AccScience Publishing / JCTR / Volume 5 / Issue 4 / DOI: 10.18053/jctres.05.2020S4.005
Submit to JCTR
Cite this article
161
Views
Journal Browser
Volume | Year
Issue
Search
Forthcoming Issue
Current Issue
View All
News and Announcements
View All
SPECIAL ISSUE ARTICLE

Examination of collegiate student-athlete concussion reporting intentions and behavior

Michelle L. Weber Rawlins1 * ,  David Welch Suggs2 ,  Laura Bierema3 ,  L. Stephen Miller4 ,  Fred Reifsteck5 ,  Julianne D. Schmidt6
Show Less
1 A.T. Still University, Mesa, AZ
2 Grady College of Journalism and Mass Communication, Grady Sports Media Initiative, University of Georgia, Athens, Georgia, United States
3 Program Adult Learning, Leadership, and Organization Development, University of Georgia, Athens, Georgia, United States
4 Department of Psychology, University of Georgia, Athens, Georgia, United States
5 University Health Center, University of Georgia, Athens, Georgia, United States
6 UGA Concussion Reserach Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, United States
JCTR 2020, 5(4), 186–196; https://doi.org/10.18053/jctres.05.2020S4.005
Submitted: 30 July 2019 | Revised: 20 November 2019 | Accepted: 22 November 2019 | Published: 16 April 2020
© 2020 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Download PDF
Cite
XML
Abstract

Background: Clinicians rely on student-athletes to self-report concussion symptoms, but more than 50% of concussions go undisclosed.

Aim: The aim of this study was to determine whether knowledge, attitudes, subjective norms, self-efficacy, social identity, and athletic identity explain variability in student-athlete concussion reporting intentions and behavior. 

Methods: One hundred and forty-seven Division I and II collegiate student-athletes (male=23, female=56, missing=168; age=19.041.98 years) completed survey segments regarding the following predictor variables: concussion knowledge, attitudes, subjective norms, self-efficacy, social identity, and athletic identity; and the following criterion variables: reporting intentions (symptom and concussion reporting) and reporting behavior (symptom and concussion reporting) (completion rate=29.2%). Separate linear and logistic regressions were performed for each criterion variable. Backwards elimination Akaike Information Criterion (AIC) was applied to determine the best fit model.

Results: A one-point increase in knowledge, attitudes, and self-efficacy predicted a significant 0.55, 0.23, and 0.31 increase in symptom reporting intentions, and 0.24, 0.30, and 0.33 increase in concussion reporting intentions of concussion reporting. As self-efficacy increased, symptom reporting behavior increased by 140%. When knowledge increased, concussion reporting behavior decreased by 23%. Whereas when subjective norms increased, concussion reporting behavior increased by 23%.

Conclusions: A student-athletes’ confidence, or self-efficacy, was a frequent predictor of concussion reporting intentions and behavior.

Relevance for patients: Clinicians should aim to increase student-athlete knowledge, attitudes, and subjective norms, but most importantly their confidence in reporting concussions. 

Keywords
reporting behavior
reporting intention
sport-related concussion
theory of planned behavior
Conflict of interest
Michelle Weber Rawlins has received stipend and travel funds from The National Collegiate Athletic Association-Department of Defense Research Grand Challenge: Changing Attitudes about Concussions in Young and Emerging Adults Grant. Julianne Schmidt was the principal investigator in receiving this grant, and too received travel funds. The grant was the research funding source for the associated manuscript being submitted. David Welch Suggs also received travel funding from this grant. Laura Bierema, L. Stephen Miller, and Fred Reifsteck have no conflicts of interest to declare.
References

[1] McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, et al. Consensus Statement on Concussion in Sport the 5th International Conference on Concussion in Sport Held in Berlin, october 2016. Br J Sports Med. 2017;51:838-47.

[2] Llewellyn T, Burdette GT, Joyner AB, Buckley TA. Concussion Reporting Rates at the Conclusion of an Intercollegiate Athletic Career. Clin J Sport Med 2014;24:76-9.

[3] Meehan W 3rd, Mannix R, O’Brien M, Collins M. The Prevalence of Undiagnosed Concussions in Athletes. Clin J Sport Med 2013;23:339-42.

[4] Rivara FP, Schiff M, Chrisman SP, Chung S, Ellenbogen R, Herring S. The Effect of Coach Education on Reporting of Concussions among High School Athletes after Passage of a Concussion Law. Am J Sports Med 2014;42:1197-203.

[5] Asken BM, McCrea MA, Clugston JR, Snyder AR, Houck ZM, Bauer RM. “Playing through it”: Delayed Reporting and Removal from Athletic Activity after Concussion Predicts Prolonged Recovery. J Athl Train 2016;51:329-35.

[6] Davies SC, Bird BM. Motivations for Underreporting Suspected Concussion in College Athletics. J Clin Sport Psychol 2015;9:101-15.

[7] Kerr ZY, Register-Mihalik JK, Kroshus E, Baugh CM, Marshall SW. Motivations Associated with Nondisclosure of Self-reported Concussions in Former Collegiate Athletes. Am J Sports Med 2016;44:220-5.

[8] Register-Mihalik J, Guskiewicz KM, McLeod TC, Linnan LA, Mueller FO, Marshall SW. Knowledge, Attitude, and Concussion-reporting Behaviors among High School Athletes: A Preliminary Study. J Athl Train 2013;48:645-53.

[9] Register-Mihalik J, Linnan LA, Marshall SW, McLeodTCV, Mueller FO, Guskiewicz KM. Using Theory to Understand High School Aged Athletes’ Intentions to Report Sportrelated Concussion: Implications for Concussion Education Initiatives. Brain Inj 2013;27:878-86.

