Youth Concussion Management Practices Among Athletic Trainers: A Vignette-Based Survey

2021 ◽  
pp. 1-8
Author(s):  
Reid Skeel ◽  
Anissa Maffett ◽  
Abigail Feder ◽  
Cayla Mitzkovitz ◽  
Sofia Lesica
Keyword(s):  
Management Practices ◽  
Athletic Trainers ◽  
Cognitive Testing ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Concussion Management ◽  
Conflicting Information ◽  
Recovery Protocols ◽  
High School Athletic ◽  
Almost All

Context: Recovery protocols for treatment of sports concussion have received widespread adoption across the country. While stages of recovery and treatment are relatively clearly defined, there remains variability in implementation of specific recommendations, particularly regarding activities that constitute rest during stages calling for limitations on activity participation. Specific recommendations being employed by practitioners have not been previously assessed. In an aim to document current concussion management practices in the field, athletic trainers were surveyed regarding how activities that may constitute rest are utilized and defined. Design: The study was based on a cross-sectional vignette-based survey. Methods: The sample used was a geographically representative convenience sample of United States-based high school athletic trainers. E-mails were sent to 2146 potential survey respondents yielding a final sample of 226 athletic trainers. Data were gathered for questions concerning recommendations for follow-up care and rest based on provided vignettes, factors considered when developing recommendations, and differences in recommendations associated with varying symptom presentations. The percentage of practitioners that would utilize each potential recommendation was used to characterize results. Results: Participants demonstrated consensus on the importance of physical and cognitive rest as well as school accommodations (all greater than 97% endorsement). Greater variability was present for recommendations regarding pain medication for headache, repeating baseline cognitive testing, and engaging in subsymptom threshold activities. Recommendations for attending but not participating in games and practice yielded conflicting information. Conclusions: Responses indicated general consensus regarding factors considered when making recommendations. There was also consensus regarding general recommendations for activity limitation following recovery with almost all participants strongly recommending cognitive and physical rest, in accordance with consensus guidelines. However, substantial differences were found for specific activities that should be limited or encouraged following youth concussion. Further research concerning the relationship between community and social interaction and clinical outcomes after concussion is warranted.

scholarly journals Exploring Athletic Trainers' Self-Confidence for Interpreting Results from Concussion Assessments

2019 ◽  
Vol 34 (5) ◽  
pp. 756-756
Author(s):  
N R D’Amico ◽  
T Covassin ◽  
N Murray ◽  
P Schatz ◽  
R J Elbin
Keyword(s):  
Online Survey ◽  
Management Practices ◽  
Athletic Trainers ◽  
Team Approach ◽  
Neurocognitive Testing ◽  
Cross Sectional ◽  
Certified Athletic Trainers ◽  
Concussion Management ◽  
Self Confidence ◽  
National Athletic Trainers Association

Abstract Purpose To explore athletic trainers' self-confidence for interpreting results from concussion assessments. Methods An online survey was administered via the National Athletic Trainers’ Association (NATA) membership listserv to a cross-sectional sample of 10,000 certified athletic trainers (ATCs) employed in high school and collegiate settings. The survey included: 1) ATC demographics (i.e., age, sex, years of experience); 2) ATC concussion management practices (i.e., previous concussion training, continuing education received on concussion, concussion assessments administered); and 3) a 4-point Likert scale (1=no confidence, 4=high confidence) assessing ATC self-confidence for interpreting results from concussion assessments. A total of 725 ATCs completed the survey yielding a response rate of 7.25%; 114 were excluded for missing data and 611 ATCs were included in final analyses. Sample demographics, ATC concussion management practices, and ATC self-confidence scores were examined with demographic statistics (i.e., means, standard deviations, frequencies, percentages) for 16 commonly used concussion assessments. Results The sample of ATCs (mean age 38.97±14.89 years) was predominately female (59.2%) and reported an average of 10.08±7.58 years of clinical experience. Clinical examinations (63.2%) and symptom scales (61.4%) were among the most frequent assessments with high ATC self-confidence for interpretation. Vestibular/oculomotor measures (27.2%) and computerized neurocognitive testing (26.2%) were among the most frequent assessments with low ATC self-confidence for interpretation. Conclusion Low ATC self-confidence scores for interpreting results from vestibular/oculomotor measures and computerized neurocognitive testing highlight the importance of incorporating a multi-disciplinary team approach and including sport neuropsychologists for the proper management of concussion.

scholarly journals Concussion-Assessment and -Management Techniques Used by Athletic Trainers

