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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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Wilke CF, Serner A, Massey A, McCall A, Fulcher M, Rosenbloom C, Carmody S, Patterson SD, Okholm Kryger K. Knowledge, attitude and behaviour around concussion at the FIFA Women's World Cup 2023: part 2 - coaches, performance staff and players. SCI MED FOOTBALL 2024:1-13. [PMID: 39166422 DOI: 10.1080/24733938.2024.2385339] [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] [Received: 03/06/2024] [Revised: 06/17/2024] [Accepted: 07/21/2024] [Indexed: 08/22/2024]
Abstract
The objective of this observational cross-sectional study was to assess the knowledge, attitude and behaviour of coaches and performance staff (i.e. 'coaching staff'), and players from the 32 teams qualified for the FIFA Women's World Cup 2023 regarding assessment and management of concussion in football. Two online surveys were developed: 1) coaching staff, and 2) players. The results were analysed descriptively. Eighty-four coaching staff and 229 players completed the survey. Concussion knowledge: 39% of coaching staff and 33% of players were aware of concussion protocol(s). Knowledge: concussion symptom onset time was correctly reported by 18% of coaching staff and 11% of players. Knowledge about risks related to sustaining a concussion or returning to play too soon varied in both groups. Attitude: 26% of coaching staff and 31% of players reported being very confident or confident in recognizing a suspected concussion. Half of the players (52%) reported to always report symptoms of concussion if feeling any. One (1%) member of the coaching staff and 24 (10%) players reported feeling that a player can return to play with mild symptoms after a concussion. Behaviour: Most coaching staff reported they would have supportive behaviour if faced with a suspected concussion on the pitch. Among players, 64% stated that they would leave the assessment to their team's medical staff, and 4% would encourage their teammates to keep playing. In conclusion, coaching staff and players showed limited knowledge about concussion. Most coaching staff reported attitudes and intended behaviour towards protecting players' health; whilst players' responses varied.
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Affiliation(s)
- Carolina Franco Wilke
- Faculty of Sport, Technology and Health Sciences, St Mary's University Twickenham, London, UK
| | - Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Andrew Massey
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Alan McCall
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, Australia
- School of Sport and Exercise Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Mark Fulcher
- Axis Sports Medicine Specialists, Auckland, New Zealand
| | - Craig Rosenbloom
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
| | - Sean Carmody
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephen D Patterson
- Faculty of Sport, Technology and Health Sciences, St Mary's University Twickenham, London, UK
| | - Katrine Okholm Kryger
- Faculty of Sport, Technology and Health Sciences, St Mary's University Twickenham, London, UK
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
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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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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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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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Salmon DM, Chua J, Brown JC, Clacy A, Kerr ZY, Walters S, Keung S, Sullivan SJ, Register-Mihalik J, Whatman C, Sole G, Badenhorst M. Quest for clarity: investigating concussion-related responsibilities across the New Zealand Rugby Community System. BMJ Open Sport Exerc Med 2023; 9:e001722. [PMID: 37860152 PMCID: PMC10582854 DOI: 10.1136/bmjsem-2023-001722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/21/2023] Open
Abstract
There is a growing concern around concussions in rugby union, at all levels of the game. These concerns highlight the need to better manage and care for players. However, consistency around concussion-related responsibilities of stakeholders across the community rugby system remains challenging. Taking a systems thinking approach, this pragmatic, qualitative descriptive study explored key stakeholder groups within New Zealand's community rugby system's perceptions of their own and others' concussion-related responsibilities. Participants included players from schools and clubs, coaches, parents, team leads and representatives from four provincial unions. A total of 155 participants (67 females and 88 males) were included in the study. Focus groups and individual interviews were conducted. Thematic content analysis was used to analyse data. Thirty concussion-related responsibilities were identified. These responsibilities were contained within four themes: (1) policies and support (responsibilities which influence policy, infrastructure, human or financial resources); (2) rugby culture and general management (responsibilities impacting players' welfare and safety, attitudes and behaviour, including education, injury reporting and communication); (3) individual capabilities (responsibilities demonstrating knowledge and confidence managing concussion, leadership or role/task shifting) and (4) intervention following a suspected concussion (immediate responsibilities as a consequence of a suspected concussion). The need for role clarity was a prominent finding across themes. Additionally, injury management initiatives should prioritise communication between stakeholders and consider task-shifting opportunities for stakeholders with multiple responsibilities. How concussions will realistically be managed in a real-world sports setting and by whom needs to be clearly defined and accepted by each stakeholder group. A 'framework of responsibilities' may act as a starting point for discussion within different individual community rugby contexts on how these responsibilities translate to their context and how these responsibilities can be approached and assigned among available stakeholders.
