An assessment of high school athletes' and coaches' knowledge, attitudes, and behaviors concerning sport-related concussion

Cerebral concussions are one of the most perplexing sports injuries to identify and manage. As a result, many of these injuries go unreported and untreated. Few studies to date have addressed the behavior of concussion reporting, specifically among young athletes. The overall purpose of this dissertation was to assess knowledge, attitudes, intentions, and behaviors concerning concussion using a pre-validated survey instrument. A convenience sample of 25 high schools participated in the study. Meetings were held at each school to explain the study and distribute the survey instruments to coaches and athletes. The Theory of Reasoned Action and Planned Behavior guided the direction of the study. A sample of 167 high school athletes (football, soccer, lacrosse, cheerleading) and 59 high school coaches completed the pre-validated survey instrument during the 2009-2010 school year. There was major under-reporting of concussive events with respondents indicating only 40% of concussion events and 13% of bell ringer events indicated had been reported. The major factors associated with increased reporting of recalled concussion/bell ringer event reporting and participating with concussions signs/symptoms in the sample of athletes included: (1) increased athlete concussion knowledge and attitude, (2) increased intention to report concussions, (3) increased positive influence form social referents, (4) decreased number of previous concussive injuries. No association was observed between school level coach knowledge/attitude scores and athlete knowledge/attitude scores. This study illustrates the multi-factorial issues concerning concussion in young athletes. The factors listed above could serve as the foundation for a multi-level intervention designed to improve concussion reporting and to decrease participation while experiencing signs and symptoms from concussion. The data obtained from this study illustrates necessary targets of future educational and behavioral interventions concerning concussion among high school athletes.