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Yeargin S, Hirschhorn RM, Adams WM, Scarneo-Miller SE. Secondary School State Athletic Association Health and Safety Policy Development Processes. THE JOURNAL OF SCHOOL HEALTH 2024; 94:591-600. [PMID: 38621415 DOI: 10.1111/josh.13454] [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: 10/04/2022] [Revised: 03/07/2024] [Accepted: 03/17/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The National Federation of State High School Associations provides recommendations regarding health and safety policies; however, policy development is governed at the state level. Given interstate differences in governance, the primary purpose was to describe processes that State High School Athletic Associations (SHSAAs) utilize to develop a new policy. The secondary objective was to determine what methods associations use to implement new policies. METHODS A cross-sectional survey requested SHSAA (n = 51) representatives to report how athlete health and safety policies are introduced, revised, approved, and implemented within their state. The 22-question survey was developed to gather variables for the aims of the study. Descriptive statistics were calculated for each survey item. RESULTS Of states who responded (n = 33), most reported a 2-committee (n = 24, 72.7%) process for developing and vetting policies, with initiation from the Sports Medicine Advisory Committee (n = 27, 81.8%), followed by an executive-level committee (n = 18, 66.7%). States reported total time from policy initiation to final approval ranged from 2 weeks to over 12 months. When a new policy was approved, most states indicated implementation began with an e-mail (n = 24, 72.7%) sent to Athletic Directors (n = 26, 78.8%). School principal or district superintendent were reported as the position in charge of compliance (36.4%, n = 12). CONCLUSIONS Most SHSAAs use a 2-step process to write and review an athlete health and safety policy before approval. SHSAAs that require a longer policy development time could delay the implementation of important health measures. SHSAAs could consider additional communication methods to ensure information reaches all stakeholders.
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Affiliation(s)
- Susan Yeargin
- University of South Carolina, 921 Assembly St, PHRC Rm 226, Columbia, SC, 29208
| | - Rebecca M Hirschhorn
- Louisiana State University, School of Kinesiology, 2213 Pleasant Hall, Baton Rouge, LA, 70803
| | - William M Adams
- Sports Medicine Research, Division of Sports Medicine, United States Olympic & Paralympic Committee, 1 Olympic Plaza, Colorado Springs, CO, 80917
| | - Samantha E Scarneo-Miller
- School of Medicine, Division of Athletic Training, West Virginia University, 1 Medical Center Drive, 8501A Health Science Center South, Morgantown, WV, 26508
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Salmon D, Badenhorst M, Clark B, Walters S, Sullivan SJ, Sole G. Unintended consequences - A qualitative exploration of baseline testing in community rugby concussion management. J Sci Med Sport 2024:S1440-2440(24)00152-X. [PMID: 38811276 DOI: 10.1016/j.jsams.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES Understanding key stakeholders' perceptions around the value of baseline testing, as well as barriers or facilitators experienced as part of the process, may assist with the decision-making process of whether to implement baseline testing in community sport. This study explored coaches', players' and physiotherapists' perceptions of the perceived value, barriers and facilitators of baseline testing as part of New Zealand Rugby's (NZR) community concussion initiative. DESIGN The study employed a pragmatic, qualitative descriptive design. METHODS Semi-structured interviews were used to explore participants' perceptions. In total, 73 individual interviews were conducted. The sample consisted of 36 players, 13 coaches and 24 physiotherapists involved in NZR's concussion management pathway. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS In terms of perceived value, baseline testing was reported to play a role in i) facilitating a positive concussion culture; ii) positive perceptions of rugby and player safety and iii) enhancing concussion management as part of the pathway. Barriers and facilitators of the baseline testing process included i) stakeholder buy-in as critical driver of the process and ii) contextual and operational factors. Although contextual and operational challenges exist, these participants, as key stakeholders in the process, perceived the value of baseline testing to be more important than the barriers experienced. CONCLUSIONS The value of baseline testing extends beyond concussion assessment and management, by enhancing community concussion awareness, attitudes and player safety. The findings of this study may assist in the decision-making process around inclusion of pre-season baseline testing in community rugby.
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Affiliation(s)
| | - Marelise Badenhorst
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, New Zealand.
| | - Brooke Clark
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Simon Walters
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, New Zealand
| | | | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
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Ingram BM, DeFreese JD, Kerr ZY, Oyesanya TO, Picha KJ, Register-Mihalik JK. Applying the National Institute on Minority Health and Health Disparities Research Framework to Social Determinants of Health in the Context of Sport-Related Concussion: A Clinical Commentary. J Athl Train 2024; 59:447-457. [PMID: 38446622 PMCID: PMC11127672 DOI: 10.4085/1062-6050-0370.23] [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: 03/08/2024]
Abstract
Sport-related concussion (SRC) is a prevalent injury. Significant disparities in SRC outcomes exist across racial and ethnic groups. These disparities may be attributed to the unequal distribution of political power (or influence) and resource allocation in various communities, shaping individuals' social determinants of health (SDOH). However, the influence of SDOH on SRC outcomes remains understudied. In this clinical commentary, we use the National Institute on Minority Health and Health Disparities Research Framework and describe how its application can help address gaps in our understanding of SDOH and SRC. This framework provides a comprehensive approach to investigating and addressing health disparities by considering SDOH along multiple levels and domains of influence. Using this framework, athletic trainers can identify areas requiring intervention and better understand how SDOH influence SRC outcomes. This understanding can help athletic trainers develop tailored interventions to promote equitable care for patients with SRC.
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Affiliation(s)
- Brittany M. Ingram
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - J. D. DeFreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | - Kelsey J. Picha
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
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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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Buckley TA, Passalugo SW, Gallo CA, Bodt B, Evans KM, Munkasy BA. Collegiate student-athletes concussion knowledge and attitudes: what a difference a decade Makes. Brain Inj 2024; 38:288-294. [PMID: 38369869 PMCID: PMC10911450 DOI: 10.1080/02699052.2024.2314549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The purpose of this study was to assess changes in concussion knowledge and attitudes amongst incoming intercollegiate student-athletes over the course of a decade (2010-2012 vs 2021-2023). METHODS There were 592 student-athletes from 2 cohorts (2010-2012, 2021-2023) who completed the Rosenbaum Concussion Knowledge and Attitudes Survey (ROCKaS) questionnaire which is comprised of a concussion knowledge index (CKI, 0-24) and attitude index (CAI, 15-75) with higher scores reflecting better performance. A three factor ANOVA (Group, Sex, Concussion History) compared performance on the CKI and CAI. Individual questions were compared between groups with a Chi-Square analysis. RESULTS For the CKI, there was a significant main effect for Group (2010-2012: 18.5 ± 2.6, 2021-2023: 19.4 ± 2.5, p < 0.001, η 2 = 0.032 ) . For the CAI, there was also a significant main effect for group (2010-2012: 52.9 ± 6.0, 2021-2023: 62.2 ± 6.5, p < 0.001, η 2 = 0.359 ) . CONCLUSIONS The results of this study show a modest increase in concussion knowledge; however, large improvements in concussion attitudes were observed between groups. These results suggest a continued improvement in student-athlete concussion awareness and provide specific areas to continue addressing persistent misconceptions.
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Affiliation(s)
- Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Scott W Passalugo
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Caitlin A Gallo
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Barry Bodt
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Kelsey M Evans
- Department of General Surgery, Orlando Health, Orlando, Florida, USA
| | - Barry A Munkasy
- School of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia, USA
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Travis E, Scott-Bell A, Thornton C. The current state of concussion knowledge and attitudes in British American Football. PHYSICIAN SPORTSMED 2024; 52:36-45. [PMID: 36510839 DOI: 10.1080/00913847.2022.2156766] [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] [Received: 08/30/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine concussion knowledge and concussion attitudes of players, coaches, and support staff in British American Football (BAF). METHODS Data from players, coaches and support staff (n = 236) were collected from across all leagues in BAF. An online survey tool was used which included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS), and questions examining concussion education and perceived risk of participating in football. RESULTS The mean score on the RoCKAS concussion knowledge was 21.0 ± 2.1 of a possible score of 25 reflecting good knowledge. Of a possible score of 65, the mean concussion attitude score was 55.6 ± 6.1 showing safe attitude. Whilst an overall safe attitude was seen, almost half of participants (45.3%) noted they would continue to play with a concussion. No relationship was found between CAI and prior concussion history. Fifty seven percent of participants agreed the benefits of playing football outweighed the risks. Forty eight percent reported that they had received no concussion-related education in the past 12 months. CONCLUSION BAF participants have good concussion knowledge and safe attitudes. However, risky behavior is demonstrated through unsafe likelihood to report and attitude to long-term health risks. Access to the British American Football Association (BAFA) concussion policy and education was poor raising questions over what sources of information stakeholders are drawing their knowledge from. These findings can help form the foundation of educational interventions (e.g. coaching workshops) to challenge current misconceptions and improve likelihood to report concussion in BAF.
