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Racial disparities in concussion knowledge and awareness in american adolescent athletes
  1. Jessica Wallace1,
  2. Tracey Covassin2,
  3. Sally Nogle3,
  4. Daniel Gould4,
  5. Jeffrey Kovan5
  1. 1Youngstown State University, Youngstown, Ohio
  2. 2Michigan State University, East Lansing, Michigan
  3. 3Head Athletic Trainer, Michigan State University, East Lansing, Michigan
  4. 4Institute for the Study of Youth in Sports, Michigan State University, East Lansing, Michigan
  5. 5Director of Sports Medicine, Michigan State University, East Lansing, Michigan


Objective To examine if concussion knowledge and awareness disparities exists between underserved African American (AA) adolescent athletes and Caucasian athletes; and, if disparities exist between AAs with and without access to a full-time athletic trainer (AT).

Design Cross-sectional.

Setting Participants from 14 US high schools (9 within underserved, AA communities and 5 within predominantly Caucasian communities) completed a one-time paper and pencil knowledge of concussion questionnaire.

Participants 577 athletes (372 AA, 205 Caucasian). All participants completed concussion education mandated by the government; participants without documentation of completion were excluded.

Intervention Race and AT access were the independent variables.

Outcome measures Knowledge of concussion was examined using a validated instrument that included 35 questions. Participants were instructed to identify signs and symptoms of concussion, complications of multiple concussions, and answer questions pertaining to general concussion awareness among distractors. Total knowledge was calculated by summing the number of correct answers out of 35. Scores could range from 0 to 35. Scores closer to 35 represented greater knowledge. Data were analysed with frequency statistics and independent t-tests. Knowledge score was the dependent variable; p=0.05.

Main results Caucasian adolescents have greater concussion knowledge than AA adolescents (t (2, 575)=5.47, p<0.001). AA adolescents with access to an AT have more knowledge than AAs lacking access to an AT (t (2, 370)=2.58, p=0.01).

Conclusions Participation of AA adolescents in concussion-risk sports, such as football, is very high; therefore, education efforts in underserved communities must address the knowledge gap and disparity of care.

Competing interests None.

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