Cross-Sectional Investigation of Self-Reported Concussions and Reporting Behaviors in 866 Adolescent Rugby Union Players: Implications for Educational Strategies.

OBJECTIVE: To examine the self-recalled concussion and bell ringer (BR) prevalence, reporting rates, and reporting behaviors in adolescent rugby players. DESIGN: Cross-sectional survey. SETTING: School classroom. PARTICIPANTS: Adolescent male rugby players aged 12 to 18 years (n = 866). MAIN OUTCOME MEASURES: Concussion and BR prevalence, reporting rates, and reporting behaviors. RESULTS: The sample reported a concussion and BR prevalence rate of 40% and 69.9%, respectively. Of these athletes with a history, 38.4% and 86.4% suffered recurrent concussions and BRs, respectively. The total reporting rates per 1000 suspected concussions and BRs were 474.8 [95% confidence interval (CI), 415.4-534.3] and 238.7 (95% CI, 217.8-259.5), respectively. The athletes highlighted several barriers which hindered their truthful reporting of concussion, including "not thinking the injury is serious enough to report" (70%), "wanting to win the game" (38%), and "not wanting to miss future games or training" (48%). CONCLUSIONS: Educational interventions are an invaluable component within a socioecological framework aimed at improving the concussion reporting rates of adolescent athletes. The self-recalled prevalence, underreporting rates, and behaviors of the sample are alarming, which prompts the need to further explore their motivational beliefs behind their decision to underreport a potential concussion. The information obtained can be used to tailor personalized interventions for specific athlete samples.

Is It Time to Give Athletes a Voice in the Dissemination Strategies of Concussion-Related Information? Exploratory Examination of 2444 Adolescent Athletes.

OBJECTIVE: The objective of the research was to screen male and female adolescent athletes on their concussion educational histories and preferred future methods of education in terms of educational messenger, modality, and concussion-related areas of interest. DESIGN: Cross-sectional survey. SETTING: Examination setting within the classroom. PARTICIPANTS: Adolescent male (n = 1854) and female (n = 590) athletes aged 12 to 18 years. MAIN OUTCOME MEASURES: To explore the concussion educational histories and preferred future methods of education in Irish male and female adolescent athletes. RESULTS: 19.7% (n = 482) of the sample received education in the past 12 months. Male athletes had a significantly higher rate of previous education than female athletes (41% vs 17%). The methods used in previous educational interventions are failing to match the interests of the athletes. Sex played a significant role in the preferred educational methods, as male and female athletes had significant differences in their choice of educational messenger, modality, and concussion-related areas of interest. CONCLUSIONS: The current disparity in previous concussion education rates between male and female adolescent athletes should be addressed. Forthcoming research should explore the efficacy of tailoring knowledge translation strategies to match the specific needs of the recipient.