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Affiliation(s)
- Danielle M Salmon
- Safety and Welfare, New Zealand Rugby, Wellington, New Zealand
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Jason Chua
- Safety and Welfare, New Zealand Rugby, Wellington, New Zealand
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - James C Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Amanda Clacy
- School of Law & Society, University of the Sunshine Coast, Maroochydore, Queensland, Australia
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Simon Walters
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Sierra Keung
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - S John Sullivan
- Safety and Welfare, New Zealand Rugby, Wellington, New Zealand
| | - Johna Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Chris Whatman
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Gisela Sole
- School of Physiotherapy, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - Marelise Badenhorst
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
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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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Campbell TR, Reilly N, Zamponi M, Leathers D, Mollica PA, Cavallario J, Martinez JC. Salivary microRNA as a prospective tool for concussion diagnosis and management: A scoping review. Brain Inj 2023; 37:588-595. [PMID: 36867013 DOI: 10.1080/02699052.2023.2184867] [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: 03/04/2023]
Abstract
BACKGROUND Despite increased efforts directed toward research, concussions are a growing concern and can be a complex injury for healthcare professionals to manage. Current practices are largely dependent on patients self-reporting symptoms and a clinical assessment, which uses objective tools that lack effectiveness. With the demonstrated effects of concussions, it is imperative that a more valid or reliable objective tool, like a clinical biomarker, be identified to improve outcomes. One potential biomarker that has shown promise is salivary microRNA. However, there is no objective consensus as to which microRNA offers the most clinical value regarding concussions, hence this review. Therefore, the purpose of this scoping review was to identify salivary miRNAs associated with concussions. METHODS Two independent reviewers performed a literature search to identify research articles. Studies using human subjects, collected salivary miRNA, and were published in English were included. Data of interest were salivary miRNA, collection timing, and relation to concussion diagnosis or management. RESULTS This paper reviews nine studies that analyzed salivary miRNA for concussion diagnosis and management. CONCLUSIONS In total, the studies have identified 49 salivary miRNA that show promise in assisting with concussion practices. With continued research, the use of salivary miRNA may enhance clinicians' abilities to diagnose and manage concussions.
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Affiliation(s)
- Thomas R Campbell
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Nicholas Reilly
- The Geneva Foundation, Womack Army Medical Center, Fort Bragg, North Carolina, USA
| | - Martina Zamponi
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Delaney Leathers
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Peter A Mollica
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Julie Cavallario
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Jessica C Martinez
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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Nedimyer AK, Chandran A, Kossman MK, Gildner P, Register-Mihalik JK, Kerr ZY. Concussion knowledge, attitudes, and norms: How do they relate? PLoS One 2023; 18:e0282061. [PMID: 36812182 PMCID: PMC9946210 DOI: 10.1371/journal.pone.0282061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Relationships between the constructs of concussion-related knowledge, attitudes, and norms and their influence on observed care-seeking behaviors have previously been examined. Current models posit that these constructs serve as potential mediators of care-seeking behaviors; however, the dynamics between them have yet to be reconciled. METHODS A cross-sectional, online survey explored relationships among the latent constructs of concussion-related knowledge, attitudes, and norms in parents of middle school children who participate in sports in multiple settings. A just-identified and two overidentified path models were explored and compared in an effort to understand such relationships. RESULTS A total of 426 parents of United States middle school students were surveyed and included in analyses (mean age = 38.7±9.9 years; 55.6% female; 51.4% white/non-Hispanic; 56.1% with at least a bachelor's degree). All parents had middle school aged children who participated in sport in both the club and school settings. The best fitting model was a just-identified model with concussion-related norms influencing concussion-related knowledge and attitudes, and concussion-related knowledge influencing attitudes. This model accounted for 14% of the variance in attitude and 12% of the variance in knowledge. CONCLUSIONS Study findings suggest that the constructs of concussion-related knowledge, attitudes and norms are directly related to one another, yet the dynamics of such relationships may be complex. As such, a parsimonious interpretation of these constructs may not be appropriate. Future research should work to further reconcile the dynamics between these constructs, and the impact these dynamics may have in influencing care-seeking behaviors beyond serving as mediators.
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Affiliation(s)
- Aliza K. Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Matthew Gfeller Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, United States of America
| | - Melissa K. Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS, United States of America
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 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
- Matthew Gfeller Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Matthew Gfeller Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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11
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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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12
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Minnig MC, Hawkinson L, Root HJ, Driban J, DiStefano LJ, Callahan L, Ambrose KR, Spang JT, Golightly YM. Barriers and facilitators to the adoption and implementation of evidence-based injury prevention training programmes: a narrative review. BMJ Open Sport Exerc Med 2022; 8:e001374. [PMID: 36187085 PMCID: PMC9516217 DOI: 10.1136/bmjsem-2022-001374] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
While there is a multitude of evidence supporting the efficacy of injury prevention training programmes, the literature investigating the implementation of these programmes is, in contrast, rather limited. This narrative review sought to describe the commonly reported barriers and facilitators of the implementation of injury prevention training programmes among athletes in organised sport. We also aimed to identify necessary steps to promote the uptake and sustainable use of these programmes in non-elite athletic communities. We identified 24 publications that discussed implementing evidence-based injury prevention training programmes. Frequently reported barriers to implementation include the perceived time and financial cost of the programme, coaches lacking confidence in their ability to implement it, and the programme including exercises that were difficult or confusing to follow. Frequently reported facilitators to implementation include the coach being aware of programme efficacy, shared motivation to complete the programme from both coaches and athletes, and the ability to easily integrate the programme into practice schedules. The current literature is focused on high-income, high-resource settings. We recommend that future studies focus on understanding the best practices of programme dissemination in culturally and economically diverse regions. Programmes ought to be of no financial burden to the user, be simply adaptable to different sports and individual athletes and be available for use in easily accessible forms, such as in a mobile smartphone application.