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Affiliation(s)
- Eleanor Travis
- Musculoskeletal Health Research Group, School of Health, Leeds Beckett University, Leeds, UK
| | - Andrea Scott-Bell
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Claire Thornton
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
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Pollard-McGrandy AM, Tracey AJ, Wallace J, Covassin T, Beidler E. Perceptions of personal control and treatment efficacy of sport-related concussions in collegiate athletes. Brain Inj 2023; 37:1362-1369. [PMID: 38111232 DOI: 10.1080/02699052.2023.2292998] [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] [Received: 09/07/2022] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE The purpose of this study was to examine healthy collegiate athletes' perceptions of personal control and beliefs regarding the treatment efficacy related to sport-related concussion (SRC) along with identifying factors that may be associated with these perceptions. METHODS This cross-sectional study included collegiate athletes (n = 956) between the age of 18-26 years. Participants completed a 10- to 15-min survey regarding their demographics, diagnosed SRC history, SRC knowledge, and Perceptions of Concussion Inventory for Athletes (PCI-A). Chi-squared analysis and multivariable logistic regressions were conducted to identify factors associated with the PCI-A outcomes of personal control and treatment efficacy perceptions. RESULTS 24.2% of respondents reported higher perceptions of personal control, while 77.3% reported higher perceptions of treatment efficacy. The multivariable logistic regression revealed males had higher odds of greater perceptions of personal control (OR = 1.50; 95% CI: 1.10-2.03), while those with a history of diagnosed SRC had lower odds of having favorable treatment efficacy beliefs (OR: 0.69; 95% CI: 0.50-0.96). CONCLUSIONS This study established that collegiate athletes generally have lower perceptions of personal control and higher perceptions of treatment efficacy related to SRC recovery. Comprehensive SRC education should be expanded for individuals to understand that they have power over their own health outcomes and that SRC is a treatable injury.
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Affiliation(s)
| | - Allie J Tracey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Jessica Wallace
- Department of Health Science, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
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Sinnott AM, Chandler MC, Van Dyke C, Mincberg DL, Pinapaka H, Lauck BJ, Mihalik JP. Efficacy of Guardian Cap Soft-Shell Padding on Head Impact Kinematics in American Football: Pilot Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6991. [PMID: 37947549 PMCID: PMC10650906 DOI: 10.3390/ijerph20216991] [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: 09/06/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Sport-related concussion prevention strategies in collision sports are a primary interest for sporting organizations and policy makers. After-market soft-shell padding purports to augment the protective capabilities of standard football helmets and to reduce head impact severity. We compared head impact kinematics [peak linear acceleration (PLA) and peak rotational acceleration (PRA)] in athletes wearing Guardian Cap soft-shell padding to teammates without soft-shell padding. Ten Division I college football players were enrolled [soft-shell padding (SHELL) included four defensive linemen and one tight end; non-soft-shell (CONTROL) included two offensive linemen, two defensive linemen, and one tight end]. Participants wore helmets equipped with the Head Impact Telemetry System to quantify PLA (g) and PRA (rad/s2) during 14 practices. Two-way ANOVAs were conducted to compare log-transformed PLA and PRA between groups across helmet location and gameplay characteristics. In total, 968 video-confirmed head impacts between SHELL (n = 421) and CONTROL (n = 547) were analyzed. We observed a Group x Stance interaction for PRA (F1,963 = 7.21; p = 0.007) indicating greater PRA by SHELL during 2-point stance and lower PRA during 3- or 4-point stances compared to CONTROL. There were no between-group main effects. Protective soft-shell padding did not reduce head impact kinematic outcomes among college football athletes.
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Affiliation(s)
- Aaron M. Sinnott
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.M.S.); (H.P.)
| | - Madison C. Chandler
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.M.S.); (H.P.)
| | - Charles Van Dyke
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.M.S.); (H.P.)
| | - David L. Mincberg
- Campus Health Services, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Hari Pinapaka
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.M.S.); (H.P.)
| | - Bradley J. Lauck
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.M.S.); (H.P.)
| | - Jason P. Mihalik
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.M.S.); (H.P.)
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Heck SJ, Acord-Vira A, Davis DR. Sex differences in college students' knowledge of concussion and concussion education sources. Concussion 2023; 8:CNC108. [PMID: 37691852 PMCID: PMC10488458 DOI: 10.2217/cnc-2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/21/2023] [Indexed: 09/12/2023] Open
Abstract
Aim To understand sex differences and sources of concussion education for college students. The literature for college students primarily focuses on sports concussions and general knowledge. Understanding how non-students-athletes learn is critical to developing interventions to improve concussion knowledge. Participants A random sample of 208 students from four-year institutions. Methods A 22-question online survey explored postsecondary students' current knowledge and education regarding concussions. Results Findings indicated that sex differences emerged with concussion knowledge and sources of concussion knowledge (e.g., leaflets, pamphlets, parents, and television). The top choices for where they wanted to learn about concussions were health educators, health centers, and campus peer educators. Conclusion This study provides an initial evaluation and implications for future research on providing concussion education.
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Affiliation(s)
- Stephen J Heck
- Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Amanda Acord-Vira
- Division of Occupational Therapy, West Virginia University, Morgantown, WV 26506, USA
| | - Diana R Davis
- Division of Occupational Therapy, West Virginia University, Morgantown, WV 26506, USA
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Chrisman SPD, Gomez D, Kroshus E, Mayer CV, Garrett K, Ramshaw D, Glang A. Developing a conceptual model of coach concussion communication by adapting the theory of planned behavior and the social ecological model. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1622-1629. [PMID: 34398704 DOI: 10.1080/07448481.2021.1944166] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/22/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
Objective: Acknowledging that coach communication about concussion increases the likelihood of athletes reporting concussive symptoms, the goal of this study was to examine factors affecting such communication, in order to develop a conceptual model that would inform the design of future educational interventions.Participants: Division I contact sport coaches.Methods: We conducted structured qualitative interviews with coaches and analyzed interviews using Thematic Analysis, viewed through the lens of the Theory of Planned Behavior nested within the Social Ecological Model.Results: Coaches had good knowledge of concussion and understood the dangers of playing with symptoms. However, they also discussed the lack of objective criteria for concussion diagnosis, and pressure to win in order to remain employed, both of which created barriers to concussion communication. Ultimately, most coaches reported not engaging in significant concussion communication as they did not feel this was their role, instead deferring to medical staff.Conclusions: Educational interventions might benefit from a focus on the importance of coach concussion safety-supportive coach communication, with a goal of increasing the likelihood of athlete concussion reporting.
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Affiliation(s)
- Sara P D Chrisman
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Douglas Gomez
- The Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Emily Kroshus
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Cecilia V Mayer
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Kimberly Garrett
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Dane Ramshaw
- The Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Ann Glang
- The Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, 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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12
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Kerr ZY, Gildner P, Parker SK, Kostogiannes V, Callahan CE, Nedimyer AK, Kossman MK, Chandran A, Register-Mihalik JK. Sport culture and communication among middle school athletes, parents, and staff: A qualitative study. PLoS One 2023; 18:e0282252. [PMID: 36920886 PMCID: PMC10016647 DOI: 10.1371/journal.pone.0282252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/10/2023] [Indexed: 03/16/2023] Open
Abstract
Middle school (MS) is an intermediary level of education between elementary and secondary school that typically includes students aged 10-15 years. There is limited research within the MS sport setting, particularly related to sport-related injury prevention. This qualitative study aimed to better understand the sport culture within MS sports and the communication strategies used among invested groups (i.e., athletes, parents, staff inclusive of coaches and school nurses). Semi-structured interviews were conducted with 19 athletes, 20 parents, and 18 staff (e.g., coaches, school nurses) from seven MS in two school districts during the 2018/19 and 2019/20 school years. Topics focused on understanding school- and sport-related factors related to education, safety, and communication. Analysis used a consensual qualitative research tradition, in which the research team discussed individually developed themes and categories from transcribed interviews, with the goal of coming to a consensus and creating a codebook. Throughout the coding process, the research team would reconvene to discuss coding decisions until consensus was reached. This study focuses on the themes of sport culture and communication. Dominant categories identified within sport culture related to participants noting why they were interested in MS sports, and their struggles with their perceived roles and engagement (e.g., helping parents stay engaged, finding coaches, oversight of school nurses). Competitiveness and safety could have conflicting roles and priority. Dominant categories identified within communication centered around limited communication between coaches and parents. Technological assistance (e.g., phone apps, websites) was available, but often varied by school and sport. Concussions were seldom discussed unless during the preseason meeting or when one occurred. Findings highlight that the MS sport settings may struggle with incorporating primary prevention into their cultures and ensuring reliable communication among individuals. Novel and tailored approaches to injury prevention are needed to help ensure buy-in and proper implementation.
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Affiliation(s)
- Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Stephanie K. Parker
- Department of Physical Therapy, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, United States of America
| | - Vasiliki Kostogiannes
- Physician Assistant Program, University of Maryland-Baltimore, Baltimore, MD, United States of America
| | - Christine E. Callahan
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Aliza K. Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Melissa K. Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS, United States of America
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, United States of America
| | - Johna K. Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Kerr ZY, Chandran A, Nedimyer AK, Rothschild AE, Kay MC, Gildner P, Byrd KH, Haarbauer-Krupa JK, Register-Mihalik JK. Use of sport-related concussion information sources among parents of United States middle school children. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:716-724. [PMID: 32417468 PMCID: PMC9729916 DOI: 10.1016/j.jshs.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/14/2020] [Accepted: 03/16/2020] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Parents may use various information sources to obtain information about sport-related concussions (SRC). This study examined SRC-related information sources used by parents of United States middle school children (age: 10-15 years). METHODS A panel of 1083 randomly selected U.S. residents, aged ≥18 years and identifying as parents of middle school children, completed an online questionnaire capturing parental and child characteristics, and utilization and perceived trustworthiness of various sources of SRC-related information. Multivariable logistic regression models identified factors associated with utilizing each source. Adjusted odds ratios (OR) with 95% confidence intervals (95%CIs) excluding 1.00 were deemed significant. RESULTS Doctors/healthcare providers (49.9%) and other healthcare-related resources (e.g., Centers for Disease Control and Prevention, WebMD) (37.8%) were common SRC-related information sources; 64.0% of parents utilized ≥1 of these sources. Both sources were considered "very" or "extremely" trustworthy for SRC-related information among parents using these sources (doctors/healthcare providers: 89.8%; other healthcare-related resources: 70.9%). A 10-year increase in parental age was associated with higher odds of utilizing doctors/healthcare providers (adjusted odd ratio (ORadjusted) = 1.09, 95%CI: 1.02-1.16) and other healthcare-related resources (ORadjusted = 1.11, 95%CI: 1.03-1.19). The odds of utilizing doctors/healthcare providers (ORadjusted = 0.58, 95%CI: 0.40-0.84) and other healthcare-related resources (ORadjusted = 0.64, 95%CI: 0.44-0.93) were lower among parents whose middle school children had concussion histories versus the parents of children who did not have concussion histories. CONCLUSION One-third of parents did not report using doctors/healthcare providers or other healthcare-related resources for SRC-related information. Factors associated with underutilization of these sources may be targets for future intervention. Continuing education for healthcare providers and educational opportunities for parents should highlight accurate and up-to-date SRC-related information.
