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Journal Article


Warmath D, Winterstein AP. J. Athl. Train. 2020; ePub(ePub): ePub.


(Copyright © 2020, National Athletic Trainers' Association (USA))






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.

Language: en


concussion education; expectancy value theory; help seeking; sport-related concussion


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