Improving concussion education: do athletic trainer opinions match expert consensus?

Abstract

The NCAA-DoD Mind Matters Challenge created "useful and feasible" consensus recommendations to improve concussion care-seeking behavior in collegiate athletes and military cadets. Given athletic trainers' (ATs') role as providers of concussion education and medical care, it is important to understand if they agree with the expert panel that the recommendations are useful and feasible. To describe and compare secondary school (SS) and collegiate setting ATs' perceptions of the utility and feasibility of the NCAA-DoD Mind Matters Challenge recommendations on improving concussion education. Cross-sectional study. Electronic survey. Five hundred and fifteen (515) ATs (age 40.7±12.4, 53.1% female gender) practicing in the SS (60.6%) or collegiate (38.4%) setting. An online survey asked participants about their awareness of the statement followed by 17 pairs of Likert-item questions regarding each recommendation's utility and feasibility with responses ranging from No (1) to Yes (9). Mimicking the consensus process, we defined consensus as a mean rating ≥7.00. We compared utility and feasibility rating responses between SS and collegiate setting participants using Mann-Whitney U tests with ι=.05. Two-thirds (66.6%) of participants were unaware of the consensus statement. Participants felt all recommendations were useful (all means≥7.0); however, 4 recommendations related to collaborating with stakeholders did not meet the feasibility cutoff (mean range=6.66-6.84). SS ATs rated lower feasibility related to educational content (p-value range=.001-.014), providing patient education throughout recovery (p=.002), and promoting peer intervention (p=.019), but higher utility (p=.007) and feasibility (p=.002) for providing parent education compared to collegiate ATs. The NCAA-DoD Mind Matters Challenge recommendations require further dissemination. ATs rated collaboration with stakeholders as a feasibility barrier. SS ATs require more resources for educational content, messaging, and promoting peer intervention, but find educating athletes' parents more useful and feasible than collegiate ATs.