AN EXAMINATION OF THE KNOWLEDGE ABOUT AND ATTITUDES TOWARD CONCUSSION IN HIGH SCHOOL ATHLETES, COACHES, AND ATHLETIC TRAINERS

Open Access
Author:
Rosenbaum, Aaron Michael
Graduate Program:
Psychology
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
August 27, 2007
Committee Members:
  • Peter Andrew Arnett, Committee Chair
  • Frank Gerard Hillary, Committee Member
  • James Lewis Farr, Committee Member
  • Semyon Slobounov, Committee Member
Keywords:
  • Concussion
  • mild Traumatic Brain Injury
  • adolescent risk behavior
  • concussion knowledge
  • concussion attitude
  • concussion attitudes
  • high school coaches
Abstract:
The focus of the first portion of the study (i.e., the pilot study) was to develop a comprehensive and psychometrically-sound measure—the Rosenbaum Concussion Knowledge and Attitude Survey (RoCKAS)—of knowledge about and attitudes toward concussion and to use the measure in the second portion of the study (i.e., the main study) to examine relationships between concussion knowledge and attitudes in high school athletes, non-athletes, coaches, and athletic trainers (ATCs). The pilot study included 698 high school students recruited from six high schools. Content validity, face validity, construct validity, and test-retest reliability were established for the RoCKAS. Due to the binary nature of some of the items, internal consistency analyses could not be conducted. The main study involved the administration of the RoCKAS to 495 high school students, 129 high school coaches, and 148 high school ATCs. Additionally, a sample of 142 high school athletic directors was recruited to obtain information about concussion incidence rates. A statistically significant moderate correlation between concussion knowledge and attitudes was identified when all participants were analyzed together. ATCs were found to have the highest knowledge and safest attitudes followed closely by coaches, and the students showed substantially lower levels. No differences were found between athletes and non-athletes on either knowledge or attitudes. Schools with larger enrollment were found to be more likely to employ an ATC than smaller schools. However, regardless of whether an ATC was on staff, at least 50% of coaches reported being the primary decision maker about return to play after concussion at both practices and games. No differences were found when concussion incidence rates were compared across schools with and without an athletic trainer on staff. However, this finding should be interpreted with caution due to methodological limitations. These findings point to the existence of a relationship between concussion knowledge and attitudes that has implications for educational interventions intended to improve concussion knowledge. Moreover, these findings suggest that concussion knowledge may influence concussion attitudes, although this conclusion cannot be definitively made due to the correlational nature of the analysis. Additional research is necessary to further elucidate this relationship.