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Affiliation(s)
- Mary Catherine Minnig
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lauren Hawkinson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill College of Arts and Sciences, Chapel Hill, North Carolina, USA
| | - Hayley J Root
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA
| | - Jeffrey Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Lindsay J DiStefano
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA.,Institute of Sports Medicine, University of Connecticut, Storrs, Connecticut, USA
| | - Leigh Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.,Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Kirsten R Ambrose
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Jeffrey T Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.,College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska, USA
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13
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Bretzin AC, Anderson M, Bhandari N, Schmitt AJ, Beidler E. Concussion Nondisclosure in Youth Sports. J Athl Train 2022; 57:688-695. [PMID: 35045181 PMCID: PMC9528706 DOI: 10.4085/1062-6050-534-21] [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: 11/09/2022]
Abstract
CONTEXT Researchers conducting studies about sport-related concussion (SRC) reporting behaviors and reasons for nondisclosure primarily focus on older athletic populations. Youth athletes participating in contact sports are also at risk for SRC; however, little is known about their SRC disclosure patterns and reasons for nondisclosure. OBJECTIVE To examine the self-reported SRC history and reasons for SRC nondisclosure of youth athletes aged 8-14 years. DESIGN Cross-sectional study. SETTING Youth athletes in organized football, ice hockey, lacrosse, or soccer. PATIENTS OR OTHER PARTICIPANTS A total of 411 youth athletes (boys = 70.0% [n = 287/410]; median age = 11 [interquartile range = 10-13] years). MAIN OUTCOME MEASURE(S) A 15-minute survey including self-reported demographics, diagnosed and nondisclosed SRC history, and reasons for nondisclosure of suspected SRCs. RESULTS Ten percent of respondents (n = 41/411) recounted ≥1 diagnosed SRC, 12.7% (n = 52/411) did not report a suspected SRC, 13.1% (n = 53/404) indicated they continued to practice, and 12.3% (n = 50/406) reported they continued to play in a game after a suspected SRC. Significant associations between sport and nondisclosure existed (P values < .001) but not with self-reported concussion history (P = .14). In sex-comparable analyses, boys' lacrosse players had a higher frequency of nondisclosure than girls (P = .05). The most common reasons for nondisclosure were not wanting to lose playing time (66.7%, n = 32/48), miss a game (56.3%, n = 27/48), and let the team down (43.8%, n = 21/48) and uncertainty over injury severity and the presence of SRC (43.8%, n = 21/48). CONCLUSIONS Ten percent of youth athletes self-reported at least 1 diagnosed SRC. However, they also described continuing to practice or play in a game after a suspected SRC. Reasons for nondisclosure at this age were similar to those reported in high school and collegiate athletes. Recent researchers suggested negative consequences of continued play with SRC, especially in the acute stages. Anyone conducting future educational initiatives should emphasize these risks and focus on reasons why athletes of both sexes withhold reporting.
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Affiliation(s)
- Abigail C. Bretzin
- Department of Biostatistics, Epidemiology and Informatics, Penn Injury Science Center, University of Pennsylvania, Philadelphia
| | | | - Neha Bhandari
- Department of Biology, Duquesne University, Pittsburgh, PA
| | - Ara J. Schmitt
- Department of Counseling, Psychology, and Special Education, Duquesne University, Pittsburgh, PA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, PA
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14
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Beran KM, Scafide KN. Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:406-417. [PMID: 35075658 DOI: 10.1111/josh.13140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sport-related concussions are a major public health problem with only 50% of concussed teens reporting their symptoms. The purpose of this systematic review was to identify individual and institutional factors that contribute to concussion knowledge, attitude, and reporting behaviors among US high school athletes. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol was used to direct the process of this systematic review. A search for English, peer-reviewed, quantitative studies published between 2010 and 2020 was conducted in 5 scholarly databases. The Joanna Briggs Critical Appraisal Tools were used to assess study quality. RESULTS Twenty-two studies met criteria for inclusion in this systematic review. The study designs were mostly cross-sectional (N = 18). Synthesis revealed individual factors including gender, age, race/ethnicity, grade level, and concussion history were associated with differences in concussion knowledge, attitude, and/or reporting behaviors. Institutional factors identified included school location, concussion education, access to an athletic trainer, sport played, and team climate. Six studies found concussion education had a positive impact on knowledge and reporting behaviors. CONCLUSION This systematic review identified certain populations which may be more vulnerable to underreporting concussion symptoms; therefore, a targeted approach to education and management may be more effective.
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Affiliation(s)
- Krista M Beran
- Doctoral Candidate, , College of Health and Human Services, George Mason University, 4400 University Dr., Fairfax, VA 22030
| | - Katherine N Scafide
- Associate Professor, , College of Health and Human Services, George Mason University, 4400 University Dr., Fairfax, VA 22030
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15
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Beidler E, Bretzin AC, Schmitt AJ, Phelps A. Factors associated with parent and youth athlete concussion knowledge. JOURNAL OF SAFETY RESEARCH 2022; 80:190-197. [PMID: 35249599 DOI: 10.1016/j.jsr.2021.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/09/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION On-site health care providers are not routinely present at all youth sport events. Therefore, parents and youth athletes are often responsible for identifying and making appropriate immediate care decisions regarding concussions, which may be influenced by their injury health literacy. Previous studies have investigated the level of concussion knowledge of parents and athletes, but few have investigated factors associated with greater awareness at the youth sport level specifically. METHOD A total of 466 parents and 390 youth contact sport athletes from Pennsylvania and Michigan completed separate surveys of concussion knowledge and personal and family demographic information. RESULTS Parents had a mean concussion knowledge score of 39.3 ± 4.6 out of a possible 47 points. Having a medical occupation (p = .04) and being older in age (p = .03) were associated with higher concussion knowledge scores in parents (R2 = 0.018; 95% CI = 32.77-38.99). Youth athletes had a mean concussion knowledge score of 35.0 ± 5.7 out of 47. Having learned about concussion previously (p < .001), having a history of diagnosed concussion(s) (p = .01), sport type (relative to girls' ice hockey, p < .001), older age (p < .001), and parent concussion knowledge (p = .04) were associated with higher youth athlete concussion knowledge (R2 = 0.176; 95% CI = 19.08-31.72). CONCLUSIONS More evidence-based concussion awareness resources are needed at the youth sport level. While it did not significantly influence concussion knowledge for parents, concussion education is a modifiable factor that may be essential for improving concussion knowledge of youth athletes, thus warranting further study into effective awareness strategies for this population. Practical Applications: The factors found to influence concussion knowledge in this study could be considered in future educational concussion initiatives for youth athletes and their parents in order to increase awareness regarding the potential dangers of participating in sport while concussed.
