Determinants of Coach Communication About Concussion Safety in US Collegiate Sport
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ORIGINAL ARTICLE
Determinants of Coach Communication About Concussion Safety in US Collegiate Sport Emily Kroshus, ScD MPH & Christine M. Baugh, MPH & Matthew J. Hawrilenko, MA & Daniel H. Daneshvar, MA
# The Society of Behavioral Medicine 2015
Abstract Background Communication between coaches and athletes about concussion safety can reinforce or undermine a sport culture in which concussion under-reporting is often endemic. Method This study tested a model in which self-reported coach communication about concussion safety was predicted by factors including concussion knowledge, attitudes and beliefs, sex of the coach, and sex of the team coached. Participants were 997 coaches of contact and collision sports teams competing in National Collegiate Athletic Association Division I, II, or III. Results Concussion attitudes and beliefs were the strongest predictors of communication, and the small effect of knowledge on communication was transmitted nearly entirely through its effect on attitudes and beliefs. Much of the
variability in communication was attributable to the sex of the coach and the sex of the team coached. Conclusions These results serve as a starting point for the design of coach-targeted interventions that encourage communication about health and safety with athletes.
E. Kroshus (*) Department of Social and Behavioral Sciences, Harvard School of Public Health, 221 Columbus Avenue, Boston, MA 02116, USA e-mail: [email protected]
C. M. Baugh Boston Children’s Hospital, Division of Sports Medicine, Boston, MA, USA
E. Kroshus Sport Science Institute, National Collegiate Athletic Association, Indianapolis, IN, USA
M. J. Hawrilenko Department of Clinical Psychology, Clark University, Worcester, MA, USA
E. Kroshus : C. M. Baugh Edmond J Safra Center for Ethics, Harvard University, Cambridge, MA, USA
D. H. Daneshvar Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA, USA
C. M. Baugh Interfaculty Initiative in Health Policy, Harvard University, Cambridge, MA, USA
D. H. Daneshvar Sports Legacy Institute, Waltham, MA, USA
Keywords Concussion . Sport . Communication . Coach . Gender
Concussions from sport and recreational activities are an important public health issue [1]. Estimates suggest that between 1.6 and 3.8 million are sustained every year in the USA [2], with a particularly high incidence in contact and collision
ann. behav. med.
sport at the high school and college levels [3]. Athletes who sustain concussions are at risk of acute and prolonged neurologic consequences [4–8]. These consequences may be magnified if the athlete sustains multiple concussions [4–9] and even more so if they sustain an additional impact when the brain is in a period of metabolic vulnerability while recovering from the initial injury [10, 11], making secondary prevention a critical form of risk reduction. Unfortunately, timely identification and removal from play do not always occur. Many athletes continue participating in their sport while experiencing sympto
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