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Affiliation(s)
- Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA.
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC 27599-8700, USA
| | - Allison E Rothschild
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7400, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - K Hunter Byrd
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
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14
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Root HJ, Lininger MR, DiStefano LJ. Hybrid effectiveness-implementation study designs in sports injury prevention research. Front Sports Act Living 2022; 4:981656. [PMID: 36203655 PMCID: PMC9530324 DOI: 10.3389/fspor.2022.981656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Despite vast evidence supporting the effectiveness of lower extremity injury prevention programs in a variety of sport settings, age groups, and levels of competition, there is limited evidence on implementation strategies that positively impact the feasibility, scale-up and sustainability of such programs. Sport-related injury prevention is affected by the research-to-practice gap, a pervasive issue in healthcare, where high-quality experimental research is not used in routine clinical practice. An intervention shown to be efficacious in a controlled environment, such as a lab or in a field-study conducted by scientists, will demonstrate a decline in benefit when implemented in the intended clinical setting. Real-world considerations, such as foundational knowledge and training, time constraints, or end user motivation, influence the quality and consistency of implementation. Acknowledging and addressing implementation barriers in a systematic way is essential to promote effective program dissemination. Study design methods that measure both clinical effectiveness and implementation strategies need to be identified. Hybrid effectiveness-implementation designs simultaneously measure both an intervention's effect on clinical outcomes as well as critical information related to implementation strategy; however these study designs are not frequently utilized. The purpose of this mini-review is to describe: the basics of hybrid designs, rationale for using hybrid designs, and examples of how these designs could be used in athletic healthcare injury prevention research.
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Affiliation(s)
- Hayley J. Root
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, AZ, United States
- *Correspondence: Hayley J. Root
| | - Monica R. Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, United States
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Fagher K, Kunorozva L, Badenhorst M, Derman W, Kissick J, Verhagen E, Ahmed OH, Jederström M, Heron N, Khoshnood AM, Silva A, Kenttä G, Lexell J. Safe and Healthy Para sport project (SHAPE): a study protocol of a complex intervention within Para sport. BMJ Open Sport Exerc Med 2022; 8:e001392. [PMID: 36101569 PMCID: PMC9422828 DOI: 10.1136/bmjsem-2022-001392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 12/02/2022] Open
Abstract
Elite Para athletes report a high incidence of sports injuries, illnesses and other health issues. Despite this, there are few prevention programmes in Para sport, and many of the existing prevention programmes are not adapted to Para athletes. To improve the success of preventive measures, it has been suggested that sports safety work should facilitate health promotion, including athlete health education. Therefore, the overarching aim of this project is to evaluate an accessible health promotion web platform as part of a complex intervention that aims to improve knowledge of athlete health in Para sport. In this protocol, the development, future implementation and evaluation of the intervention are described. To inform the implementation and use of such interventions, it is recommended to involve end users in the development and implementation process. Therefore, a participatory design process, including athletes and the sports organisation, was used to develop an accessible health promotion web platform. To evaluate this complex intervention, a process evaluation combining quantitative evaluation assessing causal pathways with qualitative methods assessing multifaceted pathways will be used. The primary outcomes are injury/illness incidence, athlete health parameters, health literacy and user behaviour. A cohort of elite Para athletes (n=150) from Sweden and South Africa will be invited to participate. This project will be the first that aims to improve athlete health in Para sport through pragmatic and accessible health promotion. It is a boundary-crossing project that will be conducted in a real-world sport setting, including athletes with different socioeconomic backgrounds.
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Affiliation(s)
- Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Lovemore Kunorozva
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch, South Africa
- IOC Research Center, Stellenbosch, South Africa
| | - Marelise Badenhorst
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch, South Africa
- IOC Research Center, Stellenbosch, South Africa
| | - James Kissick
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers – Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Osman Hassan Ahmed
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
- The FA Centre for Disability Football Research, The Football Association, Burton Upon Trent, UK
| | - Moa Jederström
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Neil Heron
- Centre for Public Health, Queen’s University Belfast, School of Medicine, Keele University, Belfast, UK
| | - Ardavan M Khoshnood
- Emergency Medicine, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Andressa Silva
- Sports Training Center, School of Physical Education, Physical Therapy and Occupational Therapy, Sports Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Göran Kenttä
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
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16
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Relationship between Aggressiveness, Self-Confidence, and Perceived Coach Support and Head Impact Exposure in Youth Football. Sports (Basel) 2022; 10:sports10080115. [PMID: 36006081 PMCID: PMC9412463 DOI: 10.3390/sports10080115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/06/2022] [Accepted: 07/23/2022] [Indexed: 11/17/2022] Open
Abstract
This study evaluated head impact exposure (HIE) metrics in relation to individual-level determinants of HIE. Youth (n = 13) and high school (n = 21) football players were instrumented with the Head Impact Telemetry (HIT) system during one season. Players completed the Trait-Robustness of Self-Confidence Inventory (TROSCI), Sports Climate Questionnaire (SCQ), and Competitive Aggressiveness and Anger Scale (CAAS), measuring self-confidence, perceived coach support, and competitive aggressiveness, respectively. Relationships between HIE metrics (number of impacts, median and 95th percentile accelerations, and risk-weighted exposure (RWE)) and survey scores were evaluated using linear regression analysis. For middle school athletes, TROSCI scores were significantly negatively associated with the number of competition impacts and the mean number of impacts per player per competition. SCQ scores were significantly positively associated with median linear acceleration during practice. CAAS scores were not significantly associated with biomechanical metrics at either level of play. Perceived coach support and self-confidence might influence HIE among middle school football players. Football athletes' competitive aggressiveness may have less influence their HIE than other factors.
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17
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du Preez J, Jhala P, Lystad RP. Availability and content of concussion guidelines in Australian combat sports. J Sci Med Sport 2022; 25:800-804. [PMID: 35871904 DOI: 10.1016/j.jsams.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the availability and content of publicly available concussion information published by peak amateur and professional combat sport governing bodies in Australia. DESIGN Cross-sectional study; document analysis. METHODS Publicly available concussion information was retrieved from the websites of eleven peak Australian amateur and professional combat sport governing bodies. Data on type of source material, concussion definition, provision of medical services, concussion evaluation, and return-to-sport information were extracted. The quality of the information was assessed using a modified version of the Global Rating Scale. RESULTS Eight out of eleven combat sport governing bodies provided concussion information in source documents ranging from competition rules to position statements to specific policies. Five governing bodies provided information on post-contest concussion evaluation or testing, four of which mentioned the Sport Concussion Assessment Tool. Eight governing bodies provided information on return-to-sport, of which six stipulated mandatory minimum rest periods and four indicated that athletes should complete a graduated return-to-sport protocol. The provided concussion information was generally of low quality, with a median score of 3 out of 9 (range: 1-4). CONCLUSIONS There is substantial scope and an urgent need for improving concussion guidelines across peak combat sport governing bodies in Australia to improve the health and safety of their athletes.
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Affiliation(s)
- James du Preez
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - Prashant Jhala
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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Sports Training Strategy and Interactive Control Method Based on Digital Twins and Wireless Sensor Networks. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2131125. [PMID: 35755755 PMCID: PMC9225840 DOI: 10.1155/2022/2131125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022]
Abstract
By combining virtual reality, the digital twin system has been deeply applied in many places. Especially with the upsurge of national sports and more attention to sports, people have also begun a more in-depth study on the strategy of sports training. This paper aims to explore the application of the Brazilian jujitsu training strategy and interactive control method in the new era. Based on the sports skills of Brazilian jujitsu, combined with digital twin technology and wireless sensor network technology, this paper develops a sports training system based on Brazilian jujitsu. It can collect the action information of the trainer and twin it into the simulation system so as to carry out better and more effective confrontation training. The experimental results show that the average delay time is 5.2 ms and the maximum delay time is 6.5 ms, which is less than the limit delay time of 20 ms. Compared with the control group, it achieved quite good results. It shows the effectiveness of the system designed in this paper for trick jujitsu training.