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Affiliation(s)
- Erica Beidler
- Department of Athletic Training, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, United States.
| | - Abigail C Bretzin
- Penn Injury Science Center, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA 19104, United States.
| | - Ara J Schmitt
- Department of Education, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, United States.
| | - Amy Phelps
- School of Business, Economics and Statistics Division, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, United States.
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16
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Bretzin AC, Hines JN, Ferguson DP. Concussion Knowledge, Attitudes, and Reporting Behaviors of Sports Car Racing Drivers. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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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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18
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Warmath D, Winterstein AP, Myrden S. Parents and coaches as transformational leaders: Motivating high school athletes' intentions to report concussion symptoms across socioeconomic statuses. Soc Sci Med 2021; 292:114559. [PMID: 34776287 DOI: 10.1016/j.socscimed.2021.114559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/29/2021] [Accepted: 11/06/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Studies demonstrate that parents and coaches play a role in an athlete's concussion reporting decision primarily through their influence on the decision environment. Little work, however, has explored how a given parenting/coaching style operates to promote intentions and much less work has examined whether the impact of parenting/coaching on concussion reporting differs by socioeconomic status. Transformational parenting/coaching (i.e., a focus on building autonomy and self-efficacy in athletes) represents one promising approach given its effects on other outcomes (e.g., health, burnout, aggression). We hypothesize that athlete perceptions of transformational parenting/coaching will be associated with their reporting intentions directly and through the athlete's motivation for playing their sport regardless of household income. METHODS A national survey of 1023 high-school athletes measured athlete perceptions of transformational parenting/coaching, sport motivation, and reporting intentions. Structural Equation Modeling was used to examine hypotheses. RESULTS Transformational parenting was directly associated with reporting intentions (β: Reporting Intentions = .265; Scenario 1 = 0.206; Scenario 2 = 0.260) and indirectly through increased autonomous/decreased controlled motivation. Transformational coaching was not directly associated with Reporting Intentions (β = 0.008, p = .816) or Scenario 2 (β = 0.046, p = .198) but was for Scenario 1 (β = 0.077, p = .003). Transformational coaching was also associated with reporting intention indirectly through increased autonomous, but not controlled motivation. Athletes with household income of $50,000+ were more likely to report transformational parenting/coaching; however, the effects of transformational parenting/coaching did not differ for athletes from higher versus lower-income households. CONCLUSIONS Transformational parenting/coaching may encourage greater concussion reporting intentions primarily through increased autonomous (i.e., self-directed) sport motivation regardless of socioeconomic status. Cultivating transformational leadership in parents/coaches can have a positive impact on the athlete's intention to report concussion-like symptoms.
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Affiliation(s)
- Dee Warmath
- Department of Financial Planning, Housing, and Consumer Economics, College of Family and Consumer Sciences, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, 30602, Georgia.
| | - Andrew P Winterstein
- Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, WI, USA.
| | - Susan Myrden
- Department of Marketing, Maine Business School, University of Maine, Orono, ME, USA.
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19
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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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20
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Yang C, Wang R. ADOLESCENTS’ HEALTHY SPORTS BEHAVIOR MODEL BASED ON THE THEORY OF SOCIAL-ECOLOGICAL SYSTEM. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127042021_0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Education administrative departments and schools should regard sports as an integral part of school education and allow students to use sports every day. Guarantee the time for sports activities; schools should organize various forms of extracurricular sports activities”. Objective: Based on the ecological system theory, the paper constructs a three-factor structural model that restricts youth sports participation and compiles a scale of factors restricting youth sports participation. Methods: The thesis selected 1,800 primary and secondary school students as the research object and used exploratory factor analysis to explore the questionnaire structure on the obstacles to sports participation. Results: 1) Exploratory factor analysis, the cumulative contribution rate of the first three factors extracted was 58.90%, and the load of each factor was more significant than 0.4. The three factors were school factors, family factors, and personal factors in order; 2) Reselected subjects, Exploring the three-factor structural model of obstacles to sports participation were verified. The final modified model RMSEA was 0.071, CFI was 0.98, and χ2/df was 8.55. The three factors were school factors, family factors, and personal factors. Conclusions: The fit of the three-factor structural indicators restricting youth sports participation is ideal, and the model is relatively stable. The “Questionnaire on Restricting Factors of Youth Sports Participation” can be used as a measurement tool to evaluate and understand youth sports participation constraints. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
| | - Rui Wang
- Northeast Agricultural University, China
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21