2013 ◽  
Vol 48 (6) ◽  
pp. 844-850 ◽  
Author(s):  
Robert C. Lynall ◽  
Kevin G. Laudner ◽  
Jason P. Mihalik ◽  
Justin M. Stanek
Keyword(s):  
Clinical Examination ◽  
Management Practices ◽  
Athletic Trainers ◽  
Assessment Tools ◽  
Self Report ◽  
Annual Number ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Web Based ◽  
National Athletic Trainers Association

Context: Understanding concussion-assessmment and -management practices that athletic trainers (ATs) currently use will allow clinicians to identify potential strategies for enhancing the quality of care provided to patients. Objective: To assess current clinical concussion diagnostic and return-to-participation practices among ATs. Design: Cross-sectional study. Setting: Web-based survey. Patients or Other Participants: A link to the survey was sent randomly to a convenience sample of 3222 members of the National Athletic Trainers' Association. A total of 1053 (32.7%) certified ATs (experience as an AT = 11.2 ± 9.1 years) responded to the survey. Intervention(s): Prospective participants received electronic correspondence informing them of the purpose of the study and providing a link to the Web-based survey instrument. A reminder e-mail was sent approximately 6 weeks later, and the survey remained online for a total of 8 weeks. Main Outcome Measure(s): We collected information on the annual number of concussions assessed and tools employed to diagnose, manage, and safely return an athlete to participation. Descriptive statistics were computed for each variable. Results: Participants reported observing 10.7 ± 11.0 concussions per year. Clinical examination (n = 743, 70.6%) was the most commonly reported means for evaluating and diagnosing concussion. Less than half of our respondents employed the Standardized Assessment of Concussion (n = 467, 44.3%), any variation of the Romberg test (n = 461, 43.8%), and computerized neuropsychological testing (n = 459, 43.6%). Clinical examination (n = 773, 73.4%), return-to-participation guidelines (n = 713, 67.7%), physician recommendation (n = 660, 62.7%), or player self-report (n = 447, 42.5%) contributed to the return-to-participation decisions of ATs. Only 20.8% (n = 219) of ATs reported using all 3 recommended domains of the concussion battery. Conclusions: Our study demonstrated a growth in the number of ATs incorporating objective clinical measures of concussion as a part of their concussion management. Conversely, fewer ATs reported using a standard clinical examination in their concussion assessment. These findings suggest ATs must continue to increase their use of both objective concussion assessment tools and the standard clinical examination.

scholarly journals Concussion beliefs in varsity athletes: Identifying the good, the bad and the ugly

2017 ◽  
Vol 1 ◽  
pp. 205970021773025
Author(s):  
Michael P Jorgensen ◽  
Fergal T O'Hagan ◽  
Hugo Lehmann
Keyword(s):  
Management Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Injury Management ◽  
Concussion Management ◽  
Personal Risk ◽  
Varsity Athletes ◽  
History Of ◽  
Discriminant Analyses ◽  
Protective Behaviours

Objective Identify and describe attitudes and intentions towards personal concussion risk and protective behaviours among varsity athletes. Determine subgroups of athletes characterized by problematic intentions towards concussion prevention and management behaviours. Design Cross-sectional survey. Main outcome measures Varsity athletes ( N = 175; 60% male; 55.4% contact athletes; 56.6% history of concussion) completed a survey examining attitudes and intentions towards personal risk and concussion-management behaviours. Cluster and discriminant analyses were used to identify athlete risk response subgroups on intention items. The clusters were examined for differences in attitudes towards concussion prevention behaviours, demographics and concussion exposure. Results A substantially problematic subgroup of athletes (28% of the sample) reported low intent to engage in post concussion management practices or primary prevention behaviours. These individuals reported high concussion-risk acceptance and very low belief in the efficacy of concussion-management behaviours. They were also more likely to have sustained a concussion. Two other clusters demonstrated more acceptable behavioural intentions towards concussion prevention and management, with one holding model attitudes and intentions. Conclusions Varsity athletes exhibit one of three different patterns of intentions and attitudes towards concussion prevention and management behaviours. Athletes in one of these groups are at much greater risk of concussion injury and poorly follow recommended treatments. Intervention programmes need to target and aim to change these problematic intentions and attitudes to improve the effectiveness of concussion prevention and injury management.

scholarly journals Athletic Trainers' Concussion-Assessment and Concussion-Management Practices: An Update

2020 ◽  
Vol 55 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Landon B. Lempke ◽  
Julianne D. Schmidt ◽  
Robert C. Lynall
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Clinical Examination ◽  
Management Practices ◽  
Athletic Trainers ◽  
Assessment Tools ◽  
Care Providers ◽  
Convenience Sample ◽  
Assessment Battery ◽  
National Athletic Trainers Association

