Predictors of Concussion Symptom-Reporting Intention Among Collegiate Athletes.

Publisher: National Athletic Trainers' Association Country of Publication: United States NLM ID: 9301647 Publication Model: Print Cited Medium: Internet ISSN: 1938-162X (Electronic) Linking ISSN: 10626050 NLM ISO Abbreviation: J Athl Train Subsets: MEDLINE

Original Publication: Dallas, TX : National Athletic Trainers' Association, c1992-

Brain Concussion*/diagnosis ; Intention* ; Athletes*/psychology ; Students* ; Athletic Injuries*/diagnosis; Humans ; Male ; Female ; Universities ; Cross-Sectional Studies ; Young Adult ; Adolescent ; Health Knowledge, Attitudes, Practice ; Self Report ; Surveys and Questionnaires

Context: Underreporting of concussion symptoms in college athletics presents a challenge for sports medicine clinicians in evaluating and diagnosing such injuries. Some athletes do not report concussion symptoms because they do not recognize that they have a brain injury; however, many athletes intentionally withhold symptoms to avoid removal from sport participation.
Objective: To examine individual factors that influence college athletes' intentions to report concussion symptoms.
Design: Cross-sectional study.
Setting: Collegiate athletics.
Patients or Other Participants: Participants were 2649 student-athletes from 23 sports, across 22 colleges and universities.
Main Outcome Measure(s): The primary outcome was intention to report concussion symptoms. Predictor variables included demographics (age, race/ethnicity, sex, sport type, number of years in sport, number of previous concussions, and perceived concussion symptom knowledge), athletic identity, attitudes toward symptom reporting, perceived social pressure (injunctive and descriptive norms), and perceived behavioral control (capacity and autonomy).
Results: Hierarchical ordinary least-squares regression revealed positive effects of attitude (b = 0.063, P = .005), descriptive norms (b = 0.131, P < .001), injunctive norms (b = 0.107, P < .001), and capacity (b = 0.196, P < .001) on intention to report symptoms. Athletic identity and participation in collision sports had small negative indirect effects on intention, and perceived concussion knowledge had a small positive indirect effect. The full regression model explained 14.24% of the variance in concussion-reporting intention.
Conclusions: These findings may help clinicians develop more focused interventions that address key social and individual determinants of underreporting, including attitude, injunctive and descriptive norms, and capacity to report. Athletic identity, sport type, and perceived understanding of concussion symptoms also influence reporting intention to a lesser extent. Previous research in this area has often failed to address a diverse population of college-age athletes from different sports and National Collegiate Athletic Association divisions.
(© by the National Athletic Trainers’ Association, Inc.)

Am J Sports Med. 2014 May;42(5):1197-203. (PMID: 24569704)
J Adolesc Health. 2014 Mar;54(3):269-274.e2. (PMID: 24560034)
Musculoskelet Sci Pract. 2019 Jul;42:186-192. (PMID: 31014920)
J Athl Train. 2017 Mar;52(3):228-235. (PMID: 28387561)
J Neurotrauma. 2020 Feb 15;37(4):593-599. (PMID: 31597536)
J Child Neurol. 2016 Dec;31(14):1555-1560. (PMID: 27581848)
Ann Behav Med. 2015 Feb;49(1):95-103. (PMID: 25236670)
J Athl Train. 2014 Mar-Apr;49(2):245-65. (PMID: 24601910)
Br J Sports Med. 2015 Dec;49(24):1548-53. (PMID: 26307498)
Pediatrics. 2008 Apr;121(4):841-8. (PMID: 18381550)
Clin J Sport Med. 2015 May;25(3):243-7. (PMID: 25051193)
Br J Sports Med. 2014 Jan;48(2):135-40. (PMID: 23956336)
Neurol Clin Pract. 2013 Aug;3(4):279-287. (PMID: 24195017)
Soc Sci Med. 2015 Jun;134:66-75. (PMID: 25917137)
Br J Sports Med. 2023 Jun;57(11):695-711. (PMID: 37316210)
Ann Behav Med. 2016 Aug;50(4):592-612. (PMID: 27169555)
Brain Inj. 2014;28(8):1009-21. (PMID: 24738743)
J Head Trauma Rehabil. 2013 Jul-Aug;28(4):274-83. (PMID: 22691965)
Am J Sports Med. 2016 Jan;44(1):220-5. (PMID: 26582799)
Clin J Sport Med. 2004 Jan;14(1):13-7. (PMID: 14712161)
Pediatrics. 2016 Sep;138(3):. (PMID: 27573089)
Clin J Sport Med. 2013 Sep;23(5):339-42. (PMID: 23727697)
Am J Sports Med. 2018 May;46(6):1465-1474. (PMID: 29558195)
Br J Soc Psychol. 2001 Dec;40(Pt 4):471-99. (PMID: 11795063)
J Sci Med Sport. 2019 May;22(5):509-515. (PMID: 30551922)
J Athl Train. 2016 Apr;51(4):329-35. (PMID: 27111584)
Brain Inj. 2013;27(7-8):878-86. (PMID: 23789865)
Sports Med. 2017 May;47(5):1003-1010. (PMID: 27544666)

Keywords: athletic identity; concussion underreporting; reasoned action

Date Created: 20240605 Date Completed: 20241125 Latest Revision: 20241204

20250114

PMC11611375

10.4085/1062-6050-0065.24

38835326