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Young M, Peterson AH. Neuroethics across the Disorders of Consciousness Care Continuum. Semin Neurol 2022; 42:375-392. [PMID: 35738293 DOI: 10.1055/a-1883-0701] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Leeds DD, Zeng Y, Johnson BR, Foster CA, D'Lauro C. Beliefs affecting concussion reporting among military cadets: advanced observations through machine learning. Brain Inj 2022; 36:156-165. [PMID: 35133926 DOI: 10.1080/02699052.2022.2034945] [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: 11/02/2022]
Abstract
BACKGROUND Untreated concussions are an important health concern. The number of concussions sustained each year is difficult to pinpoint due to diverse reporting routes and many people not reporting. A growing body of literature investigates the motivations for concussion under-reporting, proposing ties with knowledge of concussion outcomes and concussion culture. The present work employs machine learning to identify trends in knowledge and willingness to self-report concussions. METHODS 2,204 cadets completed a survey addressing athletic and pilot status, concussion symptoms and outcome beliefs, ethical beliefs, demographics, and reporting willingness. RESULTS Clustering and non-negative matrix analysis identified connections to self-report willingness within: knowledge of symptoms, ethical beliefs, reporting requirements, and belief of long-term concussion outcomes. Support vector machine classification of cadet reporting likelihood reveals symptom and outcome knowledge may be inversely related to reporting among those rating ethics considerations as low, while heightened ethics may predict higher reporting likeliness overall. CONCLUSIONS Machine-learning analysis bolsters prior theories on the importance of concussion culture in reporting and indicate more symptom knowledge may decrease willingness to report. Uniquely, our analysis indicated importance of ethical behavior may be associated with general concussion reporting willingness, inviting further consideration from healthcare practitioners seeking increased reporting.
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Affiliation(s)
- Daniel D Leeds
- Computer and Information Science Department, Fordham University, Bronx, New York, USA
| | - Yue Zeng
- Computer and Information Science Department, Fordham University, Bronx, New York, USA
| | - Brian R Johnson
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Marry Land, USA
| | - Craig A Foster
- Psychology Department for SUNY Cortland, State University of New York College at Cortland, Cortland, New York, USA
| | - Christopher D'Lauro
- Department of Behavioral Science and Leadership, United States Air Force Academy, USAF, Colorado Springs, CO, USA
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21
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Anderson MN, D'Lauro C, Johnson BR, Foster CA, Schmidt JD. Concussion reporting intentions for incoming military athletes and cadets. Brain Inj 2022; 36:332-338. [PMID: 35108138 DOI: 10.1080/02699052.2022.2033841] [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: 11/02/2022]
Abstract
Cultures of concussion reporting exist outside athletics; however, athlete-only studies dominate the literature. Comparing athletes and similar high-risk populations broadens our understanding of concussion reporting acculturation. We aimed to (1) describe and compare concussion self-report willingness as measured by anticipated concussion reporting (ACR), perceived costs, perceived rewards, brain health knowledge, and correct symptom identification for incoming cadets at the United States Air Force Academy (USAFA) (n = 1,136; female = 276, 24.43%) and (2) determine whether those variables predict ACR. Univariate analyses were performed to compare intercollegiate status, sex, and parental income for perceived costs and rewards, and brain health knowledge (α = 0.05) and multinomial logistic regressions to determine if those variables predicted ACR. A $40,000 parental increase in income resulted in one additional symptom identified (β = 0.80, p = 0.026). Athletes demonstrated greater brain health knowledge by nearly one symptom correctly identified (β = 0.98, p = 0.002); non-athletes reported significantly greater ACR (β = 5.92; p < 0.001). Our model accounted for 37% of the variance in ACR (χ2 = 393.86, p < 0.001, Nagelkerke R2 = 0.37). Before military acculturation, athletes had less intention to seek medical care for concussion, likely from prior athletic experiences.
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Affiliation(s)
- Melissa N Anderson
- Department of Kinesiology, The University of Georgia, Athens, Georgia, USA.,Uga Concussion Research Laboratory, The University of Georgia, Athens, Georgia, USA
| | - Christopher D'Lauro
- Department of Behavioral Sciences and Leadership, Concussion Lab, US Air Force Academy, Colorado Springs, CO
| | - Brian R Johnson
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Craig A Foster
- State University of New York (SUNY) at Cortland, Cortland, New York, US
| | - Julianne D Schmidt
- Department of Kinesiology, The University of Georgia, Athens, Georgia, USA.,Uga Concussion Research Laboratory, The University of Georgia, Athens, Georgia, USA
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22
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Chandran A, Boltz AJ, Morris SN, Robison HJ, Nedimyer AK, Collins CL, Register-Mihalik JK. Epidemiology of Concussions in National Collegiate Athletic Association (NCAA) Sports: 2014/15-2018/19. Am J Sports Med 2022; 50:526-536. [PMID: 34898299 DOI: 10.1177/03635465211060340] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Updated epidemiology studies examining sports-related concussions (SRCs) are critical in evaluating recent efforts aimed at reducing the incidence of SRCs in National Collegiate Athletic Association (NCAA) sports. PURPOSE To describe the epidemiology of SRCs in 23 NCAA sports during the 2014/15-2018/19 academic years. STUDY DESIGN Descriptive epidemiology study. METHODS SRC and exposure data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics by sport, event type (practices, competitions), injury mechanism (player contact, surface contact, equipment/apparatus contact), and injury history (new, recurrent). Injury rate ratios (IRRs) were used to examine differential injury rates, and injury proportion ratios (IPRs) were used to examine differential distributions. RESULTS A total of 3497 SRCs from 8,474,400 athlete-exposures (AEs) were reported during the study period (4.13 per 10,000 AEs); the competition-related SRC rate was higher than was the practice-related SRC rate (IRR, 4.12; 95% CI, 3.86-4.41). The highest SRC rates were observed in men's ice hockey (7.35 per 10,000 AEs) and women's soccer (7.15 per 10,000 AEs); rates in women's soccer and volleyball increased during 2015/16-2018/19. Player contact was the most prevalently reported mechanism in men's sports (77.0%), whereas equipment/apparatus contact was the most prevalently reported mechanism in women's sports (39.2%). Sex-related differences were observed in soccer, basketball, softball/baseball, and swimming and diving. Most SRCs reported in men's sports (84.3%) and women's sports (81.1%) were reported as new injuries. CONCLUSION Given the increasing SRC rates observed in women's soccer and volleyball during the latter years of the study, these results indicate the need to direct further attention toward trajectories of SRC incidence in these sports. The prevalence of equipment/apparatus contact SRCs in women's sports also suggests that SRC mechanisms in women's sports warrant further investigation. As most SRCs during the study period were reported as new injuries, the prevalence of recurrent SRCs in men's and women's ice hockey is also noteworthy.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Aliza K Nedimyer
- Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Johna K Register-Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,STAR Heel Performance Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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23
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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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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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Kroshus E, Lowry SJ, Garrett K, Hays R, Hunt T, Chrisman SPD. Development of a scale to measure expected concussion reporting behavior. Inj Epidemiol 2021; 8:70. [PMID: 34920752 PMCID: PMC8684105 DOI: 10.1186/s40621-021-00364-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background Most concussion education aims to increase athlete self-report of concussive symptoms. Although the population burden of concussion is high, frequency with which this injury occurs on a given sports team in a given season is relatively low. This means that powering concussion education evaluation studies to measure change in post-injury symptom reporting behavior requires what is often a prohibitively large sample size. Thus, evaluation studies are typically powered to measure proximal cognitions. Expected reporting behavior, a cognition that reflects planned and reactive decision-making, is a theoretically indicated construct for inclusion in evaluation studies. However, previously no scales were available to measure this construct with demonstrated reliability and validity among youth athletes. The objective of this study was to develop and assess the validity of a brief single-factor scale to measure expected youth athlete concussion reporting behavior (CR-E) in a sample of youth athletes.
Methods A mixed methods approach was used, including cognitive interviews with youth athletes, and quantitative item reduction and validation. Participants were youth athletes (aged 9–16) from the Seattle metropolitan and rural south-Georgia regions. After refining an initial pool of items using cognitive interviews with a diverse group of youth athletes (n = 20), a survey containing these items was administered to youth soccer and football players (n = 291). Item reduction statistics and sequential confirmatory factor analyses were used to reduce the initial scale using a randomly selected half of the sample. Then, a final confirmatory factor analysis and validation tests were applied to the other half of the sample of youth athletes. Predictive validation was conducted longitudinally in a separate sample of youth athletes (n = 155). Results Internal consistency was high (alpha = 0.89), model fit was excellent, validation tests were in the hypothesized directions, and the scale was feasible to use. Using the finalized 4-item scale, we observed that less than one-third of youth soccer and football athletes expect to “always” tell their coach about symptoms of a suspected concussion. Conclusions The CR-E measure should be included in future studies evaluating concussion education programming in youth athlete populations. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-021-00364-4.
