Headgear safety attitudes: a national survey of collegiate women's lacrosse stakeholders

Controversy exists among collegiate lacrosse about the use of headgear and whether its use will facilitate greater risk compensation by players and thus contribute to unsafe gameplay. We aimed to characterize the attitudes of headgear among women's collegiate lacrosse stakeholders. A total of 190 women's lacrosse stakeholders (players: n = 87; coaches: n = 71; officials: n = 32) participated in this study. Participants completed a survey surrounding attitudes of headgear in women's lacrosse. Descriptives, multiple regressions, and Kruskal-Wallis analyses compared attitudes surrounding headgear among stakeholder groups. Scales of Headgear Affects Play (β = -0.38, p < 0.001) and Sports Development and Safety Practices (β = 0.26, p < 0.05) significantly predicted endorsement on Headgear Safety Attitudes Scale. Among players, Aesthetics (β = 0.51, p < 0.001) and Intention to Wear Headgear (β = 0.31, p < 0.05) predicted endorsement on Headgear Safety Attitudes Scale. Stakeholders did not agree if headgear should be worn in women's lacrosse. Items related to sports development, safety and potential changes in gameplay predicted attitudes to headgear safety among all participants.

Lessons Learned and Potential Long-Term Effects on Athletic Trainers and Clinical Practice After a Global Pandemic

CONTEXT

Perceived stress and burnout are significant concerns among athletic trainers (ATs) due to growing professional demands. The global COVID-19 pandemic brought additional stressors, especially for health care providers, including the need to learn and integrate new skill sets in order to continue providing safe and effective patient care.

OBJECTIVE

To explore the influence of COVID-19 stressors on ATs engaged in patient care.

DESIGN

Cross-sectional study.

SETTING

Internet survey.

PATIENTS OR OTHER PARTICIPANTS

A total of 429 ATs (age = 33 ± 9 years; experience = 11 ± 9 years; 74 men, 355 women) currently providing patient care.

MAIN OUTCOME MEASURE(S)

We recruited participants from social media sites to complete a questionnaire with the Coronavirus Anxiety Scale (CAS), Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS MP), and qualitative questions related to the effects of COVID-19. We calculated correlations between CAS and MBI-HSS MP composite scores (emotional exhaustion, personal accomplishment, and depersonalization) and used regression analysis to explore if CAS scores could be predicted by vaccination status (vaccinated or unvaccinated), sex, and MBI-HSS MP composite scores. We analyzed the qualitative data using a phenomenological, inductive approach with multianalyst triangulation and peer review as trustworthiness strategies.

RESULTS

Significant correlations existed between CAS and MBI-HSS MP composite scores (P < .001). Emotional exhaustion (P < .001) and depersonalization (P = .008) explained 28% of the variance in CAS scores (F2,405 = 81.29, P < .001). Three major areas of focus emerged: effects on wellness, emphasis on the value of athletic training, and the lessons learned and future innovation to inform potential long-term changes in the athletic training profession.

CONCLUSIONS

Key factors of emotional exhaustion and depersonalization during the pandemic may have exacerbated the potential for burnout among ATs. The pandemic affected ATs' wellness, changed perceptions of ATs, and altered operating procedures. Healthy coping strategies and organizational support are suggested for those who are struggling.

Headgear safety attitudes among women's lacrosse stakeholders: Qualitative results

OBJECTIVE

To explore diverse stakeholders' perceptions of headgear use in collegiate women's lacrosse.

PARTICIPANTS

189 collegiate women's lacrosse stakeholders (players: n = 87; coaches: n = 71; officials: n = 32).

METHODS

Participants completed online open-ended qualitative questions surrounding headgear use in the sport. Responses were coded by the research team via inductive reasoning.

RESULTS

Stakeholders felt that incorporating headgear use into women's lacrosse would increase aggression and change the nature of the sport. Some felt that headgear was important for injury risk mitigation and invoked a need for research and development. Stakeholders raised the need for coaching and officiating improvement as primary injury prevention measures. Players were concerned about esthetics and performance limitations. Finally, many felt that it should be left to player choice to wear headgear or not.

CONCLUSION

Most stakeholders invoke concerns of risk compensation and changing the nature of the sport of women's lacrosse, and are in favor of headgear remaining optional.

An exploratory study of the convergent validity of the Test of Effort (TOE) in adults with acquired brain injury

PRIMARY OBJECTIVE

To examine the convergent validity of the Test of Effort (TOE), a performance validity test (PVT) currently under development that employs a two-subtest (one verbal, one visual), forced-choice recognition memory format.

RESEARCH DESIGN

A descriptive, correlational design was employed to describe performance on the TOE and examine the convergent validity between the TOE and comparison measures.

METHODS AND PROCEDURES

A sample of 53 individuals with chronic acquired brain injury (ABI) were administered the TOE and three well-validated PVTs (Reliable Digit Span [RDS], Test of Memory Malingering [TOMM] and Dot Counting Test [DCT]).

MAIN OUTCOMES AND RESULTS

The TOE appeared more difficult than it actually was, suggesting adequate face validity. Medium-to-large correlations were observed between the TOE and established PVTs, suggesting good convergent validity. Provisional cutoff scores are offered based on performance of a subgroup of participants with "sufficient effort."

CONCLUSIONS

Overall, the TOE shows promise as a PVT measure for clinical use. Future studies with larger and more diverse samples are needed to more fully determine the psychometric characteristics of the TOE.

