Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes

Abstract

Background The benefit of preseason concussion education on athletes’ knowledge, attitudes, and behaviors is unclear. The purpose of the study was to determine the influence of preseason concussion education on knowledge and self-reported attitudes and reporting behaviors. We hypothesized that preseason education would lead to better knowledge and self-reported attitudes and better reporting of concussion symptoms during the season. Methods Prospective cohort comparing the benefits of a preseason lectured-based concussion education session at one high school with a control school. Participants included males and females age 13–18 years from two community high schools who were participating in higher concussion risk, fall or winter sports (football, soccer, wrestling, and basketball). The education school and control school included 234 and 262 participants, respectively. Outcomes were a pre- and post-season survey assessing knowledge and self-reported attitudes about concussions and an end of season questionnaire assessing concussion reporting behaviors during the season. Results Total scores on the combined (p<.0001), knowledge-based (p=.016), and behavioral-based (p<.0001) questions demonstrated statistically significant improvement in the education group. Scores peakedimmediately post education, but dissipated at the end of the season. There was a lower proportion in the education school (72%) compared to the control school (88%) that reported continued play despite having concussion symptoms during the season (p=.025). A similar proportion of athletes diagnosed with concussion during the season in the education (27%) and control schools (23%) reported returning to play before symptoms resolved (p=.81). Conclusion These findings suggest that a didactic-based preseason concussion education likely has minimal benefits. Other factors besides knowledge are likely influencing student-athlete concussion reporting behavior. Future research focused on changing the culture of concussion reporting is needed.

Concussion Knowledge of Youth Sport Athletes, Coaches, and Parents: A Review

“…All studies included in this review developed a unique questionnaire based upon the literature, consensus statements, position statements, educational resources (e.g., CDC's Heads Up materials), Sport Concussion Assessment Tool (SCAT), and/or expert opinions. Five studies adopted and/or slightly modified a previously utilized survey (Anderson, Gittelman, Mann, Cyriac, & Pomerantz, 2016;Gourley, Valovich McLeod, & Bay, 2010;Kurowski, Pomerantz, Schaiper, & Gittelman, 2014;Kurowski, Pomerantz, Schaiper, Ho, & Gittelman 2015;Shroyer & Stewart, 2016).…”

“…For instance, Bloodgood et al (2013) revealed that only a quarter of both athletes and parents knew a concussion can be caused by a blow other than to the head. Similarly, other studies suggested knowledge deficits (i.e., only 58-61% of respondents answered correctly) in understanding the causes of concussions among parents (Mannings et al, 2014) and athletes (Kurowski et al, 2014;Kurowski et al, 2015).…”

“…Four studies (Anderson et al, 2016;Kurowski et al, 2014;Kurowski et al, 2015;Mrazik et al, 2011) that examined factors associated with repetitive concussions (i.e., prevalence) showed mixed results based on the type of stakeholder. Specifically, while the vast majority (91.6%) of coaches agreed that the likelihood of another concussion increases with a previous history (Mrazik et al, 2011), a moderate (65-77% correctly responded) level of knowledge regarding the likelihood of suffering another concussion was found among youth sport athletes (Anderson et al, 2016;Kurowski et al, 2014;Kurowski et al, 2015).…”

“…The majority of YSS in several studies correctly identified commonly perceived signs/symptoms. Specifically, over 80% of athletes (Anderson et al, 2016;Cournoyer & Tripp, 2014;Kurowski et al, 2014;Kurowski et al, 2015;Register-Mihalik et al, 2013), coaches (Chrisman et al, 2014;Mrazik et al, 2011;Naftel, Yust, Nichols, King, & Davis, 2014;O'Donoghue et al, 2009;Shenouda et al, 2012), and parents (Coghlin et al, 2009;Mannings et al, 2014;Shenouda et al, 2012) correctly identified headache, dizziness, confusion, memory loss, and blurred vision as common signs/symptoms of concussions. Furthermore, over 80% of athletes (Anderson et al, 2016;Cournoyer & Tripp, 2014;Register-Mihalik et al, 2013) and coaches (Mrazik et al, 2011;Shroyer & Stewart, 2016) were aware that a loss of consciousness is not necessary to sustain a concussion.…”

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“…11 Of interest to us are the multiple studies that provide insight regarding secondary school athletes and concussion education. 2,8,[13][14][15][16][17][18] One such study determined that secondary school athletes with previous formal concussion education are more likely to notify their coaches of concussion symptoms. 15 Secondary school athletes with a previous history of concussion are also more likely to report concussion symptoms.…”