Association between Sensation-Seeking Behaviors and Concussion-Related Knowledge, Attitudes, Perceived Norms, and Care-Seeking Behaviors among Collegiate Student-Athletes

There are limited data connecting personality and behavioral tendencies and traits related to concussion care-seeking/disclosure behaviors and minimal research exists surrounding the relationship between risky behaviors, sensation-seeking, and concussion-related outcomes. This study examined the association between sensation-seeking and a student-athlete’s concussion-related knowledge, attitudes, perceived social norms, and concussion care-seeking/disclosure behaviors (intention to disclose concussion symptoms, perceived control over symptom disclosure, self-removal from play due to concussion symptoms, continued play with concussion symptoms, and disclosure of all concussions at the time of injury). The current study utilized a retrospective cohort of collegiate student-athletes at a single National Collegiate Athletic Association Division I institution. Separate multivariable linear regression models estimating mean differences (MD) and 95% Confidence Intervals (CI) estimated the association between sensation-seeking and concussion knowledge, concussion attitudes, and perceived social norms. Separate multivariable binomial regression models estimating adjusted prevalence ratios (PR) and 95%CI estimated the association between sensation-seeking and intention to disclose concussion symptoms, perceived control over symptom disclosure, self-removal from play due to concussion symptoms, continued play with concussion symptoms, and disclosure of all concussions at the time of injury. All models were adjusted for sex, sport participation, and concussion history. Higher sensation-seeking was significantly associated with less favorable concussion attitudes (adjusted MD = -1.93; 95%CI = -3.04,-0.83), less favorable perceived social norms surrounding concussion (adjusted MD = -1.39; 95%CI = -2.06,-0.72), and continuing to play while experiencing concussion symptoms (adjusted PR = 1.50; 95%CI = 1.10, 2.06). Student-athletes with increased sensation-seeking could be at risk for failing to disclose a concussion, decreasing athlete safety and resulting in less optimal care post-injury. Results will inform future theory-based concussion education programs which consider behavioral tendencies and traits as well as sport culture to promote concussion care-seeking/disclosure and individualized interventions based on risky behavior engagement.

A Preliminary Examination of Concussion Knowledge and Attitudes by Collegiate Athletes Who Are Deaf or Hard of Hearing

Athletes who are deaf or hard of hearing (D/HoH) participate at all levels of athletic competition, but no evidence exists regarding their knowledge of and attitudes toward concussion. The purpose of our study was to explore the knowledge of and attitudes toward concussion in athletes who are D/HoH using the Rosenbaum Concussion Knowledge and Attitudes Survey. The Rosenbaum Concussion Knowledge and Attitudes Survey consists of two subscales, the Concussion Knowledge Index (range 0–25) and the Concussion Attitudes Index (15–75). Athletes who are D/HoH had a Concussion Knowledge Index score of 16.25 ± 3.83 and Concussion Knowledge Index score of 58.04 ± 6.44. There were differences between races for Concussion Knowledge Index scores (p < .01). Findings may allow health care professionals to better target educational interventions for athletes who are D/HoH.

Examining Youth American Football Coaches’ Knowledge of, and Attitudes Toward, Sport Concussions

The purpose of this exploratory study was to examine youth American football coaches and their knowledge of, and attitudes toward, sport concussions. Coaches (n = 103) were recruited from a randomized sample of Pop Warner leagues within a large Western state to complete the Rosenbaum Concussion Knowledge and Attitudes Survey. Coaches ranged from 25–75 years of age and were coaching youth athletes ranging from 6–14 years of age. Coaches scored in the 80th percentile on concussion knowledge, and in the 85th percentile on concussion attitudes. However, coaches were lacking in some areas of concussion knowledge such as concussion symptomology. There was also a statistically significant positive correlation between coaches’ scores on the Concussion Knowledge Index and the Concussion Attitudes Index, r = .43, p < .01. The results of this research indicate that while youth sport coaches report basic knowledge of concussions, there remain gaps in their education. This highlights the need for research to review current coaching curriculum, observe actual coaching behaviors, and to determine best practices for teaching coaches.

Knowledge of and attitudes towards concussion in cycling: A preliminary study

The aim of this study wasto investigate the knowledge of and attitudes towards concussion in cycling. An abbreviated Rosenbaum Concussion Knowledge and attitudes Survey (RoCKAS) was distributed online via social media and completed by 1990 respondents involved in cycling. The RoCKAS comprised separate sections to determine a concussion knowledge index (CKI) providing a score between 0-33, and a concussion attitudes index (CAI) with possible scores between 7-20. Mean scores were 25.9 ± 11.0 and 17.7 ± 3.0 for CKI and CAI, respectively. However, there remained several concussion knowledge misconceptions and disparity between reported knowledge and attitudes and actions, with 16% of respondents admitting to riding despite having concussive symptoms and 18.7% stating they would hide a concussion to stay in an event. The results of this survey indicate those involved with cycling reported reasonable knowledge of concussion symptoms and safe/desirable attitudes towards concussion education. However, despite reporting safe attitudes, the actions of those involved in cycling may be of greater concern, as a considerable number of respondents were still willing to take risks by continuing to cycle knowing they had concussive symptoms.

