Effects of Legislative Mandates, Education Type, and Education Provider on Concussion Education for Student Athletes
American Journal of Sports Science
Volume 7, Issue 3, September 2019, Pages: 94-102
Received: Jun. 23, 2019;
Accepted: Jul. 19, 2019;
Published: Aug. 5, 2019
Views 399 Downloads 83
Miriam Carroll-Alfano, Department of Communication Science and Disorders, Saint Xavier University, Chicago, US; Interdisciplinary Health Sciences, Western Michigan University, Kalamazoo, US
Roberta DePompei, School of Speech-Language Pathology and Audiology, University of Akron, Akron, US
Nickola Wolf Nelson, Interdisciplinary Health Sciences, Western Michigan University, Kalamazoo, US
Most states in the United States have enacted legislation mandating concussion education for student-athletes; however, it is not clear if such legislation leads to all students receiving the mandated education or if this education is associated with greater awareness of concussion symptoms. This work investigates whether collegiate student-athletes report receiving legislatively-mandated concussion education, and whether this varies by gender and sport. This study also investigates what methods are being used to deliver education, who is providing the education, and if receiving education is associated with an increase in ability to name the various signs and symptoms of concussion. One hundred and fifty-seven collegiate athletes from a private Midwestern university completed anonymous surveys asking about participation in high school concussion education programs, the type of education received, and who provided it. Participants were also asked to name concussion symptoms. Despite legislative mandates, 20% of student-athletes reported not receiving concussion education in high school, with women more likely to report not receiving education relative to men. The percentage reporting not receiving legislatively-mandated concussion education did not decrease over the five year period since legislation went into effect. The most common education method reported was casual conversation, and the most common providers were athletic trainers and coaches. Athletes reporting education showed no difference in ability to name concussion signs and symptoms, compared to those who reported no education. The type of education provided and the role of the person providing the education was not associated with ability to name a cognitive or behavioral signs and symptom. Legislatively-mandated concussion education is either not being delivered to all student-athletes or is not being delivered in a manner that can be remembered and reported. Education as currently being delivered is not effective in increasing awareness of diverse cognitive and behavioral signs and symptoms of concussion.
Nickola Wolf Nelson,
Effects of Legislative Mandates, Education Type, and Education Provider on Concussion Education for Student Athletes, American Journal of Sports Science.
Vol. 7, No. 3,
2019, pp. 94-102.
Cantu, R, Hyman, M. Concussions and our kids. New York, NY. Houghton Mifflin Harcourt (2012).
Centers for Diseases Control and Prevention. Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation. National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention, Atlanta, GA. http: //www.cdc.gov/traumaticbraininjury/pubs/congress_epi_rehab.html. 2015. Accessed October 16, 2016.
Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports. Neurology. 2013; 80 (24): 2250-2257.
Sarmiento K, Thomas KE, Daugherty J, et al. Emergency Department Visits for Sports- and Recreation-Related Traumatic Brain Injuries Among Children — United States, 2010–2016. MMWR Morb Mortal Wkly Rep 2019; 68: 237–242. DOI: http: //dx.doi.org/10.15585/mmwr.mm6810a2
Coronado VG, Haileyesus T, Cheng TA, et al. Trends in Sports- and Recreation-Related Traumatic Brain Injuries Treated in US Emergency Departments: The National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) 2001-2012. Journal of Head Trauma Rehabilitation. 2015; 30 (3): 185-197.
Zhang AL, Sing DC, Rugg CM, et al. The Rise of Concussions in the Adolescent Population. Orthopaedic Journal of Sports Medicine. 2016; 4 (8): 1-7.
American Academy of Neurology. Concussion during Sports Activities: Summary of Evidence-based Guideline for Patients https: //www.aan.com/Guidelines/Home/GetGuidelineContent/586 2019; Accessed April, 2019.
Centers for Disease Control and Prevention. Concussion Signs and Symptoms, Retrieved from https: //www.cdc.gov/headsup/basics/concussion_symptoms.html. 2019; Accessed April, 2019.
McCrory, P, Meeuwisse, W, Dvorak, J, Aubry, M, Bailes, J. Brogilio, S., et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport. British Journal of Sports Medicine, 2017; 51 (11): 838-84.
Stoler DR, Hill BA. Coping with Concussion and Mild Traumatic Brain Injury, New York, NY: Avery (2013).
Carroll-Alfano MA. Mandated high school concussion education and collegiate athletes’ understanding of concussion. Journal of Athletic Training. 2017; 52 (7): 689-697.
Cournoyer J and Tripp BL. Concussion knowledge in high school football players. Journal of Athletic Training. 2014; 49 (5): 654-658.
Fedor A, Gunstad J. Limited knowledge of concussion symptoms in college athletes. Applied Neuropsychology: Adult. 2015; 22 (2): 108-113.
