Johna K Register-Mihalik1, Kenneth L Cameron2, Melissa C Kay3, Zachary Y Kerr4, Karen Y Peck2, Megan N Houston2, Laura A Linnan5, Heidi Hennink-Kaminski6, Paula Gildner7, Steven J Svoboda2, Stephen W Marshall8. 1. Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, USA. Electronic address: johnakay@email.unc.edu. 2. John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, USA. 3. Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA; Curriculum in Human Movement Science, University of North Carolina at Chapel Hill, USA. 4. Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, USA. 5. Department of Health Behavior, Curriculum in Human Movement Science, University of North Carolina at Chapel Hill, USA. 6. School of Media and Journalism, Curriculum in Human Movement Science, University of North Carolina at Chapel Hill, USA. 7. Injury Prevention Research Center, University of North Carolina at Chapel Hill, USA. 8. Injury Prevention Research Center, University of North Carolina at Chapel Hill, USA; Department of Epidemiology, Curriculum in Human Movement Science, University of North Carolina at Chapel Hill, USA.
Abstract
OBJECTIVES: Non-disclosure of concussion complicates concussion management, but almost nothing is known about non-disclosure in military settings. This study describes concussion disclosure-related knowledge, attitudes, perceived social norms, perceived control, and intention. Additionally, the study identifies determinants of high intention to disclose concussion symptoms. DESIGN: Cross sectional survey. METHODS: First-year service academy cadets completed a cross-sectional survey to assess perceptions of concussion disclosure. Independent variables included: gender, race, ethnicity, high school athlete status, NCAA athlete status, previous concussion history, previous concussion education, socioeconomic proxy, concussion-related knowledge, attitudes about concussion, perceived social norms (perceived peer/organizational support and actions), and perceived control over disclosure. Log-binomial regression was used to identify determinants of high intention to disclose concussion symptoms. RESULTS: A total of 972 first-year military service academy cadets completed the survey [85% response; age=18.4±0.9y]. In the simple models, previous concussion history was associated with lower intention to disclose concussion symptoms. High perceived control over disclosure, higher concussion knowledge, more favorable attitudes and social norms about concussion were associated with high intention to disclose. In the multivariable model, a 10% shift towards more favorable perceived social norms (PR=1.28; p<0.001) and attitudes (PR=1.07; p=0.05) about concussion were associated with high intention to disclose concussion symptoms. High perceived control over disclosure was associated with high intention to disclose concussion symptoms (PR=1.39; p=0.08). CONCLUSIONS: Concussion-related perceived social norms, attitudes, and perceived control are associated with intention to disclose. Organizationally appropriate intervention strategies can be developed from these data.
OBJECTIVES: Non-disclosure of concussion complicates concussion management, but almost nothing is known about non-disclosure in military settings. This study describes concussion disclosure-related knowledge, attitudes, perceived social norms, perceived control, and intention. Additionally, the study identifies determinants of high intention to disclose concussion symptoms. DESIGN: Cross sectional survey. METHODS: First-year service academy cadets completed a cross-sectional survey to assess perceptions of concussion disclosure. Independent variables included: gender, race, ethnicity, high school athlete status, NCAA athlete status, previous concussion history, previous concussion education, socioeconomic proxy, concussion-related knowledge, attitudes about concussion, perceived social norms (perceived peer/organizational support and actions), and perceived control over disclosure. Log-binomial regression was used to identify determinants of high intention to disclose concussion symptoms. RESULTS: A total of 972 first-year military service academy cadets completed the survey [85% response; age=18.4±0.9y]. In the simple models, previous concussion history was associated with lower intention to disclose concussion symptoms. High perceived control over disclosure, higher concussion knowledge, more favorable attitudes and social norms about concussion were associated with high intention to disclose. In the multivariable model, a 10% shift towards more favorable perceived social norms (PR=1.28; p<0.001) and attitudes (PR=1.07; p=0.05) about concussion were associated with high intention to disclose concussion symptoms. High perceived control over disclosure was associated with high intention to disclose concussion symptoms (PR=1.39; p=0.08). CONCLUSIONS: Concussion-related perceived social norms, attitudes, and perceived control are associated with intention to disclose. Organizationally appropriate intervention strategies can be developed from these data.
Authors: Haley A Bookbinder; Megan N Houston; Karen Y Peck; Stephanie Habecker; Brian J Colsant; Tim F Kelly; Sean P Roach; Steven R Malvasi; Gerald T McGinty; Darren E Campbell; Steven J Svoboda; Kenneth L Cameron Journal: J Athl Train Date: 2020-08-01 Impact factor: 2.860
Authors: Christine E Callahan; Melissa K Kossman; Jason P Mihalik; Stephen W Marshall; Paula Gildner; Zachary Y Kerr; Kenneth L Cameron; Megan N Houston; Martin Mrazik; Johna K Register-Mihalik Journal: J Sports Sci Med Date: 2022-02-15 Impact factor: 2.988
Authors: Daniel H Daneshvar; Christine M Baugh; Roberto D Lama; Maya Yutsis; Roy D Pea; Shelley Goldman; Gerald A Grant; Robert C Cantu; Lee M Sanders; Ross D Zafonte; Brian Hainline; Piya Sorcar Journal: Neurotrauma Rep Date: 2021-12-08
Authors: Michelle L Weber Rawlins; Brian R Johnson; Johna K Register-Mihalik; Karin DeAngelis; Julianne D Schmidt; Christopher J D'Lauro Journal: J Athl Train Date: 2021-06-15 Impact factor: 2.860
Authors: Johna Register-Mihalik; Christine E Callahan; Melissa C Kay; Zachary Y Kerr; Madison T Hinson; Laura A Linnan; Heidi Hennink-Kaminski; Paula Gildner; Stephen W Marshall; Megan N Houston; Kenneth L Cameron Journal: J Athl Train Date: 2021-02-22 Impact factor: 2.860
Authors: Jason H Boulter; Margaret M Shields; Melissa R Meister; Gregory Murtha; Brian P Curry; Bradley A Dengler Journal: Front Neurol Date: 2021-07-12 Impact factor: 4.003