Abstract
Concussion among athletes is an issue of growing concern, with efforts underway to improve detection, diagnosis, and treatment. Success depends on communication by athletes, as brain-related symptoms are often not outwardly visible. Education programs to increase reporting behavior have not been successful to date. In accordance with the socioecological approach to health, we argue that multiple levels of influence on student athletes must be addressed, and report a multi-dimensional, mixed-methods research project conducted to identify possible points of intervention into changing the culture of concussion-injury reporting among collegiate athletes. Using quantitative, qualitative and interpretive methods, we examine the individual-level vested interests athletes have in reporting or not reporting concussion symptoms, and how these interests interact with community-level team culture and interpersonal relationships, and social-level cultural narratives to influence concussion-reporting behavior. Our findings confirm the viability of this approach, identifying immediacy, separation of responsibility and pain-enduring story systems as particularly salient elements. We conclude that competing performance versus safety value structures, reflected in cultural narratives and team culture, create mixed-messages for athletes, which are resolved in favor of performance because athletes perceive concussion injuries to be of low immediacy.
Highlights
Awareness of concussions as a problem in college sports has been on the rise in recent years
We focused on basketball and women’s soccer for this phase of data collection (Phase 2 will conduct interviews in the remaining sports)
We argued that the existing approach of educating athletes about concussion symptoms and risks is flawed because it relies on a onesize-fits-all approach and fails to consider factors other than individual attitudes
Summary
Awareness of concussions as a problem in college sports has been on the rise in recent years. As public consciousness has grown, medical research into the effects of concussion has increased [3]. This has caused growing worry by parents [4,5], a corresponding push by schools, athletic associations, and city/state governments to establish safety and treatment protocols, and alarm in some quarters that the long-term future of youth contact sports is at risk [6]. In most cases symptoms are internal, such as difficulty thinking clearly, blurry vision, sensitivity to light and/or noise, and fatigue Because these are solely perceived by the athlete, communication becomes a fundamental issue: Athletes must recognize and report symptoms for diagnosis and treatment to be effective. Embedded within athletes’ reporting decisions are elements of concussion knowledge, attitude and self-identity, attitudes of peers and coaches, and the messages communicated by the broader culture
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