently shown CC, before a follow-up assessment was administered assessing the same domains. At baseline, only 58.5% of athletes reported that they enjoyed their previous concussion education. After CC, athletes were significantly more likely to endorse that they would report a suspected concussion (from 69.3% of athletes to 85.6%; P < .01). Enjoyment of previous concussion education moderated concussion-reporting intention after CC (P = .02), with CC having a greater effect on concussion-reporting intention in athletes with low enjoyment of previous concussion education (b = 0.21, P = .02), than on individuals with high enjoyment of previous concussion education (P = .99). Enjoyment of CC did not have a moderating effect on concussion-reporting intention. Athletes who previously did not enjoy concussion education exhibited greater gains in concussion-reporting intention than athletes who enjoyed previous education. Given the potential risks associated with undiagnosed concussions, concussion education has sought to improve concussion reporting. Because most athletes participate in concussion education programs due to league or state mandates, improving concussion-reporting intention in these low-enjoyment athletes is of particular relevance to improving concussion-reporting intention broadly.
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Affiliation(s)
- Daniel H Daneshvar
- Harvard Medical School, Boston, MA, USA.,Massachusetts General Hospital, Boston, MA, USA.,Spaulding Rehabilitation Hospital, Boston, MA, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Christine M Baugh
- University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA
| | - Maya Yutsis
- Stanford School of Medicine, Palo Alto, CA, USA
| | - Roy D Pea
- Stanford University, Stanford, CA, USA
| | | | | | - Robert C Cantu
- Boston University School of Medicine, Boston, MA, USA.,Emerson Hospital, Concord, MA, USA
| | | | - Christine L Chen
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Ross D Zafonte
- Harvard Medical School, Boston, MA, USA.,Massachusetts General Hospital, Boston, MA, USA.,Spaulding Rehabilitation Hospital, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | - Piya Sorcar
- Stanford School of Medicine, Palo Alto, CA, USA
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