Exploring Sex-Based Differences in Concussion Knowledge, Attitudes and Resources in Young First Nations Hockey Players: A Cross-Sectional Survey from Ontario, Canada

Abstract

Objective:Indigenous youth are vulnerable to concussion when playing hockey. A clear characterisation of sex differences among Indigenous youth could assist in tailoring future education programmes for prevention and management of concussion. The purpose of this study was to compare and contrast concussion knowledge, attitudes and resources in First Nations girls and boys playing recreational hockey.Method:The cross-sectional survey was conducted in partnership with a First Nations’ chief, other Indigenous community leaders and a tertiary care head injury clinic. In Canada, researchers engaging with Indigenous peoples are expected to adhere to principles of Ownership, Control, Access and Possessions. The study included Indigenous boys and girls between the ages of 10 and 18 years of age.Results:More girls attending the hockey tournament participated in the study as compared to boys (girls n = 46, boys n = 29). More girls reported they had never experienced a concussion (73.9%), as compared to boys (58.6%) self-reports. Less than half of all study participants were able to identify some signs and symptoms of concussion such as vomiting/nausea, memory problems, fatigue and blurred vision and recognition of several concussion symptoms varied by sex.Conclusions:We created a unique partnership between Indigenous leaders and tertiary care clinic staff. Among Indigenous youth reasons for not reporting concussion symptoms to the coach varied by sex (although not reaching statistical significance), suggesting concussion education warrants tailoring for girls and boys.

Concussion knowledge, attitudes and reporting intention amongst UK university student-athletes: Implications for institutions, coaches and future research

“…Whilst this research aligns with studies which have shown no, or only slight, differences in the overall attitudes towards concussion expressed by males and females, 9,15,33 it also supports previous research identifying gender differences in attitudes to specific issues. For example, Hunt et al found that females are more likely than males to report concussions, 15 and Sanderson et al 14 and Jorgensen et al 12 concluded that females are more likely than males to continue playing sport when concussed. Similarly, Hunt et al 15 found that boys expressed a greater concern over the seriousness of concussions, and O’Connor and Molloy 33 noted that females reported worrying more about the potential long-term effects.…”

“…For example, Hunt et al found that females are more likely than males to report concussions, 15 and Sanderson et al 14 and Jorgensen et al 12 concluded that females are more likely than males to continue playing sport when concussed. Similarly, Hunt et al 15 found that boys expressed a greater concern over the seriousness of concussions, and O'Connor and Molloy 33 noted that females reported worrying more about the potential long-term effects. Whilst others have questioned the reliability of the RoCKAS-ST attitudes measure, 6 the complexity of this relationship revealed across studies suggests that it is an oversimplification to consider attitudes as a binary choice between safety and risk.…”

“…Whilst studies have also shown gender differences in concussion knowledge (CK) amongst both college students 8,12 and sports participants more widely, 13,14 no discernible pattern is evident. 9,15 More generally, studies have demonstrated that concussion history is not associated with changes in attitude, 16 or reporting behaviour, 4 and may even have a negative influence on concussion attitudes (CA). 17 There have been relatively few UK studies to date, but most have raised concerns about the 'limited' 18 and 'insufficient' 19 SRC knowledge within this population.…”