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

Abstract

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.

Moderating Effects of Gender Among Collegiate Student-Athletes Receiving a Novel Peer Concussion Education Program

“…The conceptual model of the PCEP employs as peer-mediated, interdisciplinary, and cognitive-behavioral model of change (Ernst & Kneavel, 2020). Based on the TRA/TBP (Azjen et al, 2007), intervention targets included not only knowledge of concussion symptoms and RTP protocol but also intention to report concussion, attitudes about reporting, subjective norms around reporting, and beliefs about ability to report concussion and about consequences of reporting.…”

“…After enrollment, site study coordinators followed the PCEP implementation process outlined in the online manual (Ernst & Kneavel, 2016). The implementation process included (a) forming an interdisciplinary implementation team, (b) selecting PCEs, (c) training the PCEs, and (d) having PCEs present and discuss the two modules with their teammates (Ernst & Kneavel, 2020).…”

“…The Peer Concussion Education Program (PCEP) was based on the theory of reasoned action/theory of planned behavior (TRA/TPB), which posits that changes in knowledge alone is only weakly associated with changes in behavior and that to be effective there must be accompanying changes in attitudes and norms surrounding the behavior (Azjen et al, 2007). The PCEP was also designed with three main components, which made it a unique program: peer-mediated with peers selected through a committee of athletic trainers, coaches, and athletic staff, a cognitive-behavioral model of change foundation, and an interdisciplinary approach utilizing multiple stakeholders (Ernst & Kneavel, 2020). Consistent with the TRA/TPB, peer programs have been shown to be effective in the maintenance of attitudes, norms, and beliefs (Chia, 2006), as they have been shown to facilitate the relationship between knowledge and performance of a behavior (Azjen et al, 2007).…”

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

“…After completing their training, the PCEs provided both education modules to their teammates and were encouraged to facilitate discussion about concussion and concussion reporting. A more detailed description about the PCEP and its development is provided in the article by Ernst and Kneavel 21 or by clicking on the following link: chc.edu/peer-concussion-education/peerconcussion-education-program-manual.…”

Going Beyond the State Law: Investigating High School Sport-Related Concussion Protocols

“…25 Educational strategies that go beyond passive information including face-to-face interactive lectures, peer-topeer instruction, or active learning games should be considered. [26][27][28] There is speculation that an increased understanding of SRC consequences may lead athletes to adopt safer styles of play, but there are no investigations that support education alone as a primary prevention strategy for SRCs. 4 Due to the lack of evidence-based SRC prevention interventions available at this time, it is not surprising that only three protocols in our study addressed this facet of SRC care.…”