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Labiste CC, McElroy E, Chaniotakis S, Duong N, Haffizulla F. Effectiveness of PitchSafe on Knowledge and Attitude of Baseball-Related Concussion. Cureus 2021; 13:e14732. [PMID: 34084667 PMCID: PMC8163345 DOI: 10.7759/cureus.14732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Traumatic brain injuries (TBIs), specifically concussions, affect many athletes and have dangerous immediate and long-term sequelae. Lack of awareness surrounding concussion impedes prevention, identification, and treatment. This study aims to assess parental knowledge and attitudes regarding concussions in youth baseball before and after administering an educational intervention called PitchSafe. PitchSafe is a short video that contains examples of baseball-related head injuries such as collisions, falls, and direct hits by baseballs; the signs and symptoms of a concussion; testimony from a former baseball player who sustained a TBI playing baseball; and a brochure detailing the potential signs, symptoms, and treatment plans associated with concussions. Methodology The Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) was used to assess three indices of parental understanding of concussion: Concussion Knowledge Index (CKI), Concussion Attitudes Index (CAI), and signs and symptoms of concussions (SS). The RoCKAS was administered at baseline and after the PitchSafe tool was administered. Parents were re-assessed one year following the initial distribution of survey materials utilizing the long-term follow-up (LTFU) RoCKAS. A paired sample t-test was conducted to compare the baseline, post-intervention (PI), and LTFU CKI, CAI, and SS among participants. Results The mean scores for CKI were 68% ± 12%, 76% ± 4%, and 76% ± 5% for baseline, PI, and LTFU, respectively. The mean scores for SS were 46% ± 20%, 62% ± 14%, and 64% ± 16% for baseline, PI, and LTFU, respectively. The mean scores for CAI were 87% ± 6%, 91% ± 5%, and 92% ± 4% for baseline, PI, and LTFU, respectively. Conclusions PitchSafe increased youth baseball parents’ long-term knowledge of concussions, ability to identify signs and symptoms of concussions, and may promote safer attitudes toward concussions. These findings support more widespread use of educational tools through social media and in clinical settings.
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Affiliation(s)
- Chase C Labiste
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Evan McElroy
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Sotiris Chaniotakis
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Nicolette Duong
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Farzanna Haffizulla
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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22
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Barnhart M, Bay RC, Valovich McLeod TC. The Influence of Timing of Reporting and Clinic Presentation on Concussion Recovery Outcomes: A Systematic Review and Meta-Analysis. Sports Med 2021; 51:1491-1508. [PMID: 33761129 DOI: 10.1007/s40279-021-01444-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Identifying risk factors for prolonged recovery following concussion can assist clinicians with appropriate management strategies. It is thought that athletes who continue to participate following a hit to the head or body may take longer to recover following a concussion diagnosis. OBJECTIVE To systematically review the body of literature regarding the effect of delayed reporting and delayed presentation to medical providers on concussion recovery times. DESIGN Systematic review with meta-analysis. DATA SOURCES PubMed, Ovid Medline, SPORTDiscus, Cochrane Central Register of Controlled Trials and hand searches of reference lists. All the searches were performed in April 2020. ELIGIBILITY CRITERIA FOR SELECTED STUDIES Studies included an investigation of immediate versus delayed reporting or early versus late presentation following a concussion, were published in the past ten years, and were level 4 evidence or higher. RESULTS 12 studies were included. Patients who continued play or delayed reporting their concussion had significantly longer recovery times (standardized mean difference = 0.36 days (95%CI 0.066, 0.662) than those who immediately reported or were removed from play (p = 0.017). Expressed in raw scores, those who immediately reported recovered in 5.4 days (95% CI - 10.14, - 0.75) fewer than delayed reporters. Comparable results were found for post-concussion symptom scores (p = 0.034) with immediate reporters demonstrating lower symptom severity scores. Our qualitative synthesis found patients who presented earlier to a concussion specialist tended to recover faster than those who presented later. CONCLUSIONS Patients who delayed reporting or continued play had longer recovery times compared to their immediately-reporting peers. Providers should ask concussion patients approximately how long they waited to report their injury, and also focus educational efforts on encouraging immediate reporting of concussion.
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Affiliation(s)
- Mitchell Barnhart
- Athletic Training Programs, A.T. Still University, 5850 E Still Circle, Mesa, AZ, 85206, USA
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ, USA
| | - Tamara C Valovich McLeod
- Athletic Training Programs, A.T. Still University, 5850 E Still Circle, Mesa, AZ, 85206, USA.
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ, USA.
- School of Osteopathic Medicine in Arizona, A.T. Still University, 5850 E. Still Circle, Mesa, AZ, 85206, USA.
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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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Post EG, Snedden TR, Snedaker K, Bouton J, Wang D. Differences in Sport-Related Concussion History, Reporting Behavior, and Return to Learn and Sport Timelines in Public versus Private High School Student Athletes. Brain Inj 2021; 35:596-603. [PMID: 33645354 DOI: 10.1080/02699052.2021.1890217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To compare: 1) history of sport-related concussion (SRC), 2) Return to learn (RTL) timelines, 3) Return to play (RTP) timelines, and 4) SRC reporting behaviors in high-school student athletes based on school type (public vs. private).Methods: A total of 2,998 athletes recruited from eleven private (n = 2121) and two public schools (n = 877) during the 2018-2019 school year completed an online questionnaire regarding sport participation and SRC history. The questionnaire examined self-reported history of SRC, reporting behavior, and RTL and RTP timelines.Results: Private school athletes were approximately twice as likely to report a history of SRC compared to public school athletes (OR [95% CI]: 2.01 [1.61-2.50], p < .001). There were no significant differences in RTL or RTP timelines between public and private-school athletes (p > .05). For those who did not report their SRC (22.4%), the most common reasons were "a desire to keep playing" (53.7%) and "not believing it was serious enough to report" (52.1%).Conclusions: Athletic trainers and healthcare professionals should be aware of the factors that may influence secondary student athletes' SRC reporting behavior, and associated RTL, and RTP timelines, so they can better target concussion education and overall management for student-athletes.Abbreviations: SRC: Sport-related concussion; RTP: Return to play; RTL: Return to learn.
