Understanding concussion reporting using a model based on the theory of planned behavior

Area of Science:

• Sports Medicine
• Psychology
• Public Health

Background:

• Concussion symptom reporting is crucial for athlete safety and risk reduction.
• Underreporting of concussive symptoms remains a significant concern in organized sports.
• The Theory of Planned Behavior (TPB) offers a framework for understanding health-related behaviors.

Purpose of the Study:

• To apply the Theory of Planned Behavior (TPB) to predict concussion symptom underreporting.
• To investigate the factors influencing reporting intentions and behaviors in male ice hockey players.
• To identify key psychosocial determinants of concussion symptom disclosure.

Main Methods:

• A survey-based study involving 256 male ice hockey players (ages 18-21) from an American Tier III Junior A league.
• Structural equation modeling was used to analyze survey data on reporting behavior, intention, perceived norms, self-efficacy, perceived outcomes, and concussion knowledge.
• Data were collected in January 2013 from 12 of 14 league teams.

Main Results:

• The TPB-based model demonstrated a good fit in explaining concussion symptom reporting behavior.
• All pathways within the model were statistically significant and aligned with hypothesized relationships.
• Perceived outcomes related to athletic performance showed the strongest association with reporting intention.

Conclusions:

• Concussion underreporting in athletes is influenced by perceived outcomes, social norms, and self-efficacy, beyond just knowledge.
• Interventions aimed at increasing concussion reporting should address these psychosocial factors.
• Applying psychosocial theories like TPB can enhance the effectiveness of athlete concussion education programs.