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Concussion Reporting Intention: A Valuable Metric for Predicting Reporting Behavior and Evaluating Concussion Education

Kroshus, Emily ScD*; Baugh, Christine M. MPH†,‡; Daneshvar, Daniel H. MA†,§; Nowinski, Christopher J. BA†,§; Cantu, Robert C. MD†,§,¶,‖

Clinical Journal of Sport Medicine: May 2015 - Volume 25 - Issue 3 - p 243–247
doi: 10.1097/JSM.0000000000000137
Original Research

Objective: This study aimed to evaluate whether preseason concussion knowledge and reporting intention predicted in-season concussion reporting behavior.

Design: Prospective cohort study.

Setting: Collegiate athletic facility of each participating team.

Participants: National Collegiate Athletic Association Division I men's ice hockey players in 1 conference of competition (n = 116).

Independent Variables: Intention to report symptoms of a “minor” concussion and concussion knowledge were assessed at preseason.

Main Outcome Measures: Postseason recall of non-report of postimpact symptoms.

Results: Preseason concussion knowledge was not significantly associated with in-season reporting behavior. Intention to report concussion symptoms was significantly related to in-season reporting behavior. There was a significant interaction between the number of different symptoms experienced and both preseason reporting intention and in-season reporting behavior.

Conclusions: Evaluations of concussion education programs tend to measure concussion knowledge. The present findings suggest that reporting intention may be more strongly predictive of reporting behavior than concussion knowledge and should be included in evaluations of concussion effectiveness. New concussion education initiatives should consider targeting psychosocial constructs that increase reporting intention.

Clinical Relevance: Sports medicine clinicians who are involved in evaluating concussion education programs should measure constructs other than just concussion knowledge. Intention, to report symptoms or to continue play while experiencing symptoms of a concussion, seems to be an important and feasible construct to include as part of proximal evaluations of education effectiveness.

*Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts;

Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, Massachusetts;

Department of Neurology, Boston University School of Medicine, Boston, Massachusetts;

§Sports Legacy Institute, Boston University School of Medicine, Boston, Massachusetts;

Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts; and

Department of Neurosurgery, Emerson Hospital, Concord, Massachusetts.

Corresponding Author: Emily Kroshus, ScD, Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, Massachusetts 02115 (

Supported in part by the National Collegiate Athletic Association Graduate Student Research Grant (E.K.).

The authors report no conflicts of interest.

Received August 27, 2013

Accepted May 30, 2014

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.