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Concussion knowledge, attitudes, and perceived level of involvement by american youth sport coaches in concussion management
  1. Melissa C Kay1,
  2. Richelle M Williams2,
  3. Tamara C Valovich McLeod3,
  4. Johna K Register-Mihalik4
  1. 1Matthew Gfeller Sport-Related Traumatic Brain Injury Research Centre, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  2. 2School of Kinesiology, University of Michigan, Ann Arbour, MI, USA
  3. 3Athletic Training Programs and School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, USA
  4. 4Injury Prevention Research Centre, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA


Objective To describe concussion knowledge and attitudes of youth sport coaches and relationships among knowledge, attitudes, and perceptions of coach involvement in concussion management.

Design Cross-sectional survey.

Setting Youth sport coaches in North Carolina and Arizona.

Subjects 81 youth sport coaches (males: n=69; females: n=11; age=42, IQR=33,45).

Intervention A validated survey identifying demographics, concussion knowledge, attitudes, and beliefs.

Outcome measures The primary outcome was perceived level of coach involvement in concussion management. Descriptive and univariable statistics were used to examine knowledge and attitude differences by demographic factors and perceived involvement. Multivariable logistic regression examined associations between knowledge and attitude and perceived level of coach involvement (lower agreement vs. higher agreement).

Results Knowledge was low-moderate (Median=13/23, IQR=11,14.5), with 75% indicating a loss of consciousness always occurs with concussion. Attitudes were positive (Median=42/42, IQR=40,42). Forty-seven (58%) strongly agreed or agreed that coaches should be involved in clinical decision-making. There were no differences in knowledge or attitudes across gender, age, previous concussion education, or previous concussion history. Knowledge and attitude were not correlated (r=0.114; p=0.343). There were no knowledge (Median=13, IQR=12,15 vs. Median = 12, IQR=11,14) or attitude (Median=42, IQR=41,42 vs. Median = 42, IQR=39,42) differences between lower and higher perceived involvement, respectively. No associations were observed in the multivariable model with perceived coach involvement (p>0.05).

Conclusions Coaches had limited knowledge, but expressed positive attitudes towards concussion. Educational efforts should target both knowledge and attitudes, as these constructs are not related, but are both key to improving the culture concerning concussion.

Competing interests The project was funded in part by a grant from the National Operating Committee on Standards for Athletic Equipment.

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