Randomized Controlled Trial of a Novel Peer Concussion-Education Program for Collegiate Athletes

CONTEXT

The National Collegiate Athletic Association and US Department of Defense have called for educational programs to change the culture of concussion reporting, increase reporting behavior, and enhance the safety of players and service members.

OBJECTIVE

To evaluate the effects of a novel peer concussion-education program (PCEP) in changing knowledge, attitudes, and norms about concussion reporting among collegiate student-athletes and assess program implementation.

DESIGN

Randomized controlled trial and qualitative analysis of interviews.

SETTING

National Collegiate Athletic Association athletic teams from randomly selected colleges or universities.

PATIENTS OR OTHER PARTICIPANTS

A total of 1614 male and female student-athletes from 60 teams at 10 colleges and universities and 8 athletic trainers.

INTERVENTION(S)

The PCEP intervention trains 2 peer concussion educators to provide 2 education modules to their teammates. Knowledge, attitudes (oneself and teammates), and concussion occurrence or reporting were assessed at baseline, postintervention, and 1 month later. Eight athletic trainers were interviewed about program implementation.

RESULTS

Compared with the control group, the intervention group showed greater increases occurred postintervention and at 1 month in concussion knowledge (F_1,2648 = 51.3, P < .0001), intention to report (oneself, F_2,2633 = 82.3, P < .0001; teammates, F_2,2624 = 53.9, P < .0001), return-to-play protocol knowledge, (F_2,2632 = 28.4, P < .0001), direct subjective norms (oneself, F_2,2625 = 51.7, P < .0001; teammates, F_2,2644 = 40.6, P < .0001), direct perceived behavioral control (oneself, F_2,2628 = 53.7, P < .0001; teammates, F_2,2615 = 68.2, P < .0001), and indirect attitudes (oneself, F_2,2626 = 47.1, P < .001; teammates, F_2,2623 = 40.9, P < .0001). Peer concussion-education program participants discussed concussion more often with a teammate (F_1,1396 = 13.96, P < .0001) or athletic staff (F_1,1396 = 6.62, P < .001). Qualitative program analysis revealed both positive aspects of the PCEP and areas for improvement.

CONCLUSIONS

The PCEP showed promise in increasing concussion knowledge, intention to report concussion, reporting a teammate's concussion, and facilitating attitudinal changes that support reporting among student-athletes.

Development of a Peer Education Program to Improve Concussion Knowledge and Reporting in Collegiate Athletes

CONTEXT

A novel peer concussion-education program (PCEP) was developed to enhance concussion knowledge and reporting among collegiate student-athletes.

OBJECTIVE

To describe the PCEP and its development and implementation.

DESIGN

Program development consisting of a literature review, focus group, and pilot implementation.

SETTING

Athletics department at a college participating at the National Collegiate Athletic Association Division II-sanctioned competition level.

PATIENTS OR OTHER PARTICIPANTS

Fifteen student-athletes from the women's soccer and men's lacrosse teams participated in the focus group. Four peer concussion educators (PCEs) were debriefed after the pilot implementation of the PCEP with the women's soccer and men's lacrosse teams.

DATA COLLECTION AND ANALYSIS

Focus-group data were analyzed qualitatively. The PCEs were debriefed, and responses were organized into recommendation types.

RESULTS

The literature review contributed information that supported the development of the PCEP's conceptual model. Focus-group results provided information used to train the PCEs and refine the PCEP's education modules. The pilot implementation and PCE debriefing supplied information used to further revise the education modules, PCE training, and PCEP implementation procedure.

CONCLUSIONS

The PCEP was developed based on the Theory of Reasoned Action and Planned Behavior and uses a peer-mediated, cognitive-behavioral, and interdisciplinary model to enhance concussion knowledge of and reporting by collegiate student-athletes. After a focus-group discussion and pilot implementation, we revised the PCEP and its education modules and developed an online manual to facilitate broad dissemination.

Results of a Controlled Trial of a Peer Concussion Education Program With Collegiate Football Players

Purpose

To determine if a novel peer concussion education program (PCEP) increased concussion knowledge and intention-to-report in collegiate football players.

Methods

A sample of football players (N=666) from 10 NCAA colleges were assessed at three time points (baseline, post-test, 1-month follow-up) with adapted measures of the concussion knowledge checklist (adapted from Gioia & Collins [2006]; McLeod et al. [2007], score range=0–27) and intention-to-report questionnaire (adapted from Register-Mihalik et al. [2013], score range=6–42). Five teams (n=408) were randomly assigned to control; five (n=258) to the PCEP. The data were from a larger randomized multi-site trial of men’s and women’s sports (n=1,614).

Results

There was a significant effect of the PCEP on concussion knowledge across time, F(2, 1012)=17.3, p<.0001, ηp2=.03. Model-estimated concussion knowledge scores (M[SE]) at all three timepoints were 19.20 (0.73), 19.90 (0.73) and 19.77 (0.73) for control; 19.81 (0.78), 22.12 (0.78), and 21.83 (0.78) for the PCEP. There was also a significant effect of the PCEP on intention-to-report one’s own concussion across time, F(2,1004)=7.51, p<.001, ηp2=.02. Intention-to-report scores (model-estimated M[SE]) increased for control across all three time points (30.87 [1.13], 32.72 [1.13], and 33.37 [1.13]) but at a faster rate for the PCEP (30.44 [1.25], 34.43 [1.25], and 34.67 [1.26].

Conclusion

There was a significant increase in concussion knowledge and intention-to-report concussion among football players who participated in the PCEP compared to controls which held at a 1-month follow-up.