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Concussion under-reporting and pressure from coaches, teammates, fans, and parents

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  • Kroshus, Emily
  • Garnett, Bernice
  • Hawrilenko, Matt
  • Baugh, Christine M.
  • Calzo, Jerel P.

Abstract

Concussions from sport present a substantial public health burden given the number of youth, adolescent and emerging adult athletes that participate in contact or collision sports. Athletes who fail to report symptoms of a suspected concussion and continue play are at risk of worsened symptomatology and potentially catastrophic neurologic consequences if another impact is sustained during this vulnerable period. Understanding why athletes do or do not report their symptoms is critical for developing efficacious strategies for risk reduction. Psychosocial theories and frameworks that explicitly incorporate context, as a source of expectations about the outcomes of reporting and as a source of behavioral reinforcement, are useful in framing this problem. The present study quantifies the pressure that athletes experience to continue playing after a head impact—from coaches, teammates, parents, and fans—and assesses how this pressure, both independently and as a system, is related to future concussion reporting intention. Participants in the study were 328 male and female athletes from 19 teams competing in one of seven sports (soccer, lacrosse, basketball, softball, baseball, volleyball, field hockey) at four colleges in the northeast region of the United States. Results found that more than one-quarter of the sample had experienced pressure from at least one source to continue playing after a head impact during the previous year. Results of a latent profile mixture model indicated that athletes who experienced pressure from all four of the measured sources were significantly more likely to intend to continue playing in the future than were athletes who had not experienced pressure from all sources, or only pressure from coaches and teammates. These findings underscore the importance of designing interventions that address the system in which athletes make decisions about concussion reporting, including athletes' parents, rather than focusing solely on modifying the individual's reporting cognitions.

Suggested Citation

  • Kroshus, Emily & Garnett, Bernice & Hawrilenko, Matt & Baugh, Christine M. & Calzo, Jerel P., 2015. "Concussion under-reporting and pressure from coaches, teammates, fans, and parents," Social Science & Medicine, Elsevier, vol. 134(C), pages 66-75.
    • Handle: RePEc:eee:socmed:v:134:y:2015:i:c:p:66-75
    DOI: 10.1016/j.socscimed.2015.04.011
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    References listed on IDEAS

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    1. Vermunt, Jeroen K., 2010. "Latent Class Modeling with Covariates: Two Improved Three-Step Approaches," Political Analysis, Cambridge University Press, vol. 18(4), pages 450-469.
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    1. Keita Suzuki & Satoshi Nagai & Satoru Nishida & Koichi Iwai & Masahiro Takemura, 2023. "Reasons for the Reporting Behavior of Japanese Collegiate Rugby Union Players Regarding Suspected Concussion Symptoms: A Propensity Analysis," IJERPH, MDPI, vol. 20(3), pages 1-15, January.
    2. Yanbing Chen & Conor Buggy & Seamus Kelly, 2022. "Managing the Wellbeing of Elite Rugby Union Players from an Occupational Safety and Health Perspective," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    3. Craig A Foster & Christopher D’Lauro & Brian R Johnson, 2019. "Pilots and athletes: Different concerns, similar concussion non-disclosure," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-19, May.
    4. Warmath, Dee & Winterstein, Andrew P. & Myrden, Susan, 2022. "Parents and coaches as transformational leaders: Motivating high school athletes’ intentions to report concussion symptoms across socioeconomic statuses," Social Science & Medicine, Elsevier, vol. 292(C).
    5. Tyler S. Gibb & Kathryn Redinger & Casey Fealko & Sonia Parikh, 2021. "Considerations for Pediatric Retirement from Athletics Following Repetitive Concussive Traumatic Brain Injury: Incorporating the Right to an Open Future," IJERPH, MDPI, vol. 18(5), pages 1-10, February.

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