Objective To investigate concussion knowledge and self-reported attitudes in Italian youth rugby players and their coaches.

Design Cross-sectional population-wide survey study.

Setting All rugby clubs (n=52) of the Veneto region, Italy.

Participants Players and coaches of all under 15, 17 and 19 teams were eligible to participate. 1719 athlete surveys (92.2% male; response rate 71.1%) and 235 coach surveys (93.6% male; response rate 93.2%) were eligible for analysis.

Outcome measures Knowledge scores were reported as a percentage of correct answers, along with interquartile ranges. Descriptive statistics were reported for all answers.

Results Median knowledge scores were 55% (IQR: 44–67) for athletes and 60% (IQR: 52.5–69) for coaches. Only 33.3% of athletes and 40% of coaches were aware of an increased risk of a second concussion after sustaining one. Only 25.5% of coaches acknowledged the priority of return to school over return to sport. As for self-reported attitudes, of those coaches who witnessed a concussion, more than 97% declared they never allowed or put pressure on a player with suspected concussion to keep playing. However, 23.9% admitted they saw other coaches engaging in such a behaviour. Among athletes, 45.4% would not disclose concussion-related symptoms to anyone for fear of not playing the following games. Multivariate analysis of factors associated with concussion knowledge is ongoing.

Conclusion Knowledge about concussion was sub-optimal in athletes and coaches. Tendencies from some coaches to mismanage concussion and from athletes to under-report it for fear of not playing the following games appear consistent with previous reports from different countries, including those with nation-wide dedicated policies.