Files
Abstract
Statement of the Problem: Approximately 50% of sport-related concussions are unreported. Many factors influence why a student-athlete may report or conceal their injury. We aimed to (1) explore factors that influence concussion reporting from the patients perspective, (2) examine masculinity, optimism bias, and perceived pressure from stakeholders items on concussion reporting intention and behavior, and (3) predict concussion reporting intentions and behavior using the Health Belief Model (HBM). Methods: The first objective included an analysis of the lived experience of a concussion and injury reporting through semi-structured interviews. The second and third objectives used survey-based methods and multiple regression (linear and logistic) analyses. Surveys were utilized to examine masculinity (winning, emotional control, risk-taking, violence, power over women, playboy, self-reliance, primacy of sport, and heterosexual self-presentation), optimism bias, pressure from perceived stakeholders (coaches, teammates, parent/guardians, sports medicine professionals, athletic administrators, sport fans), HBM items (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action), and concussion reporting intentions (symptom and concussion reporting), and behavior (symptom and concussion reporting). Results: We discovered three themes for aim one of concussion perceptions, reporting behavior, and support system. Our results for aim two indicated that concussion reporting intentions were negatively influenced by playboy, primacy of sport, heterosexual self-preservation, and pessimism, but not perceived pressure from stakeholders. However, optimists had a higher likelihood of reporting their concussion. Also, our results for aim three indicated that as perceived benefits and cues to action increased and perceived barriers decreased, concussion reporting intentions increased (symptom and concussion reporting). Conclusions: Our findings highlight that concussion reporting is multifactorial and sport culture plays a role. If concussion is suspected, clinicians may consider a more conservative diagnosis approach with individuals who exhibit playboy mentalities, primacy of sport, and an aversion for being thought of as gay. Clinicians may also relay to student-athletes the realistic risks and consequences of concussion in efforts to improve concussion reporting. Lastly, the benefits of concussion reporting should be highlighted while the barriers minimized within concussion education. Student-athletes should be encouraged by various individuals and cued to action in actual concussion reporting behavior.