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Affiliation(s)
- Eric G Post
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, Indiana, USA
| | - Traci R Snedden
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Jason Bouton
- PINK Concussions, Connecticut, Norwalk, USA.,University Medical Director and Director of Sports Medicine, Quinnipiac University, Hamden, CT
| | - David Wang
- Department of Orthopaedics, University of Connecticut, Farmington, CT
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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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Chandran A, Nedimyer AK, Kerr ZY, O'Neal C, Mensch J, Yeargin SW. Concussion Knowledge, Attitudes, and Self-Reporting Intentions in Youth Athletes. J Athl Train 2020; 55:1027-1034. [PMID: 33032324 DOI: 10.4085/1062-6050-232-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Although it has been suggested that developmental and sociological factors play a role in concussion reporting, the empirical evidence related to this is limited. OBJECTIVE To examine the influences of sex, school level, school location, concussion-reporting history, and socioeconomic status on concussion-related knowledge, attitudes, and reporting intentions among middle school and high school athletes. DESIGN Cross-sectional study. SETTING Master students and High School athletes attending pre-participation examinations (PPEs) were asked to complete paper-based surveys. PATIENTS OR OTHER PARTICIPANTS Overall, 541 athletes representing 18 sports returned fully completed surveys. MAIN OUTCOME MEASURE(S) Outcomes were concussion-related knowledge, perceived seriousness, positive feelings about reporting, and self-reporting intentions. We examined group differences in these outcomes across levels of the explanatory variables of sex, school level (middle school versus high school), school location (urban versus rural), concussion self-reporting history (yes or no), and socioeconomic status (free or reduced-price lunch versus no free or reduced-price lunch) using Wilcoxon rank sum tests. Then we used multivariable ordinal logistic regression models to identify predictors of higher score levels for each outcome. Odds ratio (OR) estimates with 95% confidence intervals (CIs) excluding 1.00 were deemed significant. RESULTS Odds of higher levels of knowledge were higher in urban versus rural school student-athletes (ORAdjusted = 1.81; 95% CI = 1.03, 3.17), and lower in student-athletes on free or reduced-price lunch versus those not on free or reduced-price lunch (ORAdjusted = 0.52; 95% CI = 0.36, 0.77). Similarly, odds of higher levels of seriousness were lower in male versus female student-athletes (ORAdjusted = 0.48; 95% CI = 0.32, 0.72). Further, odds of higher levels of self-reporting intentions were lower among male versus female student-athletes (ORAdjusted = 0.53; 95% CI = 0.37, 0.75). CONCLUSIONS Developmental and sociological factors were differentially associated with concussion-related knowledge, attitudes, and self-reporting intentions. These results can inform medical providers, parents, and coaches with regard to context-specific clinical assessments of concussion symptoms.
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Affiliation(s)
- Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill
| | - Aliza K Nedimyer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill.,Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill
| | - Cathleen O'Neal
- Department of Exercise Science, University of South Carolina, Columbia
| | - James Mensch
- Department of Exercise Science, University of South Carolina, Columbia
| | - Susan W Yeargin
- Department of Exercise Science, University of South Carolina, Columbia
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Murata Y, Scarneo-Miller SE, McMahon LJ, Casa DJ. Adoption of Emergency Action Plans in Secondary Schools: A Study of School Nurses' Knowledge and Behavior. THE JOURNAL OF SCHOOL HEALTH 2020; 90:694-702. [PMID: 32779227 DOI: 10.1111/josh.12930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 12/16/2019] [Accepted: 01/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The adoption of an emergency action plan for athletics (AEAP) minimizes the consequences of injuries. School nurses may play an important role in the adoption of an AEAP. The purpose of our study was to describe school nurse's knowledge and perceptions related to AEAP adoption. METHODS An online survey, following the Precaution-Adoption Process Model, examining respondents' readiness to act, was distributed to 1228 school nurses to evaluate their knowledge and perception of an AEAP, with N = 131 (10.6%) responding. RESULTS Sixty-one school nurses were unaware of AEAP adoption at their school. A lack of athletic training services at the school was associated with not adopting an AEAP. The most frequently reported barrier to adopting an AEAP related to finances. When nurses reported perceiving more barriers to adopting an AEAP, their schools were less likely to adopt one. CONCLUSIONS A large number of nurses were unaware if their school adopted an AEAP. There is a need to improve nurses' knowledge and perceptions to promote AEAP development.
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Affiliation(s)
- Yuki Murata
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Samantha E Scarneo-Miller
- Division of Athletic Training, School of Medicine, West Virginia University, 1 Medical Center Drive, 8501A Health Sciences Center South, Morgantown, WV 26506-9225
| | - Liza J McMahon
- Department of Health Sciences and Nursing, University of Hartford, 200 Bloomfield Avenue, West Hartford, CT 06117
| | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, 2095 Hillside Road U-1110, Storrs, CT 06269-1110
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Chen J, Kouts J, Rippee MA, Lauer S, Smith D, McDonald T, Kurylo M, Filardi T. Developing a Comprehensive, Interdisciplinary Concussion Program. Health Serv Insights 2020; 13:1178632920938674. [PMID: 32782428 PMCID: PMC7385849 DOI: 10.1177/1178632920938674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022] Open
Abstract
There has been a growing trend of local and national coverage of and interest in concussion injuries over the past 2 decades. Increasing public concern over potential catastrophic and unknown long-term effects of sports-related concussion injuries has led to an acknowledgment of the strong public health need for addressing all concussion injuries, regardless of mechanism of injury. In efforts to address this need for concussion prevention and management, both in sports and nonsports, The University of Kansas Health System initiated the interdisciplinary Center for Concussion Management program in 2012. The program was created as a virtual clinic concept and includes voluntary participation from various providers across the institution, limited budget, and space obstacles. Since its inception, the program has continued to operate as its initial design of a multidisciplinary team model outside the sole ownership of 1 department, and has expanded to include education and outreach to local and regional schools and groups.
