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

Abstract

Context The National Collegiate Athletic Association and US Department of Defense have called for educational programs to change the culture of concussion reporting, increase reporting behavior, and enhance the safety of players and service members. Objective To evaluate the effects of a novel peer concussion-education program (PCEP) in changing knowledge, attitudes, and norms about concussion reporting among collegiate student-athletes and assess program implementation. Design Randomized controlled trial and qualitative analysis of interviews. Setting National Collegiate Athletic Association athletic teams from randomly selected colleges or universities. Patients or Other Participants A total of 1614 male and female student-athletes from 60 teams at 10 colleges and universities and 8 athletic trainers. Intervention(s) The PCEP intervention trains 2 peer concussion educators to provide 2 education modules to their teammates. Knowledge, attitudes (oneself and teammates), and concussion occurrence or reporting were assessed at baseline, postintervention, and 1 month later. Eight athletic trainers were interviewed about program implementation. Results Compared with the control group, the intervention group showed greater increases occurred postintervention and at 1 month in concussion knowledge (F1,2648 = 51.3, P < .0001), intention to report (oneself, F2,2633 = 82.3, P < .0001; teammates, F2,2624 = 53.9, P < .0001), return-to-play protocol knowledge, (F2,2632 = 28.4, P < .0001), direct subjective norms (oneself, F2,2625 = 51.7, P < .0001; teammates, F2,2644 = 40.6, P < .0001), direct perceived behavioral control (oneself, F2,2628 = 53.7, P < .0001; teammates, F2,2615 = 68.2, P < .0001), and indirect attitudes (oneself, F2,2626 = 47.1, P < .001; teammates, F2,2623 = 40.9, P < .0001). Peer concussion-education program participants discussed concussion more often with a teammate (F1,1396 = 13.96, P < .0001) or athletic staff (F1,1396 = 6.62, P < .001). Qualitative program analysis revealed both positive aspects of the PCEP and areas for improvement. Conclusions The PCEP showed promise in increasing concussion knowledge, intention to report concussion, reporting a teammate's concussion, and facilitating attitudinal changes that support reporting among student-athletes.

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

“…The effectiveness of the PCEP was investigated during a national randomized controlled trial, and the results are reported in ''Randomized Controlled Trial of a Novel Peer Concussion Education Program in Collegiate Athletes. 41…”

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

“…Participation in the study was voluntary. For more complete details of the RCT, see Kneavel et al (2020).…”

“…An adapted version of a Theory of Planned Behavior questionnaire (Kneavel et al, 2020) contained subscales to measure (a) intention to report concussion, (b) direct attitudes, (c) direct perceived behavioral control, (d) indirect attitude, and (e) indirect perceived behavioral control.…”

“…Models employing both peer-mediated and cognitive-behavioral modification programs have been shown with a wide range of positive outcomes in diverse populations (Dart et al, 2014; Dawson et al, 2014). In a nationwide randomized controlled trial of both male and female NCAA athletes, the PCEP significantly improved knowledge of concussion symptoms, understanding of the return to play protocol, and most important, direct and indirect attitudes both immediately and 1-month following implementation relative to control (Kneavel et al, 2020). The PCEP also increased how much participants discussed concussions with key health care personnel (Kneavel et al, 2020).…”

“…In a nationwide randomized controlled trial of both male and female NCAA athletes, the PCEP significantly improved knowledge of concussion symptoms, understanding of the return to play protocol, and most important, direct and indirect attitudes both immediately and 1-month following implementation relative to control (Kneavel et al, 2020). The PCEP also increased how much participants discussed concussions with key health care personnel (Kneavel et al, 2020). The current analysis evaluates the moderating effects of gender on the effectiveness of the PCEP.…”