Coach, sports medicine, and parent influence on concussion care seeking intentions and behaviors in collegiate student-athletes

Julianne D Schmidt; David Welch Suggs; Michelle L Weber Rawlins; Laura Bierema; Lloyd Stephen Miller; Ron Courson; Fred Reifsteck

Coach, sports medicine, and parent influence on concussion care seeking intentions and behaviors in collegiate student-athletes

J Clin Transl Res. 2020 May 26;5(4):215-226.

Authors

Julianne D Schmidt^{1

2}, David Welch Suggs³, Michelle L Weber Rawlins⁴, Laura Bierema⁵, Lloyd Stephen Miller⁶, Ron Courson⁷, Fred Reifsteck^{7

8}

Affiliations

¹ Department of Kinesiology, University of Georgia, Athens, Georgia, USA.
² UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia, USA.
³ Grady College of Journalism and Mass Communication, University of Georgia, Athens, Georgia, USA.
⁴ Department of Interdisciplinary Health Sciences, AT Still University, Mesa, AZ, USA.
⁵ Department of Lifelong Education, Administration, and Policy, University of Georgia, Athens, Georgia, USA.
⁶ Department of Psychology, University of Georgia, Athens, Georgia, USA.
⁷ Athletic Association, University of Georgia, Athens, Georgia, USA.
⁸ University Health Center, University of Georgia, Athens, Georgia, USA.

PMID: 32671281
PMCID: PMC7357618

Abstract

Background: Sport is a socio-ecological framework where student-athletes are part of a larger community of stakeholders, including coaches, sports medicine professionals (SMPs), and parents. This framework may hold influence over whether student-athletes seek care for a concussion.

Aim: We aimed to describe, compare, and determine the influence of stakeholder concussion knowledge, attitudes, and concussion scenario responses.

Materials and methods: We recruited a sample of 477 student-athletes and their 27 coaches (response rate=46.6%), 24 SMPs (48.7%), and 31 parents/guardians (4.8%). Stakeholder surveys assessed their concussion knowledge, attitudes toward care seeking, and concussion scenario responses. Surveys administered to student-athletes assessed their concussion care seeking intentions and behaviors. Kruskal-Wallis tests were used to compare responses between stakeholder groups and to determine the differences in student-athlete intentions and behaviors (alpha=0.05).

Results: SMPs had significantly better knowledge (p<0.001) and concussion scenario responses (p<0.001) compared to both coaches and parents. SMPs also had significantly better attitudes compared to parents, but not coaches (p=0.038). Coach concussion scenario responses (p=0.044) and SMP knowledge positively influenced student-athletes' concussion care seeking intentions (p=0.049). Parent responses were not associated with their child's concussion care seeking intentions and behaviors.

Conclusions: The gap in coach and parent concussion knowledge and concussion scenario response relative to SMPs is a preliminary target for stakeholder concussion education and supports the current sports medicine model where SMPs primarily disseminate concussion education. Stakeholders, specifically coaches and SMPs, do hold influence over collegiate athlete concussion care seeking intentions and behaviors.

Relevance for patients: Stakeholders should be addressed within educational efforts aimed at student-athletes and should also complete stakeholder-specific concussion education.

Keywords: brain injury; concussion non-disclosure; concussion reporting; mild traumatic brain injury; socio-ecological model; sport culture.