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Knowledge, attitudes and intended behaviours in relation to concussion in professional rugby union players
  1. Keith Stokes1,
  2. Simon Kemp2,
  3. Miss Rachel Michell3,
  4. Martyn Standage1,
  5. Carly McKay1
  1. 1University of Bath, UK
  2. 2Rugby Football Union, Twickenham, UK
  3. 3University of Bath, Rugby Players’ Association, Twickenham, UK


Objective To investigate knowledge, attitudes and intended behaviours in relation to concussion in professional Rugby Union players.

Design Cross-sectional study.

Setting English Premiership and Championship (the highest levels of domestic competition in England).

Participants 1236 professional male players enrolled on a compulsory online concussion education module were invited to respond to an online survey in October 2014. 383 players completed the survey (age 17–40 years; 0.5–19 years of professional rugby).

Outcome measures Number of career self-reported concussions; pre-module concussion identification and management knowledge score (5 multiple-choice questions); attitudes towards concussion (14 7-point Likert-scale questions; higher scores represent more favourable attitudes); intended behaviours regarding concussion reporting (3 7-point Likert-scale questions; lower scores represent more favourable intended behaviours).

Main results 271 players (71%) recalled at least one concussion during their playing career; 249 (65%) recalled 1–5, 17 (4%) recalled 6-10 and 3 (1%) recalled >10 concussions. Knowledge scores (n=292) ranged from 0 to 5 correct answers out of 5; mean(SD) 3.4 (1.8). Attitudes scores (n=383) ranged from 42 to 98 out of a possible 98; mean(SD), 75.7 (11.9). Intended behaviour scores (n=383) ranged from 6 to 21 out of a possible 21; mean(SD), 10.2 (3.3). Spearmans Rank indicated that knowledge scores and concussion history were not associated with attitudes or intended behaviours; however, more favourable attitude scores were associated with more favourable intended behaviour scores (rs=−0.34, p<0.001).

Conclusions Concussion education interventions should focus on positively influencing player attitudes towards concussion as this has the greatest potential to improve player behaviour.

Competing interests Dr. Keith Stokes – Receives research funding from the Rugby Football Union

Dr. Simon Kemp – Employed by the Rugby Football Union

Miss Rachel Michell – Employed by Rugby Players Associationis

Dr. Martyn Standage, Dr. Carly McKay - None.

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