Knollman-Porter, K, Brown, J., Flynn, M. Preliminary Examination of Concussion Knowledge by Collegiate Athletes and Non-Athletes. American Journal of Speech-Language Pathology 2018; 27: 778–795
Bramlett, H. M., Dietrich, W. D. Long-Term Consequences of Traumatic Brain Injury: Current Status of Potential Mechanisms of Injury and Neurological Outcomes. Journal of Neurotrauma, 2015; 32 (23): 1834–1848.
Corrigan J. D., and Hammond F. M. Traumatic brain injury as a chronic health condition. Arch. Phys. Med. Rehabil. 2013; 94: 1199–1201.
Institute of Medicine and National Research Council. Sports-related concussions in youth: Improving the science, changing the culture. National Academies Press. October 30, 2013.
Masel B. E., and DeWitt D. S. Traumatic brain injury: a disease process, not an event. Journal of Neurotrauma, 2010; 27: 1529–1540.
Guskiewicz KM, McCrea M, Marshall SW, et al. Cumulative effects associated with recurrent concussion in collegiate football players: The NCAA concussion study. Journal of the American Medical Association. 2003; 290 (19): 2549-2555.
Scorza K, Raleigh M, O’Connor F. Current concepts in concussion: evaluation and management, American Family Physician. 2012; 85 (2): 123-132.
Halstead ME, Mcavoy K, Devore CD., et al. Returning to learning following a concussion. Pediatrics. 2013; 132 (5): 948-957.
Chrisman SP, Quitiquit C, Rivara FP. Qualitative study of barriers to concussive symptom reporting in high school athletics. Journal of Adolescent Health. 2013; 52 (3): 330-335.
The Network for Public Health Law. Summary matrix of state laws addressing concussions in youth sports. March 31, 2016 https: //www.networkforphl.org/_asset/7xwh09/StateLawsTableConcussions_2-19-13.pdf. Accessed January 2019.
State of Illinois. Illinois public act 097-0204, “Protecting our student athletes act”. July, 2011. http: //www.ilga.gov/legislation/publicacts/97/PDF/097-0204.pdf. Accessed January 2019.
State of Indiana. Indiana public act IC 20-34-7. May 2011 http: //www.in.gov/legislative/bills/2011/ES/ES0093.2.html. Accessed January, 2019.
Chrisman SP, Schiff MA, Chung SK, et al. Implementation of concussion legislation and extent of concussion education for athletes, parents, and coaches in Washington state. American Journal of Sports Medicine. 2014; 42 (5): 1190-1196.
Bagley AF, Daneshvar DH, Schanker BD, et al. Effectiveness of the SLICE program for youth concussion education. Clinical Journal of Sport Medicine 2012; 22 (5): 385-389.
Parker E, Gilchrist J, Shuster D, et al. Reach and Knowledge Change among coaches and other participants of the online course: “Concussion in sports: what you need to know”, Journal Head Trauma Rehabilitation, 2015; 30 (3): 198-206.
Kurowski B, Pomerantz WJ, Schaiper C, et al. Factors that influence concussion knowledge and self-reported attitudes in high school athletes. Journal of Trauma and Acute Care Surgery. 2014; 77 (3 SUPPL. 1): S12-S17.
Kurowski, B. G., Pomerantz, W. J., Schaiper, C. Gittelman, M. Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes. Journal of Trauma and Acute Care Surgery. 2015; 79 (3): S21-S28.
Cusimano, M, Zhang S, Topolovec-Vranic, J, Grosso, A, Jing R., Ilie, G. Pros and Cons of 19 Sport-Related Concussion Educational Resources in Canada: Avenues for Better Care and Prevention. Frontiers in Neurology. 2018; 9: Article 872.
Kroshus, E, Daneshvar, D., Baugh, C, Nowinski, N, Cantu, R. NCAA concussion education in ice hockey: an ineffective mandate. British Journal of Sports Medicine. 2014; 48: 135–140.
Provvidenza C, Engebretsen L, Tator C, et al. From consensus to action: Knowledge transfer, education and influencing policy on sports concussion. British Journal of Sports Medicine. 2013; 47 (5): 332-338.
Sady MD, Vaughan CG, Gioia GA. School and the concussed youth: Recommendations for concussion education and management. Physical Medicine and Rehabilitation Clinics of North America. 2011; 22 (4): 701-719.
Sullivan, L, Pursell, L, Molcho, M. Evaluation of a theory-based concussion education program for secondary school student-athletes in Ireland. Health Education Research, 2018; 33 (6): 492–504.
Vassilyadi M, Duquette C, Shamji MF, et al. Evaluation of Thinkfirst for kids injury prevention curriculum for grades 7/8. Canadian Journal of Neurological Sciences. 2009; 36 (6): 761-768.
Wallace, J., Covassin, T., Nogle, S., Gould, D., Kovan, J. Concussion Knowledge and Reporting Behavior Differences Between High School Athletes at Urban and Suburban High Schools. Journal of School Health. 2017; 87 (9): 665-674.