Context Athletic trainers (ATs) are often the first health care providers to conduct concussion assessments and carry out postinjury management. Best practices for concussion evaluation and management have changed rapidly in recent years, outdating previous reports of ATs' concussion practices. Objective To examine ATs' current concussion-assessment and -management techniques. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A random convenience sample of 8777 ATs (response rate = 15.0% [n = 1307]; years certified = 15.0 ± 10.6) from the National Athletic Trainers' Association membership. Main Outcome Measure(s) Survey Web links were e-mailed to prospective participants, with 2 follow-up e-mails sent by the National Athletic Trainers' Association. The survey collected demographic information, the number of concussions assessed, the concussion-recovery patterns, and the assessment and return-to-participation (RTP) decision-making methods used. Results The ATs reported assessing a median of 12.0 (range = 0–218) concussions per year. A total of 95.3% (953/1000) ATs cited clinical examination as the most frequently used concussion-assessment tool, followed by symptom assessment (86.7%; 867/1000). A total of 52.7% (527/1000) ATs described a 3-domain minimum multidimensional concussion-assessment battery. Published RTP guidelines were the most common RTP decision-making tool (91.0%; 864/949), followed by clinical examination (88.2%; 837/949). The ATs with master's degrees were 1.36 times (95% confidence interval [CI] = 1.02, 1.81) more likely to use a 3-domain concussion-assessment battery than ATs with only bachelor's degrees (χ2 = 4.44, P = .05). Collegiate ATs were 2.12 (95% CI = 1.59, 2.84) and 1.63 (95% CI = 1.03, 2.59) times more likely to use a 3-domain concussion-assessment battery than high school and clinic-based ATs, respectively (χ2 = 26.29, P < .001). Conclusions Athletic trainers were using the clinical examination, standardized assessment tools, and a 3-domain concussion-assessment–battery approach more frequently in clinical practice than previously reported. However, despite practice improvements, nearly half of ATs were not using a 3-domain minimum concussion-assessment battery. Clinicians should strive to implement multidimensional concussion assessments in their practices to ensure optimal diagnosis and management.

scholarly journals Public knowledge, attitudes and practice about COVID-19 pandemic

2021 ◽  
Author(s):  
Loai I. Tawalbeh ◽  
Ahmad Mohammad Al-Smadi ◽  
Ala Ashour ◽  
Abedalmajeed Alshajrawi ◽  
Omar Gammoh ◽  
...  
Keyword(s):  
Linear Regression ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Bachelor Degree ◽  
Social Media Networks ◽  
Health Authorities ◽  
Global Pandemic ◽  
High Knowledge ◽  
Cross Sectional Design ◽  
Almost All

Background: COVID-19 is a newly discovered global pandemic that affected almost all countries including Jordan. Knowledge, attitude and practices are fundamental to suppress the spread of the virus. Objective: This study aimed to examine knowledge, attitude and practices about COVID-19 in Jordan. Methods: A cross-sectional design was used to recruit a convenience sample of public from Jordan. An online instrument used to assess knowledge, attitude and practices about COVID-19, and was developed by the research team. The data were collected online through social media networks in Jordan. The data were collected during May 2020. Results: 2470 participants participated and completed the study questionnaire. Results indicated good knowledge, practice, and attitude, about COVID-19 among the public in Jordan. Linear regression showed that female, aged 40 years or more, married, with Bachelor degree or higher, employed, and participants believe that Jordan will control COVID-19 had higher knowledge compared to their counterparts. Besides, linear regression showed that female, living in Amman city, with high knowledge about COVID-19, and believe that Jordan will control COVID-19 had higher practice compared to their counterparts. Conclusion: Knowledge, attitude and practices levels regarding COVID-19 among Jordanian population during the pandemic were high. However, health authorities and government have to implement and maintain educational programs to enhance the Jordanian population’s awareness regarding COVID-19 and to prevent its spread specially among male, aged less than 40 years, unmarried, with less than Bachelor degree, unemployed, and for participants believe that Jordan will not control COVID-19

scholarly journals Understanding Athletic Trainers' Beliefs Toward a Multifacted Sport-Related Concussion Approach: Application of the Theory of Planned Behavior

2013 ◽  
Vol 48 (5) ◽  
pp. 636-644 ◽  
Author(s):  
Justin Rigby ◽  
Luzita Vela ◽  
Jeff Housman
Keyword(s):  
Theory Of Planned Behavior ◽  
Planned Behavior ◽  
Practice Guidelines ◽  
Behavioral Control ◽  
Management Practice ◽  
Athletic Trainers ◽  
Perceived Behavioral Control ◽  
Cross Sectional ◽  
Concussion Management ◽  
National Athletic Trainers Association