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Affiliation(s)
- Emily Kroshus
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA. .,Department of Pediatrics, University of Washington, 6200 NE 74th St, Ste 110, Seattle, WA, 98115, USA.
| | - Sarah J Lowry
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
| | - Kimberly Garrett
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
| | | | - Tamerah Hunt
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, P.O. Box 8076, 30460, USA
| | - Sara P D Chrisman
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA.,Department of Pediatrics, University of Washington, 6200 NE 74th St, Ste 110, Seattle, WA, 98115, USA
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Radzak KN, Hunzinger KJ, Costantini KM, Swanik CB, Buckley TA. Concussion Knowledge and Attitudes in Reserve Officers' Training Corps Cadets. Mil Med 2021; 188:usab521. [PMID: 34915567 DOI: 10.1093/milmed/usab521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Military members' knowledge of concussion signs and symptoms may be critical to appropriate concussion identification and health-seeking behavior, particularly for those in leadership roles. The current study aimed to characterize concussion knowledge and attitudes among future military officers undergoing U.S.-based Reserve Officers' Training Corps (ROTC) training. MATERIALS AND METHODS Army and Air Force ROTC cadets at 2 large, public universities were utilized for a survey-based observational study. The study was approved by the institutional review board at both university research sites. Cadets completed a modified Rosenbaum Concussion Knowledge and Attitude Survey to obtain cadets' Concussion Knowledge Index and Concussion Attitude Index, where higher scores are preferable. Cadets' concussion knowledge and attitudes were characterized via descriptive statistics. RESULTS Cadets (n = 110) had a mean Concussion Knowledge Index of 18.8 ± 3.2 (range = 9-23, out of 25). Potentially detrimental misconceptions included: belief that typically concussion symptoms no longer persist after 10 days (79.1%) and brain imaging shows visible physical damage following concussion (74.5%). Mean Concussion Attitude Index was 60.6 ± 7.4 (range = 46-75, out of 75). In general, cadets reported higher agreement with safe concussion behavior than what they believe peers would report. CONCLUSIONS Cadets were found to have a high concussion knowledge, yet common misconceptions remained. Cadets consistently reported safe choices but were less sure that peers felt similarly; future investigations should evaluate ROTC concussion social norms and education should note peers' beliefs supporting safe concussion attitudes.
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Affiliation(s)
- Kara N Radzak
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Las Vegas, NV 89154, USA
| | - Katherine J Hunzinger
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA
- Interdisciplinary Biomechanics and Movement Science Program, University of Delaware, Newark, DE 19716, USA
| | - Katelyn M Costantini
- Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA 19104, USA
| | - C Buz Swanik
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA
- Interdisciplinary Biomechanics and Movement Science Program, University of Delaware, Newark, DE 19716, USA
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA
- Interdisciplinary Biomechanics and Movement Science Program, University of Delaware, Newark, DE 19716, USA
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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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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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Sport Motivation as a Possible Indicator of Concussion Reporting Intentions Among Young Athletes. Clin J Sport Med 2021; 31:e216-e220. [PMID: 32852306 DOI: 10.1097/jsm.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/21/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the relationship between sport motivation and intentions to report concussion symptoms among young adult athletes. DESIGN Cross-sectional study (level of evidence: 3). SUBJECTS One thousand three hundred five young adult athletes of various sports and levels of competitiveness from the Survey Sampling International panel. METHODS Data were collected through an online survey. Ordinary least squares regression was used to examine the relationship between motivation and reporting intentions controlling for competitiveness and perceived risk of injury. RESULTS Athletes who play their sport for self-regulated (autonomous) reasons have higher intentions to seek care for concussion-like symptoms, whereas those who play to achieve gains external to the sport or avoid punishment (controlled motivation) have lower intentions. A one-point increase in autonomous motivation was associated with an 11.5-point increase in reporting intention (t = 6.629, P < 0.001), whereas a one-point increase in controlled motivation was associated with an 8.1-point decrease in reporting intention (t = -4.562, P < 0.001). Betas from the model suggested that autonomous motivation had a stronger effect than controlled motivation (0.226 vs -0.163). CONCLUSIONS Innovation in care, concussion education, and cultivation of team culture supportive of autonomous motivation could increase concussion reporting. Measuring sport motivation may reveal which athletes require more proactive attention to ensure symptoms are not concealed. Furthermore, messages to reinforce autonomous motivation may increase willingness to report.
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Beidler E, Bogar K, Wallace J, McAllister-Deitrick J, Anderson M, Schatz P. The burden of unsubstantiated messaging: collegiate athletes' chronic traumatic encephalopathy mechanism beliefs. Brain Inj 2021; 35:1259-1266. [PMID: 34499577 DOI: 10.1080/02699052.2021.1972146] [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: 10/20/2022]
Abstract
OBJECTIVE To investigate factors associated with collegiate athletes' beliefs regarding chronic traumatic encephalopathy (CTE) mechanism. DESIGN Cross-sectional study. METHODS A total of 838 collegiate athletes (61.9% men) from seven institutions completed a 10-minute survey that captured information relative to demographics, diagnosed concussion history, formal sport-related concussion education, additional sources of concussion information, and beliefs about multiple concussions and premature return-to-play following a head impact as mechanisms for CTE. RESULTS More than half of collegiate athletes believed that multiple concussions (58.2%) and premature return-to-play (59.1%) may cause CTE. Those who reported getting concussion information from sports news had higher odds of believing multiple concussions and premature return-to-play were CTE mechanisms compared to those who did not get information from sports news sources. Additionally, CTE mechanism beliefs were significantly greater in collegiate athletes who were male, had sustained a previous diagnosed concussion, or had acquired concussion information from the NCAA. CONCLUSIONS Sports news' reporting of CTE storylines, which highlight former male athletes with complex brain injury histories, may influence collegiate athletes' beliefs about concussion. Therefore, it is recommended that concussion awareness initiatives incorporate information related specifically to CTE to empower collegiate athletes with evidence-based, patient-oriented information and knowledge regarding this condition.
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Affiliation(s)
- Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsyvania
| | - Kacie Bogar
- Department of Psychology, Saint Joseph's University, Philadelphia, Pa
| | - Jessica Wallace
- Department of Health Science, University of Alabama, Tuscaloosa, AL
| | | | - Morgan Anderson
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Phillip Schatz
- Department of Psychology, Saint Joseph's University, Philadelphia, Pa
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Chandran A, Morris SN, Powell JR, Boltz AJ, Robison HJ, Collins CL. Epidemiology of Injuries in National Collegiate Athletic Association Men's Football: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:643-650. [PMID: 34280281 DOI: 10.4085/1062-6050-447-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Football is among the most popular collegiate sports in the United States, and participation in National Collegiate Athletic Association (NCAA) football has risen in recent years. BACKGROUND Continued monitoring of football injuries is important for capturing the evolving burden of injuries in NCAA football. The purpose of this study was to describe the epidemiology of football-related injuries among men's NCAA football players during the 2014-2015 through 2018-2019 academic years. METHODS Exposure and injury data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. RESULTS The overall injury rate was 9.31 per 1000 athlete-exposures. Most injuries occurred during general play (17.5%), blocking (15.8%), and tackling (14.0%). Concussions (7.5%), lateral ligament complex tears (6.9%), and hamstring tears (4.7%) were the most commonly reported injuries. CONCLUSIONS Results of this study were generally consistent with previous findings, though changes over time in rates of commonly reported injuries warrant attention. Continued monitoring of injury incidence is needed to appraise the effectiveness of recently implemented rules changes.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Jacob R Powell
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
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Lexell J, Lovén G, Fagher K. Incidence of sports-related concussion in elite para athletes - a 52-week prospective study. Brain Inj 2021; 35:971-977. [PMID: 34185611 DOI: 10.1080/02699052.2021.1942551] [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: 10/21/2022]
Abstract
Objective: To assess the 52-week incidence proportion and incidence rate of sports-related concussion (SRC) among elite Para athletes, and to analyze the injury mechanisms.Method: In total, 70 male and 37 female Swedish elite Para athletes (median age 29 years) with vision, physical and intellectual impairment, weekly self-reported sports-related injuries including concussion in an eHealth application adapted to Para athletes. Descriptive statistics were used to assess the incidence rate and incidence proportion. Chi-square statistics were used to analyze differences in the proportion of SRC.Results: A total of 13 SRC were reported: three athletes each sustained two SRC. The incidence proportion was 9.3% (95% CI 4.8-16.7), and the incidence rate 0.5 SRC/1000 hours (95% CI 0.3-0.9) of sports exposure. Athletes with vision impairment and female athletes reported a significantly higher proportion of SRC. A majority of the injuries (n = 9; 69%) occurred during sport-specific training. The injury mechanisms were collision with object (n = 7; 54%), collision with person (n = 4; 31%), and poor playing field conditions (n = 2; 16%).Conclusion: The incidence of concussion among elite Paralympic athletes is comparable to sports for able-bodied athletes. Athletes with vision impairment and female athletes reported a significantly higher incidence of SRC, and collisions were the most common injury mechanism. These results can form the basis for future preventive research studies.
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Affiliation(s)
- Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Gustav Lovén
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
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Assessing Differences in Concussion Symptom Knowledge and Sources of Information Among Black and White Collegiate-Athletes. J Head Trauma Rehabil 2021; 36:139-148. [PMID: 33938514 DOI: 10.1097/htr.0000000000000672] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Basic concussion symptom knowledge is fundamental to concussion identification; however, racial disparities in concussion knowledge exist in high school and youth sports. It is unknown whether similar differences exist in collegiate-athletes. Identifying racial disparities in concussion knowledge and sources of concussion information is essential to inform equitable approaches to knowledge translation and educational interventions. This study examined how Black and White collegiate-athletes differed in their knowledge of concussion symptoms and use of concussion information sources. SETTING National Collegiate Athletic Association (NCAA) institutions. PARTICIPANTS Collegiate-athletes. DESIGN Cross-sectional. MAIN MEASURES Collegiate-athletes completed a questionnaire that assessed personal and sports demographics, concussion symptom knowledge, and use of concussion information sources. Fisher's exact tests and Wilcoxon rank-sum tests examined differences in outcome measures between Black and White collegiate-athletes. A multivariable Poisson regression model examined the association between race and concussion symptom knowledge scores while accounting for sex, sports contact level, NCAA division, concussion history, and specific concussion information sources. Incidence rate ratios (IRRs) with 95% CIs excluding 1.00 were deemed significant. RESULTS A total of 768 (82.6% White, 17.4% Black) collegiate-athletes completed the questionnaire. Black athletes were more likely to have lower concussion symptom knowledge scores than White athletes (P < .001). In the multivariable Poisson regression model controlling for covariates, this finding was retained (IRR = 0.97; 95% CI, 0.94-0.997). White athletes were more likely to report school-based professional (P < .001), online medical sources (P = .02), and the NCAA (P = .008) as sources of concussion information. Black athletes were more likely to report referees (P = .03) as a source of concussion knowledge. CONCLUSION Despite NCAA concussion education requirements for athletes, Black collegiate-athletes were found to have lower concussion knowledge than White collegiate-athletes. The findings highlight the need for equitable strategies to disseminate concussion information to diverse populations by improving the physician-patient relationship and investing in culturally appropriate educational materials.
