Abstract
PurposeA significant proportion of sport-related concussions goes unreported among adolescents, which can result in irreversible brain damage. It is critical to identify and intervene on factors that significantly impact concussion reporting. MethodsThis study tests factors associated with collegiate athletes' intentions to (1) self-report concussion symptoms; (2) report another athlete's concussion symptoms; and (3) encourage others to report. Drawing on the Integrated Behavioral Model, predictors at the athlete level included perceived norms (bystander descriptive norms, injunctive norms, and subjective norms), attitudes (positive and negative expectancies about reporting and playing through a concussion and concussion reporting attitudes), personal agency (self-efficacy to recognize symptoms and communicate), and perceived coach communication. At the team level, coaches' self-reported communication was also included. Athletes (N = 1,858) and coaches (N = 254) at 16 colleges and universities completed Web-based surveys in 2016. Multilevel modeling accounted for the nesting of athletes within athletic team. ResultsBystander descriptive norms, positive reporting expectancies, concussion reporting attitudes, self-efficacy to communicate about a concussion, and athletes' perceptions of their coach's communication were positively associated with all three outcomes. By contrast, subjective norms were only positively associated with intentions to self-report and bystander reporting intentions, negative reporting expectancies were only associated with intentions to self-report, and positive and negative expectancies for playing through a concussion were only associated with intentions to self-report and bystander encouragement. ConclusionsIn sum, multiple factors within the Integrated Behavioral Model predict reporting intentions and underscore the complexity of athletes' concussion reporting behaviors and offer guidance for the development of prevention strategies.
Highlights
The Integrated Behavioral Model includes important factors related to concussion reporting
This study draws on the IBM [11] to identify and test several predictors of concussion reporting intentions among a sample of collegiate athletes and includes parts of the Theory of Reasoned Action and Theory of Planned Behavior
Neither injunctive norms measures were independently associated with the outcomes, it is an important factor related to other college student behaviors [21]
Summary
The Integrated Behavioral Model includes important factors related to concussion reporting. Interventions promoting concussion reporting should target important factors such as reporting expectancies, expectancies of playing through concussion symptoms, reporting attitudes, and self-efficacy to communicate. This study draws on the IBM [11] to identify and test several predictors of concussion reporting intentions among a sample of collegiate athletes and includes parts of the Theory of Reasoned Action and Theory of Planned Behavior. Athletes who believe that other important individuals (e.g., teammates, parents, and coaches) approve of (injunctive) and expect (subjective) them to report their concussion symptoms will be more likely to do so. Our first hypothesis was that athlete norms related to concussion symptom reporting would be positively associated with reporting intentions (Figure 1, Box 1)
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