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Affiliation(s)
- Jamie Chen
- Center for Concussion Management, The University of Kansas Health System, Kansas City, KS, USA
| | - Jill Kouts
- Center for Concussion Management, The University of Kansas Health System, Kansas City, KS, USA
| | - Michael A Rippee
- Department of Neurology, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Stephen Lauer
- Department of Pediatrics, The University of Kansas Medical Center, Kansas City, KS, USA
| | - David Smith
- Department of Family Medicine, Department of Sports Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Tracy McDonald
- Department of Trauma/Acute Care Surgery, Burn, and Concussion Administration, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Monica Kurylo
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Tanya Filardi
- Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, KS, USA
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Salmon DM, Mcgowan J, Sullivan SJ, Murphy I, Walters S, Whatman C, Keung S, Clacy A, Romanchuk J. What they know and who they are telling: Concussion knowledge and disclosure behaviour in New Zealand adolescent rugby union players. J Sports Sci 2020; 38:1585-1594. [PMID: 32264762 DOI: 10.1080/02640414.2020.1749409] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to survey high school rugby players from a range of ethnic, geographic and socioeconomic backgrounds in New Zealand (NZ) to gain an understanding of concussion knowledge, awareness of NZ Rugby's (NZR) guidelines and attitudes towards reporting behaviours. Male and female high school rugby players (n= 416) from across NZ were surveyed. The findings indicated that 69% of players had sustained a suspected concussion, and 31% had received a medical diagnosis of concussion. 63% of players indicated they were aware of NZR's guidelines. Māori and Pasifika players were less likely to be aware of the guidelines compared to NZ European, Adjusted OR 0.5, p = 0.03. Guideline awareness was significantly higher for those from high decile schools when compared to low (Unadjusted OR 1.63, p = 0.04); however, when ethnicity and school locations were controlled for this became non-significant (Adjusted OR= 1.3, p=0.37). The coach was the key individual for the provision of concussion information and disclosure of symptoms for players. The findings of this study will inform the development and delivery of NZR's community concussion initiative and how these examined factors influence a high school player's concussion knowledge and reporting behaviour.
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Affiliation(s)
- Danielle M Salmon
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
| | - Jody Mcgowan
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
| | - S John Sullivan
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago , Dunedin, New Zealand
| | - Ian Murphy
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
| | - Simon Walters
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology , Auckland, New Zealand
| | - Chris Whatman
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology , Auckland, New Zealand
| | - Sierra Keung
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology , Auckland, New Zealand
| | - Amanda Clacy
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast , Birtinya, Australia
| | - Janelle Romanchuk
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
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Plourde V, Kung JY, Gates A, Jun S, Brooks BL, Sebastianski M. How Perceptions Impact Recovery from Concussion in Childhood and Adolescence: a Systematic Review. Neuropsychol Rev 2020; 30:142-163. [PMID: 32124152 DOI: 10.1007/s11065-020-09430-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 02/16/2020] [Indexed: 12/24/2022]
Abstract
Perceptions about the causes and consequences of concussion, and individual representations and interpretations of these factors, can influence the post-concussive recovery process. The goal of this project was to synthesize evidence on perceptions related to concussions as experienced by children, adolescents, and parents, and to evaluate how these perceptions impact post-concussive recovery in physical, behavioural, cognitive, and psychological domains. We undertook a systematic review based on the Cochrane Handbook, conducting a comprehensive search of six databases and Google Scholar. Duplicate, independent screening was employed and the quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT). A total of 1552 unique records were identified, and six records (5 scientific articles and 1 thesis, published between 1990 and 2018; N = 26 to 412, age range from 2 to 18 years) were included. Perceptions about concussions were assessed differently between studies, with a range in types of measures and respondents. Some evidence suggested that perceptions could negatively impact concussion recovery, mostly post-concussive symptoms. However, results were not consistent between studies and the methodological quality was variable (and often low). There is limited evidence of the impact of perceptions of children, adolescents, and their parents on concussion recovery. Priorities for future research investigating concussion recovery should include recruiting representative samples, accounting for potential confounders, and measuring perceptions in children, adolescents and parents using validated measures. Higher quality studies are needed to better understand the role of perceptions in concussion recovery and to inform clinical care.