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Milroy J, Sanders L, Mendenhall B, Dudley WB, Wyrick D. A Latent Profile Analysis to Categorize and Describe Athletes Based on Factors Related to Concussion Disclosure. J Athl Train 2021; 56:85-91. [PMID: 33534901 DOI: 10.4085/1062-6050-0308.19] [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: 11/09/2022]
Abstract
CONTEXT Collegiate student-athletes continue competing after experiencing symptoms of a concussion. Self-report of concussion symptoms is a critical element of the recovery process. Identifying factors related to concussion disclosure can aid in encouraging self-reporting. OBJECTIVE To use latent profile analysis to categorize and describe athletes based on factors related to concussion disclosure. DESIGN Cross-sectional study. SETTING Web-based survey. PATIENTS OR OTHER PARTICIPANTS A total of 2 881 (52.4% female; 65.3% in-season; 40% collision sport) student-athletes from 16 National Collegiate Athletic Association member institutions. MAIN OUTCOME MEASURE(S) Student-athlete concussion expectations, attitudes, and norms were the profile variables and reporting intentions served as the distal outcome variable. We conducted latent profile analysis using select profile variables to determine the optimal number of classes. Differences in concussion-reporting intentions by profile assignment were then examined. Lastly, the extent to which a student-athlete's sex, season status, and level of contact predicted his or her intentions to report a concussion within each profile was investigated. RESULTS Five unique student-athlete profiles emerged, including 1 profile that was most risky and another that was least risky. Females had significantly higher odds of being in the least risky profile. Those participating in collision sports had significantly higher odds of being in the top 2 most risky profiles. Contact-sport and in-season athletes were less likely to be in the least risky profile. CONCLUSIONS With a better understanding of student-athlete profiles, athletic trainers have an opportunity to encourage concussion disclosure. Prompt disclosure would allow student-athletes to begin the return-to-play protocol in a more timely manner.
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DiFabio MS, Buckley TA. Effectiveness of a Computerized Cognitive Training Program for Reducing Head Impact Kinematics in Youth Ice Hockey Players. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:149-161. [PMID: 34055136 PMCID: PMC8136557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cognitive training (CT) is an effective technique to improve neurological performance, but has not been investigated as a head impact primary prevention strategy. The purpose of this study was to investigate the CT's effectiveness in reducing head impact kinematics in youth ice hockey players. Twenty youth were divided into two groups: a CT and Control group. The CT group performed two 30-minute sessions of IntelliGym CT weekly for 20 weeks and the control group performed two 30-minute sessions weekly evaluating hockey videos. The dependent variables, number of head impacts, cumulative linear acceleration (CLA) and rotational acceleration (CRA) and mean linear and rotation peak acceleration, were compared with repeated measures ANOVAs, with post-hoc for main effect of time for each group, between the first and second half of the season. There were significant interactions for number of head impacts (p = 0.014) and CLA (p = 0.043) and post-hoc testing identified reductions in the second half of the season for the CT, but not control, group. There were no interactions for CRA, mean peak linear acceleration, and mean peak rotational acceleration. These preliminary results suggest CT may be an effective primary prevention strategy to reduce head impacts and cumulative linear acceleration in youth ice hockey players.
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Affiliation(s)
- Melissa S DiFabio
- Department of Biomedical Engineering, University of Delaware, Newark, DE, USA
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
- Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA
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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: 21] [Impact Index Per Article: 7.0] [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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Weber Rawlins ML, Johnson BR, Jones ER, Register-Mihalik JK, Foster C, De Angelis K, Schmidt JD, D'Lauro CJ. The Role of Social Support in Concussion Disclosure in United States Air Force Academy Cadets: A Mixed Methods Approach. Mil Med 2021; 187:e1193-e1200. [PMID: 33724395 DOI: 10.1093/milmed/usab102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/18/2021] [Accepted: 03/04/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION United States Air Force Academy (USAFA) cadets are at risk for sustaining concussions; however, several factors inhibit disclosure. We aimed to better understand the role of social support in concussion disclosure. METHODS AND MATERIALS We used a mixed methods approach with an electronic survey and interviews. The survey used a 9-point Likert scale (1 = strongly disagree and 9 = strongly agree) to assess concussion disclosure. Survey items asked cadets whom they felt most comfortable disclosing a concussion or bell-ringer/ding to, how quickly they would seek medical attention for a suspected concussion or bell-ringer/ding, whether cadets would be generally supportive/unsupportive of another cadet disclosing a concussion to medical staff, and whether other cadets important to them would be generally supportive/unsupportive if they reported a concussion to medical staff. Two multivariate linear regressions, one for concussion and one for bell-ringers/dings, were calculated to determine whether cadet choice of the person they felt most comfortable disclosing a concussion or bell-ringer/ding to predicted whether they would immediately seek medical attention for either condition. Choice of person included Air Officer Commanding (AOC)/Academy Military Trainer (AMT), upper classmen, cadet who had recovered from a concussion, cadet, closest friend, teammate, and squadmate. Descriptive analyses assessed whether cadets felt supported or unsupported by other cadets and by those who were important to them concerning concussion reporting. Thirty-four semi-structured interviews were conducted with cadets to explore their views on concussion disclosure. RESULTS Increased comfort with disclosing a suspected concussion to an AOC/AMT had higher agreement seeking medical attention (β = 0.28, P < .001). For every 1-point increase in being comfortable disclosing a potential bell-ringer/ding to an AOC/AMT (β = 0.272, P < .001), squadmate (β = 0.241, P = .002), and teammate (β = -0.182, P = .035), agreement for seeking medical attention immediately increased 0.27, increased 0.24, and decreased 0.18, respectively. Interviews indicated cadets would often speak to a peer before seeking medical attention. CONCLUSIONS Our results suggested that cadets felt comfortable reporting a suspected concussion or bell-ringer/ding to various peers and that those peers would be supportive of that choice, indicating social support. Future interventions should include educating cadets that peers may come to them, especially if they are AOCs/AMTs or squadmates.
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Affiliation(s)
- Michelle L Weber Rawlins
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
| | - Brian R Johnson
- Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Emily R Jones
- United States Air Force Academy, USAF Academy, CO 80840, USA
| | - Johna K Register-Mihalik
- Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Craig Foster
- United States Air Force Academy, USAF Academy, CO 80840, USA
| | | | - Julianne D Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA 30602, USA
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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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Daly E, Pearce AJ, Ryan L. A Systematic Review of Strength and Conditioning Protocols for Improving Neck Strength and Reducing Concussion Incidence and Impact Injury Risk in Collision Sports; Is There Evidence? J Funct Morphol Kinesiol 2021; 6:jfmk6010008. [PMID: 33462169 PMCID: PMC7838928 DOI: 10.3390/jfmk6010008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 11/22/2022] Open
Abstract
The objective of this systematic literature review was to evaluate the evidence regarding the development of neck strength in reducing concussion and cervical spine injuries in adult amateur and professional sport populations. PubMed, CINAHL, Science Direct, and Web of Science databases were searched systematically. The criteria for inclusion in the review were as follows: (1) a human adult (≥18 or above); (2) involved in amateur, semi-professional, or professional sports; (3) sports included involved collisions with other humans, apparatus or the environment; (4) interventions included pre- and post-neck muscle strength measures or neck stability measures; (5) outcomes included effects on increasing neck strength in participants and/or injury incidence. Database searches identified 2462 articles. Following title, abstract, and full paper screening, three papers were eligible for inclusion. All of the papers reported information from male participants, two were focused on rugby union, and one on American football. Two of the included studies found a significant improvement in isometric neck strength following intervention. None of the studies reported any impact of neck strengthening exercises on cervical spine injuries. This review has shown that there is currently a lack of evidence to support the use of neck strengthening interventions in reducing impact injury risk in adult populations who participate in sport.
