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  • 7.5 The role of racial concordance between athletic trainers and collegiate athletes in concussion diagnosis and recovery in the United States: a limbic matars consortium investigation

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7.5 The role of racial concordance between athletic trainers and collegiate athletes in concussion diagnosis and recovery in the United States: a limbic matars consortium investigation
  1. Erica Beidler1,
  2. Patricia Kelshaw2,
  3. Jessica Wallace3,
  4. Thomas Bowman4,
  5. Monique Pappadis5,
  6. Thayne Munce6,
  7. Nyaz Didehbani7,
  8. David Cifu8,
  9. Jacob Resch9
  1. 1Department of Athletic Training, Duquesne University, Pittsburgh, PA, USA
  2. 2Department of Kinesiology, Department of Psychology, Brain Research and Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, NH, USA
  3. 3Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
  4. 4Department of Athletic Training, University of Lynchburg, Lynchburg, VA, USA
  5. 5Department of Nutrition, Metabolism, and Rehabilitation Science, University of Texas Medical Branch at Galveston, Galveston, TX, USA
  6. 6Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD, USA
  7. 7Department of Psychiatry and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
  8. 8Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
  9. 9Department of Kinesiology, University of Virginia, Charlottesville, VA, USA

Abstract

Objective Investigate diagnosis and recovery timelines of concussions in relation to racial identity concordance and discordance between the injured collegiate athlete and treating Athletic Trainer (AT).

Design Retrospective chart review of medical records.

Setting Six National Collegiate Athletic Association (NCAA) institutions.

Participants Of 774 cases recorded, 534 (69.0%) diagnosed concussions from sports with full-time sports medicine coverage were included in this study. Racial demographic frequencies for athletes and treating ATs were: White (Athlete: n=358; AT: n=513), Black (Athlete: n=154; AT: n=8), Hispanic/Latino (Athlete: n=12; AT: n=0), Native Hawaiian/Pacific Islander (Athlete: n=8; AT: n=11), American Indian/Alaska Native (Athlete: n=1; AT: n=0), and Asian (Athlete: n=1; AT: n=0).

Interventions (or Assessment of Risk Factors) Concussion cases were coded into two groups; racial concordance (i.e., racial identities were the same; n=345) and racial discordance (i.e., racial identities were different; n=189). Sex (male; female) was included as a covariate.

Outcome Measures Three multivariable Cox proportional hazard regression models were used to assess days from date-of-injury to 1) diagnosis, 2) symptom resolution, and 3) return to participation.

Main Results Racially discordant concussion cases were diagnosed sooner than racially concordant cases (HR: 1.22, 95%CI: 1.01–1.47, p=0.04). There were no differences by racial identity concordance and discordance for time to symptom resolution (HR: 1.04, 95%CI: 0.86–1.26, p=0.68) or return to participation (HR: 1.10, 95%CI: 0.85–1.41, p=0.48).

Conclusions While racial identity concordance/discordance among collegiate athletes and ATs may play a role in concussion diagnosis, this factor may not influence concussion recovery times. Diversification of sports medicine healthcare providers is needed.

https://doi.org/10.1136/bjsports-2023-concussion.298

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