Context: Practice guidelines recommend a multifaceted approach for managing concussions, but a relatively small percentage of athletic trainers (ATs) follow these recommendations. Understanding ATs' beliefs toward the recommended concussion practice guidelines is the first step in identifying interventions that could increase compliance. The theory of planned behavior (TPB) allows us to measure ATs' beliefs toward the recommended concussion practice guidelines. Objective: To examine the influence of ATs' beliefs toward the current recommended concussion guidelines on concussion-management practice through an application of the TPB. Design: Cross-sectional study. Setting: A Web link with a survey was e-mailed to 1000 randomly selected members of the National Athletic Trainers' Association (NATA). Patients or Other Participants: A total of 221 certified ATs working in secondary school/clinic, high school, and college/university settings. Main Outcome Measure(s): A 66-item survey reflecting the current recommended concussion guidelines of the NATA and International Conference on Concussion in Sport was created to measure beliefs using the TPB constructs attitude toward the behavior (BA), subjective norms (SN), perceived behavioral control (PBC), and behavioral intention (BI) of ATs. We used a linear multiple regression to determine if the TPB constructs BA, SN, and PBC predicted BI and if PBC and BI predicted behavior according to the TPB model. Results: We found that BA, SN, and PBC predicted BI (R = 0.683, R2 = 0.466, F3,202 = 58.78, P < .001). The BA (t202 = 5.53, P < .001) and PBC (t202 = 9.64, P < .001) contributed to the model, whereas SN (t202 = −0.84, P = .402) did not. The PBC and BI predicted behavior (R = 0.661, R2 = 0.437, F2,203 = 78.902, P < .001). Conclusions: In this sample, the TPB constructs predicted BI and behavior of ATs' compliance with recommended concussion-management guidelines. The BA and PBC were the most influential constructs, indicating that those with positive attitudes toward concussion-management recommendations are more likely to implement them, and ATs are less likely to implement them when they do not believe they have the power to do so. We theorize that interventions targeting ATs' attitudes and control perceptions will lead to improved compliance.

scholarly journals Perception of adults toward electronic cigarettes: a cross-sectional study from Jordan

2021 ◽  
Vol 22 ◽  
Author(s):  
Muna Barakat ◽  
Areej M. Assaf ◽  
Raja’a Al-Qudah ◽  
Samar Thiab ◽  
Manar Alhamed ◽  
...  
Keyword(s):  
Social Media ◽  
Smoking Cessation ◽  
Tobacco Smoking ◽  
Electronic Cigarettes ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Awareness Campaigns ◽  
Almost All

Abstract Introduction: The rate of Jordanian tobacco smokers has been reported to be one of the highest rates in the world. The electronic cigarette (E-cig) has become an option, or an alternative, to tobacco cigarette smoking. This study was aimed to measure the perception of Jordanian adults toward E-cig use. Methods: A cross-sectional study design was used. A self-administered survey was developed and validated to solicit anonymous responses from the study participants. A convenience sample (n = 984) was recruited electronically through social media platforms. Descriptive statistics and correlation analyses were completed using the Statistical Package for the Social Sciences (SPSS). Results: More than half of the participants (53%) were females, and almost all participants had heard about E-cig (99.2%), mainly from their friends (40%) and social media (34.5%). About half of the participants were nonsmokers and around one-third of them (33.1%) were current E-cig users. The majority of the participating E-cig users had replaced tobacco with E-cig (56.4%)/All the E-cig users reported positive beliefs toward the E-cig as a safer alternative for tobacco smoking. About 45% of participants believed that the E-cig is helpful in tobacco smoking cessation, but should be highly regulated. Conclusion: This study illustrated a significant prevalence of E-cig usage among Jordanian adults. E-cig users perceived E-cig as a safer and cheaper alternative to tobacco smoking and that it helps in tobacco smoking cessation. However, health awareness campaigns are needed for the entire Jordanian community about E-cig use, related emerging health findings, and how to promote tobacco smoking cessation.

scholarly journals Post-concussion Driving Management Practices Among Certified Athletic Trainers

2019 ◽  
Vol 34 (5) ◽  
pp. 787-787
Author(s):  
J D Schmidt ◽  
R C Lynall ◽  
L B Lempke ◽  
H Devos
Keyword(s):  
High School ◽  
Management Practices ◽  
Motor Vehicle ◽  
Athletic Trainers ◽  
Medical Professional ◽  
Convenience Sample ◽  
Novice Drivers ◽  
Certified Athletic Trainers ◽  
The Road ◽  
On The Road