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Affiliation(s)
- Ed Daly
- School of Science and Computing, Galway-Mayo Institute of Technology (GMIT), H91 T8NW Galway, Ireland;
| | - Alan J. Pearce
- College of Science Health and Engineering, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Lisa Ryan
- School of Science and Computing, Galway-Mayo Institute of Technology (GMIT), H91 T8NW Galway, Ireland;
- Correspondence:
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Kerr ZY, Pierpoint LA, Rosene JM. Epidemiology of Concussions in High School Boys' Ice Hockey, 2008/09 to 2016/17 School Years. Clin J Sport Med 2021; 31:e21-e28. [PMID: 30451700 DOI: 10.1097/jsm.0000000000000697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study examined the epidemiology of concussions in high school boys' ice hockey during the 2008/09 to 2016/17 school years. DESIGN Prospective cohort study. Athletic trainers from an average 33 high schools annually reported boys' ice hockey concussion and athlete-exposure (AE) data for the High School Reporting Information Online system. SETTING Convenience sample of high school boys' ice hockey programs during the 2008/09 to 2016/17 school years. PATIENTS OR OTHER PARTICIPANTS High school boys' ice hockey players (aged ∼14-18 years). INDEPENDENT VARIABLES Concussion data on event type, injury mechanism, symptom resolution time, and time loss were obtained. MAIN OUTCOME MEASURES Concussion rates with 95% confidence intervals (CIs) and distributions were calculated. RESULTS Overall, 348 concussions were reported in boys' ice hockey during the 2008/09 to 2016/17 academic years, leading to a concussion rate of 0.68/1000 AEs (95% CI, 0.61-0.75). Most occurred in competitions (85.6%), particularly after the first period (72.1% of all competition concussions). Among practice concussions, most occurred after the first hour of practice (60.0%). Most concussions were due to player contact (47.7%) and boards/glass contact (31.9%). Although 69.0% of concussed athletes had symptoms resolve in less than 7 days, only 14.1% returned to activity within a week. CONCLUSIONS Most concussions occurred within the second and third periods. Preventive strategies that counter an increased risk of concussion due to a greater intensity of gameplay coupled with increased fatigue may be warranted. Moreover, athletes may further benefit from prevention efforts that focus on anticipating impacts during gameplay.
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Affiliation(s)
- Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina
| | - Lauren A Pierpoint
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado; and
| | - John M Rosene
- Department of Exercise and Sport Performance, University of New England, Biddeford, Maine
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Beidler E, Wallace J, Alghwiri AA, O'Connor S. Collegiate Athletes' Concussion Awareness, Understanding, and -Reporting Behaviors in Different Countries With Varying Concussion Publicity. J Athl Train 2021; 56:77-84. [PMID: 33259602 DOI: 10.4085/1062-6050-0575.19] [Citation(s) in RCA: 15] [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
CONTEXT Concussions are a global public health concern, and education on the importance of self-reporting may not reach all athletes to the same degree around the world. OBJECTIVE To determine if differences were present in the concussion awareness, understanding, and -reporting behaviors of collegiate athletes' in 3 countries with varied degrees of concussion publicity. DESIGN Cross-sectional survey. SETTING Collegiate sports medicine clinics. PATIENTS OR OTHER PARTICIPANTS Collegiate athletes in the United States (n = 964; high publicity), Ireland (n = 302; moderate publicity), and Jordan (n = 129; low publicity). The degree of concussion publicity was categorized based on the extent of national public health awareness initiatives, care guidelines, research publications, and mass media coverage. MAIN OUTCOME MEASURE(S) Participants completed a 10- to 15-minute survey on concussion awareness, understanding, and -reporting behaviors. The main outcome measures were concussion education (awareness; 21 options; select all sources of concussion information), concussion knowledge (understanding; maximum score of 49), and diagnosed/nondisclosed concussion history (reporting behaviors; self-report yes/no items). RESULTS A higher proportion of Jordanian athletes reported never having received concussion information previously (73.6%) than Irish (24.2%) or US athletes (9.4%). Knowledge differed among countries (P < .0001, η2 = .28), with US athletes displaying higher total knowledge scores (40.9 ± 4.5) than Jordanian (35.1 ± 5.6) and Irish (32.1 ± 3.5) athletes. Greater percentages of Irish and US athletes reported a history of a diagnosed concussion (31.8% and 29.6%, respectively) and history of concussion nondisclosure (25.2% and 15.5%, respectively) than Jordanian athletes (2.3% and 0.0% for history of a diagnosed concussion and history of concussion nondisclosure, respectively). CONCLUSIONS In the United States, where concussion publicity is high, formal legislation exists, and sports medicine resources and concussion awareness and understanding were increased. More culturally appropriate concussion initiatives are needed globally to ensure that athletes around the world can identify concussive injuries and understand the dangers of continued sport participation while concussed.
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Affiliation(s)
- Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, PA
| | - Jessica Wallace
- Department of Health Science, University of Alabama, Tuscaloosa
| | | | - Siobhan O'Connor
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Ireland
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Schmitt AJ, Beidler E, O'Connor S, Eagle S, Wallace J, Anderson M, Kontos A. Development and factor structure of the perceptions of concussion inventory for athletes (PCI-A). Brain Inj 2020; 35:292-298. [PMID: 33370168 DOI: 10.1080/02699052.2020.1861655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: This study evaluated the factor structure of the Perceptions of Concussion Inventory for Athletes (PCI-A) using exploratory factor analytic (EFA) techniques in a sample of collegiate student-athletes. Perception differences by sex and sport-related concussion (SRC) risk level were explored.Methods: This cross-sectional-design study included 298 male and 183 female collegiate student-athletes from 18 sports at six institutions. Participants completed a demographic and concussion history survey, and the PCI-A.Results: The EFA revealed a 6-factor solution (Anxiety, Effects, Clarity, Treatment, Control, and Symptom Variability) that accounted for 56.1% of the variance in responses. Female collegiate student-athletes displayed statistically higher levels of Anxiety, Clarity, Symptom Variability, and Control than males. Lower concussion risk sport athletes reported statistically higher levels of anxiety surrounding SRC and concerns relating to the long-term and major effects of an SRC.Conclusions: This study provides evidence that the PCI-A is an acceptable measure to examine the perceptions of collegiate student-athletes regarding SRC. The findings supported a six-factor structure of the PCI-A in the current study for collegiate student-athletes compared to the seven-factor structure indicated in previous research. The findings reveal sex and concussion risk sport differences in PCI-A responses.
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Affiliation(s)
- Ara J Schmitt
- Department of Counseling, Psychology, and Special Education, Duquesne University, Pittsburgh, PA, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, PA, USA
| | - Siobhan O'Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Shawn Eagle
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
| | - Jessica Wallace
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Morgan Anderson
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | - Anthony Kontos
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
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Phillips N, Crisco JJ. The Effectiveness of Regulations and Behavioral Interventions on Head Impacts and Concussions in Youth, High-School, and Collegiate Football: A Systematized Review. Ann Biomed Eng 2020; 48:2508-2530. [PMID: 33051744 DOI: 10.1007/s10439-020-02624-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/14/2020] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to assess the effectiveness of regulations and behavioral interventions on head impacts and concussions in youth, high-school, and collegiate football, using a systematic search strategy to identify relevant literature. Six databases were searched using key search terms related to three categories: football, head-injuries, and interventions. Studies that met inclusion criteria were included in the study and underwent data extraction. Twenty articles met inclusion criteria and were included in the final systematized review. Of the 20 included studies, 8 studies evaluated interventions in high-school football, 5 studies evaluated interventions in collegiate football, 6 studies evaluated interventions in youth football, and 1 study evaluated interventions in both, high-school and collegiate football. The four categories of interventions and regulations included rule changes, training, education/instruction/coaching tactical changes, and tackle football alternatives. Studies evaluating the effectiveness of interventions and regulations on reducing head impact exposures or head injuries have shown mixed results. Some regulations may be more effective than others, but methodological design and risk of bias pose limitations to generalize effects.
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Affiliation(s)
- Nicole Phillips
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, CORO West, Suite 404, 1 Hoppin Street, Providence, RI, 02903, USA
| | - Joseph J Crisco
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, CORO West, Suite 404, 1 Hoppin Street, Providence, RI, 02903, USA.
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Warmath D, Winterstein AP. A Social-Marketing Intervention and Concussion-Reporting Beliefs. J Athl Train 2020; 55:1035-1045. [DOI: 10.4085/1062-6050-242-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Context
Concussion-symptom education remains the primary approach used by athletic trainers to address underreporting of possible sport-related concussions. Social marketing represents an untapped approach to promote concussion reporting by communicating the benefits or consequences of reporting or not reporting, respectively.
Objective
To apply expectancy value theory and identify how marketing the possible consequences of concealing concussion symptoms influenced young adults' concussion-reporting beliefs to increase the likelihood of reporting.
Design
Randomized controlled clinical trial.
Setting
Laboratory.
Patients or Other Participants
A total of 468 competitive collegiate club sport athletes at a large US university who engaged in 1 of 46 sports with various levels of concussion risk.
Intervention(s)
Participants were randomly assigned by team to 1 of 3 conditions. The treatment condition was a social-marketing program focused on the possible consequences of the reporting decision. The control condition was traditional concussion-symptom education based on the National Collegiate Athletic Association's publication, “Concussion: A Fact Sheet for Student-Athletes.” An additional condition mirrored the traditional symptom education but included a less clinical delivery.
Main Outcome Measure(s)
Positive and negative beliefs regarding concussion reporting were assessed. We applied expectancy value theory, which posits that changing beliefs in the short term will produce greater reporting intentions in the long term.
Results
Club sport athletes exposed to consequence-based social marketing showed higher levels of positive reporting beliefs and lower levels of negative reporting beliefs than athletes exposed to traditional or revised symptom education. We observed no differences between the traditional and revised symptom-education programs. Exposure to consequence-based marketing decreased negative beliefs about reporting (B = −0.165, P = .01) and increased positive beliefs about reporting (B = 0.165, P = .01).