[10] Chrisman SP, Quitiquit C, Rivara FP. Original Article: Qualitative Study of Barriers to Concussive Symptom Reporting in High School Athletics. J Adolesc Health 2013;52:330-5.e333.

[11] Kroshus E, Baugh CM, Daneshvar DH, Nowinski CJ, Cantu R. Concussion Reporting Intention: A Valuable Metric for Predicting Reporting Behavior and Evaluating Concussion Education. Clin J Sport Med 2015;25:243-7.

[12] Baugh CM, Kroshus E, Daneshvar DH, Stern RA. Perceived Coach Support and Concussion Symptom-reporting: Differences between Freshmen and Non-freshmen College Football Players. J Law Med Ethics 2014;42:314-22.

[13] Kroshus E, Daneshvar DH, Baugh CM, Nowinski CJ, Cantu R. Ncaa Concussion Education in Ice Hockey: An Ineffective Mandate. Br J Sports Med 2014;48:1-7.

[14] Kroshus E, Baugh CM, Daneshvar DH, Viswanath K. Understanding Concussion Reporting Using a Model Based on the Theory of Planned Behavior. J Adolesc Health 2014;54:269-74.

[15] Ajzen I. The Theory of Planned Behavior. Organ Behav Hum Decis Process 1991;50:179-211.

[16] Kroshus E, Garnett B, Hawrilenko M, Baugh CM, Calzo JP. Concussion under-reporting and Pressure from Coaches, Teammates, Fans, and Parents. Sco Sci Med 2015;134:66-75.

[17] McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported Concussion in High School Football Players: Implications for Prevention. Clin J Sport Med 2004;14:13-7.

[18] Kroshus E, Baugh CM, Hawrilenko M, Daneshvar DH. Pilot Randomized Evaluation of Publically Available Concussion Education Materials: Evidence of a Possible Negative Effect. Health Educ Behav 2015;42:153-62.

[19] Terry DJ, Hogg MA, White KM. The Theory of Planned Behaviour: Self-identity, Social Identity and Group Norms. Br J Soc Psychol 1999;38:225-44.

[20] Elder JP, Ayala GX, Harris S. Theme Articles: Theories and Intervention Approaches to Health-behavior Change in Primary Care. Am J Prev Med 1999;17:275-84.

[21] Tajfel H, Turner JC. The Social Identity Theory of Intergroup Behavior; Psychology of Intergroup Relations. New York: Nelson-Hall Publishers; 1986.

[22] Kroshus E, Kubzansky LD, Goldman RE, Austin SB. Norms, Athletic Identity, and Concussion Symptom underreporting among Male Collegiate Ice Hockey Players: A Prospective Cohort Study. Ann Behav Med 2015;49:95-103.

[23] Determann D, Lambooij MS, Steyerberg EW, de BekkerGrob EW, de Wit GA. Impact of Survey Administration Mode on the Results of a Health-related Discrete Choice Experiment: Online and Paper Comparison. Value Health 2017;20:953-60.

[24] Matz CM. Administration of Web Versus Paper Surveys: Mode Effects and Response Rates. Master’s Paper Submitted; 1999.

[25] Lottridge SM, Nicewander WA, Mitzel HC. A Comparison of Paper and Online Tests Using a Within-subjects Design and Propensity Score Matching Study. Multivariate Behav Res 2011;46:544-66.

[26] Denscombe M. Item Non-response Rates: A Comparison of Online and Paper Questionnaires. Int J Soc Res Methodol 2009;12:281.

[27] Rosenbaum AM, Arnett PA. The Development of a Survey to Examine Knowledge about and Attitudes Toward Concussion in High-school Students. J Clin Exp Neurospychol 2010;32:44.

[28] Broglio, Cantu RC, Gioia GA, Guskiewicz KM, Kutcher J, Palm M, et al. National Athletic Trainers’ Association Position Statement: Management of Sport Concussion. J Athl Train 2014;49:245-65.

[29] Bogardus ES. Measuring Social Distance. J Appl Soc 1925;9:299-308.

[30] Esses VM, Dovidio JF. The Role of Emotions in Determining Willingness to Engage in Intergroup Contact. Pers Soc Psychol Bull 2002;28:1202-14.

[31] Ortiz M, Harwood J. A Social Cognitive Theory Approach to the Effects of Mediated Intergroup Contact on Intergroup Attitudes. J Broadcast Electron Media 2007;51:615-31.

[32] Stephan WG, Stephan CW. Intergroup Anxiety. J Soc Issues 1985;41:157-75.

[33] Brewer BW, Van Raalte JL, Linder DE. Athletic Identity: Hercules’ Muscles or Achilles Heel? Int J Sport Psychol 1993;24:237-54.

[34] Bennett RJ, Haining RP, Griffith DA. The Problem of Missing Data on Spatial Surfaces. Ann Assoc Am Geogr 1984;74:138-56.

[35] Poh N, Windridge D, Mottl V, Tatarchuk A, Eliseyev A. Addressing Missing Values in Kernel-based Multimodal Biometric Fusion Using Neutral Point Substitution. IEEE Trans Inf Forensics Secur 2010;5:461-9.

[36] Yates F. The Analysis of Replicated Experiments when the Field Results are Incomplete. Emp J Exp Agric 1933;1:129-42.

[37] Akaike H. A New Look at the Statistical Model Identification. IEEE Trans Automat Control 1974;19:716-23.

[38] Guskiewicz K, Bruce S, Cantu R, Ferrara M, Kelly J, McCrea M, et al. National Athletic Trainers’ Association Position Statement: Managment of Sport-related Concussion. J Athl Train 2004;39:280-97.

Share
Back to top
Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept