Concussion reporting in college football players: Potential mechanism to improve injury outcomes

Background/Purpose: Concussions are increasingly recognized as an important public health issue. Although the injury can be sustained from any sufficient acceleration and deceleration of the head, one main and modifiable mechanism through which concussions are sustained is organized sport. Among sports, football athletes are at greatest risk for concussion. Due to the invisible nature of many signs of concussion, diagnosis often relies on athletes honestly reporting symptoms. Understanding factors that influence athletes’ decisions whether or not to report a potential concussion is critical.

Methods: During the 2014 football season, a survey was administered to National Collegiate Athletic Association (NCAA) Division I Football Championship Series athletes (n=817). Athletes were asked questions regarding their concussion histories, intention to report concussion symptoms, and factors that influence their decisions whether or not to report symptoms of a possible concussion.

Results/Outcomes: A variety of factors were associated with athletes’ intention to report a potential concussion, including: perceived team concussion reporting norms, opinions of important stakeholders (e.g., coaches, teammates), and perceived concussion reporting consequences.

Conclusions: In 2010, the NCAA adopted a policy requiring schools to have a concussion management plan that requires athletes to be removed from play if they are suspected of having sustained a concussion. However, injury diagnosis and medical management still relies heavily on athlete self-reporting of concussion. The extent to which reporting can be increased, through modifying factors influencing athletes’ decisions, is an important area of future study.