Concussion knowledge and attitudes amongst Stellenbosch University hostel rugby players

Background: Concussion occurs more frequently in contact sports, such as rugby, and is furthermore not fully recognised during play. It is also underreported in the literature, to medical personnel, or to coaches. Objectives: The objective of this study was to describe the knowledge about and attitudes towards concussion by Stellenbosch University hostel rugby players. Methods: The study focussed on gathering quantitative information through implementing a cross-sectional study design. One hundred and eighty Stellenbosch University hostel rugby players completed the modified Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST). The RoCKAS-ST questionnaire is divided into three parts, namely, the evaluation of the Concussion Knowledge Index (CKI) and Concussion Attitudes Index (CAI), and a 16-symptom checklist. Results: The participants scored on average 75% in the CKI and 81% in the CAI. The correlation between CKI and CAI was r=0.14 which is considered a weak positive correlation. Discussion: The participants demonstrated sufficient knowledge of concussion and thus a safer attitude towards concussion. There were some concerning factors from the knowledge of the concussion questions and the symptoms that may have an effect on attitudes towards concussion. Conclusion: The study revealed that Stellenbosch University hostel rugby players have sufficient knowledge of what constitutes concussion, as well as the necessity of having safe attitude towards it. However, a small number of participants showed that they still may lack knowledge in certain areas concerning concussion.

Concussion knowledge and attitudes among amateur South African rugby players

Background: The South African Rugby Union’s BokSmart programme currently educates coaches and referees on concussion. Rugby players are often more familiar with their teammates than the coach or referee. Therefore they are well-positioned to play a pivotal role in rugby safety if they have adequate knowledge to identify subtle signs and abnormal behaviour displayed by a concussed teammate. However, no programme focuses on concussion education among South African rugby players and there is a dearth of literature on concussion education programmes among rugby players which could lead to safer return to play (RTP) habits.Objectives: To evaluate South African rugby players’ concussion knowledge and attitudes/behaviours regarding RTP following a concussion.Methods: A descriptive, cross-sectional study was used. Participants (n=294) were divided into junior amateur high school (JAHS) (n=216) and senior amateur club (SAC) (n=78) players. The modified RoCKAS-ST questionnaire was used to evaluate their concussion knowledge index (CKI) and concussion attitudes/behaviours index (CAI) regarding RTP.Results: On average, 62% (JAHS) and 60% (SAC) of the CKI questions were answered correctly. JAHS participants correctly identified 66% of concussion symptoms, similarly to the SAC participants (63%), rendering similar (p=0.37) overall CKI scores when comparing the two groups. The CAI questions yielded similar (p=0.98) results between the groups, reporting safe responses in 66% (JAHS) and 67% (SAC) of the items.Discussion and conclusion: Junior and senior South African amateur rugby players lacked approximately one-third of essential concussion knowledge, which may lead to a display of unsafe attitudes/behaviours to concussion and RTP. Further research is warranted to inform educational programmes on concussion among rugby players.

Concussion knowledge and attitudes among amateur South African rugby players

Background: The South African Rugby Union’s BokSmart programme currently educates coaches and referees on concussion. Rugby players are often more familiar with their teammates than the coach or referee. Therefore they are well-positioned to play a pivotal role in rugby safety if they have adequate knowledge to identify subtle signs and abnormal behaviour displayed by a concussed teammate. However, no programme focuses on concussion education among South African rugby players and there is a dearth of literature on concussion education programmes among rugby players which could lead to safer return to play (RTP) habits.Objectives: To evaluate South African rugby players’ concussion knowledge and attitudes/behaviours regarding RTP following a concussion.Methods: A descriptive, cross-sectional study was used. Participants (n=294) were divided into junior amateur high school (JAHS) (n=216) and senior amateur club (SAC) (n=78) players. The modified RoCKAS-ST questionnaire was used to evaluate their concussion knowledge index (CKI) and concussion attitudes/behaviours index (CAI) regarding RTP.Results: On average, 62% (JAHS) and 60% (SAC) of the CKI questions were answered correctly. JAHS participants correctly identified 66% of concussion symptoms, similarly to the SAC participants (63%), rendering similar (p=0.37) overall CKI scores when comparing the two groups. The CAI questions yielded similar (p=0.98) results between the groups, reporting safe responses in 66% (JAHS) and 67% (SAC) of the items.Discussion and conclusion: Junior and senior South African amateur rugby players lacked approximately one-third of essential concussion knowledge, which may lead to a display of unsafe attitudes/behaviours to concussion and RTP. Further research is warranted to inform educational programmes on concussion among rugby players.