High School Student-Athletes’ Awareness of Concussion Education May Differ by Age

Abstract

Background:A tremendous amount of resources and education have been directed towards those involved in high school athletics to help recognize the signs and symptoms of a concussion and ensure removal from play of potentially concussed athletes. Concussion education policies have been broadly implemented across the country; however, the success of these educational methods at encouraging adolescents to disclose their symptoms has yet to be determined.Purpose:The purpose of this study was to (1) identify how many student-athletes recognized they had been provided concussion education and (2) document disclosure and non-disclosure patterns.Methods:An anonymous survey was distributed to student-athletes at four Connecticut high schools. The survey contained demographic questions (sex, age, primary sport, and prior history of concussion) along with a question asking if the individual had received formal concussion education. The survey then asked in which of six provided situations the athlete would disclose their symptoms and which of eight provided reasons would prevent the athlete from disclosing their symptoms. Respondents were grouped by education status (received or not) and the difference in response frequency was evaluated using Chi-Square tests.Results:A total of 872 athletes (average age 15.8±1.3 years, 410 Males, 462 Females) completed the survey (61.2% response rate). A total of 583 (66.9%) athletes reported having received concussion education. Athletes who reported that they had not received concussion education were significantly younger than athletes that reported that they had received concussion education (p=<0.001). Both the education and non-education groups identified an important game as the least likely situation to disclose symptoms, and practice as the most likely situation. The most common reason for non-disclosure was “Don’t want to miss game” in the education group and “Don’t think I have a concussion” in the non-education group. Significant differences in response rates between groups were found for ‘Don’t think I have a concussion’ (p=0.038) and ‘Others played with concussions’ (p=0.005).Conclusion:Current educational efforts may not be successfully educating younger student-athletes about the importance of recognizing and reporting concussion symptoms. Within our small cohort of Connecticut high schools, approximately 1/3 of individuals reported not receiving education, and more than half of student-athletes report that they would not disclose concussion symptoms during important games despite receiving education. Further work is required to re-evaluate the efficacy of current educational programs available to high school athletes, focusing on non-disclosure reasons reported by varying ages of student-athletes.Table 1.Status of Concussion Education and Disclosure and Non-Disclosure Patterns of High School Student Athletes Education (n=583) No Education (n=289) p-value Age (years)16.0 ± 1.315.5 ± 1.2 <0.001 Gender (Female)50.957.10.086History of Prior Concussion (yes)30.515.6 <0.001 Would tell in a… Practice79.178.5.857Important Game38.936.3.455Regular Game59.760.6.806Unimportant game77.773.6.155Early Season63.066.1.363Late in Season53.249.5.304 What is the reason you wouldn’t tell Don’t Think you have a concussion53.961.2 .038 Don’t want to let team down48.449.1.831Part of the Game12.516.6.100Not Serious Enough44.844.3.893Don’t want to miss game58.051.9.089Don’t want to disappoint parents13.214.9.500Don’t want to disappoint coach36.732.5.224Other played with concussions4.10.7 .005 All values reported as percentage (%), except for age and history of concussions.