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Affiliation(s)
- Vickie Plourde
- School of Psychology, Université de Moncton, 18 Av Antonine-Maillet, Moncton, NB, E1A 3E6, Canada.
| | - Janice Y Kung
- John W. Scott Health Sciences Library, University of Alberta, 2K3.28 Walter C. Mackenzie Health Sciences Centre, Edmonton, Alberta, T6G 2R7, Canada
| | - Allison Gates
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, 4-482C, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
| | - Shelly Jun
- Department of Surgery, University of Alberta, 3E1.14 Walter Mackenzie Centre, 8440-112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Brian L Brooks
- Neurosciences program, Alberta Children's Hospital, Calgary, Canada
- Departments of Pediatrics, Clinical Neurosciences, and Pediatrics, University of Calgary, Calgary, Canada
- Alberta Children's Research Institute, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - Meghan Sebastianski
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, University of Alberta, 4-486D, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
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Kroshus E, Hoopes T, Bernstein E, Chrisman SPD, Rivara FP. Direct Verbal Communication by Parents, Pressure Related to Sport Achievement, and Concussion Safety in Youth Football. JOURNAL OF HEALTH COMMUNICATION 2019; 24:770-779. [PMID: 31665984 DOI: 10.1080/10810730.2019.1668512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Direct verbal communication from parents about concussion safety and parent pressure related to sport achievement may influence concussion risk-related behavior among youth athletes. This study assessed whether less parental pressure related to sport achievement and more parental communication about concussion safety were associated with lower intentions to continue sport participation while experiencing concussion symptoms. Participants were youth football players (ages 10-14) and their parents (n = 278 dyads, response rate = 45%). Structural equation modeling was used to predict the athlete's intention to continue play with concussive symptoms. One quarter of parents had never talked with their child about any concussion safety topic, and more than half had not talked about concussion safety within the past year. Greater parent communication about concussion and less pressure on sport achievement were both associated with lower child intention to continue playing while symptomatic post-concussion. Parents who placed more pressure on their child related to sport achievement were less likely to talk about concussion safety with their child. Determining how to shape parenting that is supportive of concussion safety is an important avenue for future health education program development work. This may include efforts to parenting behaviors in the sport context that reinforce effort rather than winning.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | | | | | - Sara P D Chrisman
- Division of Adolescent Medicine, University of Washington, Seattle, Washington, USA
| | - Frederick P Rivara
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
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Development of a Concussion Risk Function for a Youth Population Using Head Linear and Rotational Acceleration. Ann Biomed Eng 2019; 48:92-103. [PMID: 31659605 PMCID: PMC6928097 DOI: 10.1007/s10439-019-02382-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/09/2019] [Indexed: 12/21/2022]
Abstract
Physical differences between youth and adults, which include incomplete myelination, limited neck muscle development, and a higher head-body ratio in the youth population, likely contribute towards the increased susceptibility of youth to concussion. Previous research efforts have considered the biomechanics of concussion for adult populations, but these known age-related differences highlight the necessity of quantifying the risk of concussion for a youth population. This study adapted the previously developed Generalized Acceleration Model for Brian Injury Threshold (GAMBIT) that combines linear and rotational head acceleration to model the risk of concussion for a youth population with the Generalized Acceleration Model for Concussion in Youth (GAM-CY). Survival analysis was used in conjunction with head impact data collected during participation in youth football to model risk between individuals who sustained medically-diagnosed concussions (n = 15). Receiver operator characteristic curves were generated for peak linear acceleration, peak rotational acceleration, and GAM-CY, all of which were observed to be better injury predictors than random guessing. GAM-CY was associated with an area under the curve of 0.89 (95% confidence interval: 0.82–0.95) when all head impacts experienced by the concussed players were considered. Concussion tolerance was observed to be lower for youth athletes, with average peak linear head acceleration of 62.4 ± 29.7 g compared to 102.5 ± 32.7 g for adults and average peak rotational head acceleration of 2609 ± 1591 rad/s2 compared to 4412 ± 2326 rad/s2. These data provide further evidence of age-related differences in concussion tolerance and may be used for the development of youth-specific protective designs.
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Salmon D, Romanchuk J, Murphy I, Sullivan J, Walters S, Whatman C, Clacy A, Keung S, Van Der Vis K. Infographic. New Zealand Rugby's concussion management pathway. Br J Sports Med 2019; 54:298-299. [PMID: 31300392 DOI: 10.1136/bjsports-2019-100950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Danielle Salmon
- Health, Safety and Welfare, New Zealand Rugby Union, Wellington, New Zealand
| | - Janelle Romanchuk
- Health, Safety and Welfare, New Zealand Rugby Union, Wellington, New Zealand
| | - Ian Murphy
- Health, Safety and Welfare, New Zealand Rugby Union, Wellington, New Zealand
| | - John Sullivan
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Simon Walters
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Chris Whatman
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Amanda Clacy
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Sierra Keung
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Klazina Van Der Vis
- School of Medicine, University of Otago Medical School, Dunedin, New Zealand
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Scarneo SE, Kerr ZY, Kroshus E, Register-Mihalik JK, Hosokawa Y, Stearns RL, DiStefano LJ, Casa DJ. The Socioecological Framework: A Multifaceted Approach to Preventing Sport-Related Deaths in High School Sports. J Athl Train 2019; 54:356-360. [PMID: 30870600 DOI: 10.4085/1062-6050-173-18] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The socioecological framework is a multilevel conceptualization of health that includes intrapersonal, interpersonal, organizational, environmental, and public policy factors. The socioecological framework emphasizes multiple levels of influence and supports the idea that behaviors both affect and are affected by various contexts. At present, the sports medicine community's understanding and application of the socioecological framework are limited. In this article, we use the socioecological framework to describe potential avenues for interventions to reduce sport-related deaths among adolescent participants.
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Affiliation(s)
- Samantha E Scarneo
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Emily Kroshus
- University of Washington, Department of Pediatrics, Seattle.,Seattle Children's Research Institute, Center for Child Health, Behavior and Development, WA
| | | | - Yuri Hosokawa
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Rebecca L Stearns
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | | | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
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