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Abstract
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CONTEXT: Mandated concussion education has aimed to improve student-athlete knowledge; however, some collegiate student-athletes continue to not disclose concussion. Concussion knowledge may not be the only factor influencing reporting, as student-athlete sex, sport, and pressure from external stakeholders (eg, coaches, teammates, fans, parents or family) have all been documented as influencing collegiate concussion-reporting behavior.
OBJECTIVE: To examine predictors of concussion nondisclosure in collegiate student-athletes.
DESIGN: Cross-sectional study. SETTING: Four National Collegiate Athletic Association Division I and two Division II universities. PATIENTS OR OTHER PARTICIPANTS: A total of 1125 collegiate student-athletes completed the survey, and 741 provided viable responses and were included for data analysis. MAIN OUTCOME MEASURE(S): We used a 10- to 15-minute electronic or paper-and-pencil survey that asked about personal and sport demographics, diagnosed concussions and nondisclosed concussion history, concussion knowledge, and level of agreement regarding pressure to play after a head impact experienced during collegiate sport participation. Significant univariable predictor variables were entered into a multivariable logistic regression analysis.
RESULTS: Sex (P =.005), sport-risk type (P <.001), diagnosed concussion history (P <.001), concussion knowledge (P =.017), and pressure from coaches (P <.001), teammates (P <.001), fans (P =.024), and parents or family (P =.003) were predictors of concussion nondisclosure in individual univariable logistic regressions. After we conducted multivariable analyses, male sex (P =.001), high concussion-risk sport participation (P =.048), diagnosed concussion history (P <.001), increased concussion knowledge (P =.013), and experiencing pressure from coaches to continue playing after sustaining a hit to the head (P =.002) were predictors of concussion nondisclosure in collegiate student-athletes.
CONCLUSIONS: Our results suggest that concussion-education programs should go beyond the identification of signs and symptoms to include the dangers of continuing to play, long-term consequences, and transparency about concussion protocols. Comprehensive concussion-education programs should involve coaches and athletes to improve the reporting culture.
Language: en |