Conclusions
Social marketing offers athletic trainers another strategic tool for motivating athletes to report concussion symptoms by translating scientific findings into marketable statements and then communicating the benefits of reporting or the negative consequences of concealing concussion 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, Athens
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Wallace J, Bretzin A, Beidler E, Hibbler T, Delfin D, Gray H, Covassin T. The Underreporting of Concussion: Differences Between Black and White High School Athletes Likely Stemming from Inequities. J Racial Ethn Health Disparities 2020; 8:1079-1088. [PMID: 32926391 DOI: 10.1007/s40615-020-00864-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Previous studies have found that Black high school athletes have poorer knowledge about concussions and have fewer sports medicine healthcare resources than White athletes, but research on concussion disclosure by race is still needed. Therefore, the purpose of this study was to examine racial differences in concussion reporting behaviors between Black and White high school athletes. This cross-sectional study administered surveys to 577 high school athletes (64.5% Black; 72.3% males; 16.02 ± 1.2 years) from 14 schools (title I, n = 9; non-title I, n = 5). The survey included self-reported items on concussions and bell-ringers experienced during games and practices and the number of these episodes that were reported to an authoritative figure. Reasons for reporting and not reporting were also assessed. Results found that White athletes were more likely to recall experiencing a bell-ringer in games compared with Black athletes. They were also more likely to report a bell-ringer or concussion that occurred in a game. There was a significantly higher proportion of Black athletes compared with White athletes that did not report their bell-ringer experienced in games and concussions experienced in practices. White athletes were more likely than Black athletes to disclose a concussion because they thought they had a concussion, while there were no racial differences in the reasons for not reporting. The findings of this study highlight the critical role that race, as a social determinant of health, may play in concussion reporting in high school athletes. Future public health efforts should seek to further understand and overcome inequities in healthcare resources for concussion education and management.
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Affiliation(s)
- Jessica Wallace
- Department of Health Science, University of Alabama, 270 Kilgore Lane, 2106 Capital Hall, Tuscaloosa, AL, 35487, USA.
| | - Abigail Bretzin
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Blockley Hall Room 937, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, 600 Forbes Avenue, 118 Health Sciences Building, Pittsburgh, PA, 15282, USA
| | - Tamaria Hibbler
- Department of Kinesiology, Athletic Training, Michigan State University, East Lansing, MI, 48840, USA
| | - Danae Delfin
- Department of Health Science, University of Alabama, 270 Kilgore Lane, 2106 Capital Hall, Tuscaloosa, AL, 35487, USA
| | - Haleigh Gray
- Department of Health Science, University of Alabama, 270 Kilgore Lane, 2106 Capital Hall, Tuscaloosa, AL, 35487, USA
| | - Tracey Covassin
- Department of Kinesiology, Athletic Training, Michigan State University, East Lansing, MI, 48840, USA
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Kroshus E, Cameron KL, Coatsworth JD, D'Lauro C, Kim E, Lee K, Register-Mihalik JK, Milroy JJ, Roetert EP, Schmidt JD, Silverman RD, Warmath D, Wayment HA, Hainline B. Improving concussion education: consensus from the NCAA-Department of Defense Mind Matters Research & Education Grand Challenge. Br J Sports Med 2020; 54:1314-1320. [PMID: 32912847 DOI: 10.1136/bjsports-2020-102185] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 11/03/2022]
Abstract
Early disclosure of possible concussive symptoms has the potential to improve concussion-related clinical outcomes. The objective of the present consensus process was to provide useful and feasible recommendations for collegiate athletic departments and military service academy leaders about how to increase concussion symptom disclosure in their setting. Consensus was obtained using a modified Delphi process. Participants in the consensus process were grant awardees from the National Collegiate Athletic Association and Department of Defense Mind Matters Research & Education Grand Challenge and a multidisciplinary group of stakeholders from collegiate athletics and military service academies. The process included a combination of in-person meetings and anonymous online voting on iteratively modified recommendations for approaches to improve concussion symptom disclosure. Recommendations were rated in terms of their utility and feasibility in collegiate athletic and military service academy settings with a priori thresholds for retaining, discarding and revising statements. A total of 17 recommendations met thresholds for utility and feasibility and are grouped for discussion in five domains: (1) content of concussion education for athletes and military service academy cadets, (2) dissemination and implementation of concussion education for athletes and military service academy cadets, (3) other stakeholder concussion education, (4) team and unit-level processes and (5) organisational processes. Collectively, these recommendations provide a path forward for athletics departments and military service academies in terms of the behavioural health supports and institutional processes that are needed to increase early and honest disclosure of concussion symptoms and ultimately to improve clinical care outcomes.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle, Washington, USA .,Department of Pediatrics, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Kenneth L Cameron
- Orthopaedics, Keller Army Community Hospital, West Point, New York, USA
| | - J Douglas Coatsworth
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher D'Lauro
- Behavioral Science and Leadership, US Air Force Academy, Colorado Springs, Colorado, USA
| | | | - Katherine Lee
- Health Readiness and Policy Oversight, Health Affairs, Department of Defense, Falls Church, Virginia, USA
| | - Johna K Register-Mihalik
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffery J Milroy
- Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - E Paul Roetert
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | | | - Ross D Silverman
- Richard M Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
| | - Dee Warmath
- Family and Consumer Sciences, University of Georgia, Athens, Georgia, USA
| | - Heidi A Wayment
- Psychological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Brian Hainline
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
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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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Perlin A, Kroshus E. Content analysis of concussion education for coaches of youth and high school sport. Brain Inj 2020; 34:905-913. [PMID: 32362145 DOI: 10.1080/02699052.2020.1755894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Describe the extent to which concussion education provided to coaches of US high school and youth sport is inclusive of information necessary for them to engage in target behaviors related to the prevention, identification and management of concussion. METHODS Sport organizations included in the sample were US state high school governing bodies and national governing bodies (NGBs) for youth sports with the highest concussion incidence rates. The concussion education resources made available online for coaches by these organizations were coded for content relevant to concussion prevention, identification and management. RESULTS All but one state high school governing body required coach concussion education, two NGBs required coach education, seven recommended it and only one did not require or recommend it. All educational materials covered at least 84% (n = 16/19) of the relevant knowledge domains. DISCUSSION Existing concussion education for coaches is addressing most, but not all, topics that may help coaches engage in concussion prevention, identification and management. Additional program development work is warranted to augment educational content related to coach communication about concussion safety with athletes and parents. Content appropriateness notwithstanding, further research is needed to understand the acceptability, efficacy, and implementation of concussion education for coaches.
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Affiliation(s)
- Amit Perlin
- Tulane Brain Institute, Tulane University New Orleans, Louisiana, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute , Seattle, Washington, USA
| | - Emily Kroshus
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute , Seattle, Washington, USA.,Department of Pediatrics, University of Washington , Seattle, Washington, USA
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Milroy JJ, Wyrick DL, Rulison KL, Sanders L, Mendenhall B. Using the Integrated Behavioral Model to Determine Sport-Related Concussion Reporting Intentions Among Collegiate Athletes. J Adolesc Health 2020; 66:705-712. [PMID: 32169526 DOI: 10.1016/j.jadohealth.2020.01.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE A significant proportion of sport-related concussions goes unreported among adolescents, which can result in irreversible brain damage. It is critical to identify and intervene on factors that significantly impact concussion reporting. METHODS This study tests factors associated with collegiate athletes' intentions to (1) self-report concussion symptoms; (2) report another athlete's concussion symptoms; and (3) encourage others to report. Drawing on the Integrated Behavioral Model, predictors at the athlete level included perceived norms (bystander descriptive norms, injunctive norms, and subjective norms), attitudes (positive and negative expectancies about reporting and playing through a concussion and concussion reporting attitudes), personal agency (self-efficacy to recognize symptoms and communicate), and perceived coach communication. At the team level, coaches' self-reported communication was also included. Athletes (N = 1,858) and coaches (N = 254) at 16 colleges and universities completed Web-based surveys in 2016. Multilevel modeling accounted for the nesting of athletes within athletic team. RESULTS Bystander descriptive norms, positive reporting expectancies, concussion reporting attitudes, self-efficacy to communicate about a concussion, and athletes' perceptions of their coach's communication were positively associated with all three outcomes. By contrast, subjective norms were only positively associated with intentions to self-report and bystander reporting intentions, negative reporting expectancies were only associated with intentions to self-report, and positive and negative expectancies for playing through a concussion were only associated with intentions to self-report and bystander encouragement. CONCLUSIONS In sum, multiple factors within the Integrated Behavioral Model predict reporting intentions and underscore the complexity of athletes' concussion reporting behaviors and offer guidance for the development of prevention strategies.
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Affiliation(s)
- Jeffrey J Milroy
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina; Institute to Promote Athlete Health & Wellness, Greensboro, North Carolina.
| | - David L Wyrick
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina; Institute to Promote Athlete Health & Wellness, Greensboro, North Carolina
| | - Kelly L Rulison
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Lindsey Sanders
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina; Institute to Promote Athlete Health & Wellness, Greensboro, North Carolina
| | - Brandon Mendenhall
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina
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Fagher K, Dahlström Ö, Jacobsson J, Timpka T, Lexell J. Injuries and illnesses in Swedish Paralympic athletes—A 52‐week prospective study of incidence and risk factors. Scand J Med Sci Sports 2020; 30:1457-1470. [DOI: 10.1111/sms.13687] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/13/2020] [Accepted: 03/27/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Kristina Fagher
- Department of Health Sciences Rehabilitation Medicine Research Group Lund University Lund Sweden
| | - Örjan Dahlström
- Department of Medical and Health Sciences Athletics Research Center Linköping University Linköping Sweden
- Department of Behavioural Sciences and Learning Linköping University Linköping Sweden
| | - Jenny Jacobsson
- Department of Medical and Health Sciences Athletics Research Center Linköping University Linköping Sweden
| | - Toomas Timpka
- Department of Medical and Health Sciences Athletics Research Center Linköping University Linköping Sweden
| | - Jan Lexell
- Department of Health Sciences Rehabilitation Medicine Research Group Lund University Lund Sweden
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