Concussion Education Video Exposure Does Not Significantly Improve Youth Athlete Concussion Knowledge

Abstract

Few studies have investigated the effects of publicly available educational materials and reinforcement strategies on improving concussion knowledge among youth athletes. PURPOSE: This study examined knowledge differences before and after a concussion education video intervention with and without in-person reinforcement. METHODS: Participants were North Carolina (NC) and Arizona (AZ) youth athletes (n=225) that participated in football, boys/girls soccer, boys/girls ice hockey, and boys/girls lacrosse. Athletes were cluster-randomized by team to two study arms: 1) video with in-person reinforcement (RE) or 2) video with no in-person reinforcement (NoRE). Participants completed assent forms with parental consent prior to participation. A validated concussion survey was administered pre-post intervention. The outcome was concussion knowledge (max=29; higher score=more knowledge). A mixed model ANCOVA (controlling for state of residence) examined intervention effects (a priori α=0.05). RESULTS: A total of 180/225 participants (104 NoRE; 76 RE) completed all pre-post knowledge score questions and were included in the analyses. There were no age, concussion history, or previous concussion education differences between intervention groups (p>0.05). Arizona athletes’ pre-test knowledge was lower than NC athletes’ (p<0.001). When controlling for state, there was no intervention group by time interaction (F(1,177)=14.1; p=0.095) as there was no difference in post-intervention improvement between study arms. Regardless of group, there was no significant improvement in knowledge following the intervention [F(1,177)=0.070; p=0.792; post=25.1 (95%CI: 24.7, 25.5) vs. pre=23.0 (95%CI: 22.5, 23.5)]. CONCLUSIONS: In-person reinforcement did not enhance concussion knowledge changes following educational videos for youth athletes. In addition, no overall improvement in knowledge was observed following the videos, suggesting these types of educational materials are likely not effective at increasing overall knowledge among youth sport athletes. These findings suggest that additional educational methods, such as those that are more interactive and culturally relevant, should be explored. Funded by the National Operating Committee on Standards for Athletic Equipment.