Predictors Of Sport-related Concussion Non-disclosure In Collegiate Athletes

Abstract

Sport-related concussion (SRC) non-disclosure continues to be a barrier to injury identification, despite recent National Collegiate Athletics Association educational initiatives to increase favorable reporting behaviors. Therefore, understanding factors associated with SRC non-disclosure in collegiate athletes is warranted. PURPOSE: To examine predictors of SRC non-disclosure in collegiate athletes. METHODS: A multisite cross-sectional design was used. Collegiate athletes (n = 741; males = 448, females = 293; mean age = 19.89 ± 1.32 years) completed a 15-minute survey that included personal and sport demographics, diagnosed and non-disclosed SRC history, and pressure from external sources (i.e., coaches, teammates, family/parents, fans) to continue to play following a head impact. Age, sex (male/female), sport type (contact/non-contact), SRC history (yes/no), and degree of pressure from external sources (1-strongly disagree to 7-strongly agree) were potential predictor variables of SRC non-disclosure. Univariate logistic regression analyses determined the odds of SRC non-disclosure (yes/no) for each predictor. Significant univariate predictor variables were used in the multivariate logistic regression analysis. Significance was set a priori at p ≤ .05. RESULTS: A total of 116 (15.65%) collegiate athletes reported not disclosing a potential SRC. Following univariate logistic regression analysis, sex (p = .004), sport type (p = .002), SRC history (p < .001), pressure from teammates (p < .001), pressure from coaches (p < .001), pressure from parents/family (p < .001), and pressure from fans (p < .001) were entered into a multivariate logistic regression. Previous history of SRC (OR, 2.66, [95% CI 1.74-4.08]; p < .001), being a male (OR, 1.69 [95% CI, 1.04-2.75]; p = .033), and experiencing pressure to play following a head impact from a coach (OR, 1.36 [95% CI 1.16-1.59]; p < .001) were significant predictors of SRC non-disclosure. CONCLUSIONS: SRC non-disclosure behaviors are influenced by intrinsic and extrinsic factors and may be magnified in athletes with a history of SRC, males, and athletes that experience pressure from coaches. To reinforce favorable reporting behaviors, future educational initiatives should consider these predictive factors.