Related Experiment Video
Updated: May 9, 2026
A Neuroscientific Approach to the Examination of Concussions in Student-Athletes
Published on: December 8, 2014
Knowledge, attitude, and concussion-reporting behaviors among high school athletes: a preliminary study
Johna K Register-Mihalik1, Kevin M Guskiewicz, Tamara C Valovich McLeod
1Emergency Services Institute, WakeMed Health and Hospitals, Raleigh, NC.
Context:
Many athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors.
Objective:
To examine the influence of knowledge and attitude on concussion-reporting behaviors in a sample of high school athletes.
Design:
Cross-sectional study.
Setting:
Participants completed a validated survey instrument via mail.
Patients Or Other Participants:
A total of 167 high school athletes (97 males, 55 females, 5 sex not indicated; age = 15.7 ± 1.4 years) participating in football, soccer, lacrosse, or cheerleading.
Intervention(S):
Athlete knowledge and attitude scores served as separate predictor variables.
Main Outcome Measure(S):
We examined the proportion of athletes who reported continuing to participate in games and practices while symptomatic from possible concussion and the self-reported proportion of recalled concussion and bell-ringer events disclosed after possible concussive injury.
Results:
Only 40% of concussion events and 13% of bell-ringer recalled events in the sample were disclosed after possible concussive injury. Increased athlete knowledge of concussion topics (increase of 1 standard deviation = 2.8 points) was associated with increased reporting prevalence of concussion and bell-ringer events occurring in practice (prevalence ratio [PR] = 2.27, 95% confidence interval [CI] = 1.60, 3.21) and the reporting prevalence of bell-ringer-only events overall (PR = 1.87, 95% CI = 1.38, 2.54). Athlete attitude scores (increase of 1 standard deviation = 11.5 points) were associated with decreases in the proportion of athletes stating they participated in games (PR = 0.74, 95% CI = 0.66, 0.82) and practices (PR = 0.67, 95% CI = 0.59, 0.77) while symptomatic from concussions.
Conclusions:
Most recalled concussion events in our study were not reported to a supervising adult. Clinicians should be aware that knowledge and attitude influence concussion reporting. Clinicians and administrators should make concussion education a priority and encourage an optimal reporting environment to better manage and prevent concussive injuries in young athletes.
More Related Videos
10:31A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
07:02An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
Published on: January 12, 2011