Abstract Purpose To describe post-concussion driving management practices and opinions among athletic trainers (ATs) and to compare practices across highest earned degree, setting, and years certified. Methods A survey weblink was emailed to a convenience sample of 8,723 ATs (10.8% response rate [945/8723]; years certified=14.5±10.7; years worked clinically=12.4±9.4). The validated survey captured AT driving management practices and opinions (agreement on a seven-point Likert scale). We compared the percentage of patients instructed to refrain from driving across highest earned degree, setting, and years certified using Kruskal-Wallis tests (alpha=0.05). Results When asked whether they recommended concussed patients refrain from driving, 58.5% of ATs responded “sometimes” (n=553/945), 37.9% responded “always” (n=358/945), and 3.6% responded “never” (n=34/945). ATs most commonly: recommended patients refrain from driving until symptom resolution (44.7%, n=399/892); utilized their clinical exam to determine readiness to return-to-drive (64.9%, n=579/892); and provided instructions verbally (94.2%, n=840/892). ATs agreed that “patients that are impaired by a concussion are a danger on the road”, but only somewhat agreed that “patients with suspected concussion should not drive a motor vehicle until cleared to do so by a medical professional” (median=5). High school (60.5±37.6%) and clinic-based ATs (66.5±31.2%) trended towards higher percentages of patients instructed to refrain from driving relative to college (52.3±38.2%; H(2)=5.92,p=0.052). No other differences observed. Conclusion ATs recommend driving restrictions to some, but not all, concussed patients. ATs recognize post-concussion driving dangers, but do not strongly endorse refraining from driving after concussion. High school and clinic-based ATs may manage more adolescent novice drivers and, therefore, act more conservatively.

scholarly journals SMEs Management Practices in a Hostile Business Environment in Zimbabwe

2017 ◽  
Vol 4 (1) ◽  
pp. 13
Author(s):  
Bekezela Moyo ◽  
Edinah Moyo
Keyword(s):  
Management Practices ◽  
Sampling Methods ◽  
Business Environment ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Qualitative Research Design ◽  
Product Service ◽  
Conceptual Paper ◽  
Almost All

 A great deal of extant literature has emphasised the importance of SMEs role in the economic performance of any country. It is this realization that has propelled almost all countries to nurture their SMEs so as to achieve economic development. This paper intends to interrogate the management practices adopted by SMEs in Zimbabwe, particularly in Gweru metropolitan albeit the macro factors that bedevilled the country to date. To achieve this discussion, emphasis will be drawn to the adoption and adaptation of management practices by these SMEs particularly in four facets: management of human resources, cash management, management of capital assets, and management of the product/service.    This is a conceptual paper and a qualitative research design is going to be used to define the methodology of this paper. A cross sectional survey is proposed for this study, using a sample size of fifty SMEs who will be chosen using purposive and snowballing sampling methods. Questionnaires will be administered on the chosen sample and this will be followed by semi-structured interviews on five cases that will constitute the main cases for discussion and confirmation. Data will be analysed using a thematically data analysis approach as put forth by respondents narrating their encounters.  

scholarly journals Community education and health promotion activities of naturopathic practitioners: results of an international cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amie Steel ◽  
Iva Lloyd
Keyword(s):  
Health Promotion ◽  
Patient Education ◽  
Online Survey ◽  
Community Education ◽  
Stakeholder Involvement ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Wide Range ◽  
Almost All

Abstract Background Health promotion and patient education are crucial to improved population health and are also among the core principles that define naturopathy. Yet, the activities of naturopathic practitioners (NPs) with regards to health promotion and community education have not been widely studied. Methods A cross-sectional online survey of an international convenience sample of NPs was conducted through disseminating a 15-item questionnaire prepared in five languages. Correlates of most frequently mentioned NP activities were studied. Results The survey was completed by 813 NPs representing all world regions. Almost all participants (98%) reported at least one health promotion activity. Most reported were information sheets and handouts (92.7%) or social and professional network communications (91.8%) and information talks presented to community members (84.9%). The majority of NPs (79.5%) indicated that the ‘health issues individuals in NPs’ community have said they need help with’ were a ‘very important’ consideration when they designed health promotion activities. NP characteristics associated with the likelihood of engaging in specific health promotion activities varied between activities but include gender, time since first qualification, factors considered to identify need when designing an activity, and stakeholder involvement in activity design. Conclusions Health promotion is a key activity of the global naturopathic profession. There are a wide range of patient education tools utilized by NPs.

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