Coach, sports medicine, and parent influence on concussion care seeking intentions and behaviors in collegiate student-athletes

Abstract Context: Athletic trainers (ATs) are the most visible members of the sports medicine team and are responsible for the health and well-being of student-athletes (SAs). Objective: Quantifying the representation from Black, Indigenous, and People of Color (BIPOC) ATs in National Collegiate Athletic Association (NCAA) member institutions has not been previously studied. Design: Retrospective study Setting: National Collegiate Athletic Association's (NCAA) Demographic Database Participants: NCAA teams' athletic personnel at NCAA member institutions. Main Measures: Chi-square tests were employed to assess differences in racial and ethnic frequencies across division, calendar year and gender. Linear regressions models were used to examine change in racial and ethnic distributions of head and assistant ATs over time. Results: The majority of NCAA athletic trainers were categorized as white (88%), which was reflected in both head (90.8%) and assistant (87.2%) AT positions. Black ATs made up the largest proportion of a specific racial/ethnicity group within BIPOC ATs (3.4% of head ATs, 4.6% of assistant ATs), with the next most prevalent being Hispanic (2.8% of head ATs, 3.9% of assistant ATs). Historically Black College and Universities (HBCUs) showed higher proportions of BIPOC ATs in both head and assistant categories compared to non-HBCU institutions. Division I schools had the greatest AT racial/ethnicity diversity in comparison to Division II and Division III (p<0.0001). In our linear regression models, we found statistically significant increases in many of the racial/ethnic categories for both head and assistant ATs. Conclusions: Our study demonstrates that BIPOC ATs represent a small proportion of the ATs currently working at NCAA member institutions. Although there has been an increase in BIPOC athletic trainers over the past ten years, a large racial and ethnic discordance gap still exists between student athletes and the ATs caring for them. Future studies may identify barriers encountered by BIPOC ATs and the effectiveness of current diversity initiatives.

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Effect of contextual/procedure-based concussion education on community college student-athlete reporting of concussion

Neurology ◽

10.1212/01.wnl.0000550635.41641.4f ◽

2018 ◽

Vol 91 (23 Supplement 1) ◽

pp. S7.1-S7

Author(s):

Nancy Chinn ◽

Monica Ohkubo ◽

Brianna Scott

Keyword(s):

Sports Medicine ◽

Student Athletes ◽

Male Student ◽

Community College Student ◽

Traditional Learning ◽

Learning Approach ◽

Student Athlete ◽

Learning Group ◽

Group Data ◽

Concussion Education

Various measures have been recommended to facilitate early identification of concussion including concussion education. Most commonly, concussion education is provided via lecture, video, and written materials. The extent to which these modes of concussion education result in greater self-reporting of concussion by student-athletes is unclear. This retrospective study compared student-athlete concussion reporting behaviors of participants who received traditional concussion education with those who also received a contextual/procedure-based learning approach. Sports medicine charts were reviewed for 2 groups: collegiate student-athletes (n = 301) who received concussion education in the fall semester of 2015 in a classroom setting that included lecture, hand-outs and viewing a video (Traditional Learning Group) and collegiate student-athletes (n = 271) who received traditional education in the fall 2016 semester and additionally received contextual/procedure-based learning approach (Contextual/Procedure-based Learning Group). Data was analyzed using a series of t-tests. Percent of concussions identified increased by 42% when comparing the fall 2015 Traditional Learning Group to the fall 2016 Contextual/Procedure-based Learning Group. Self-reporting of concussion by student-athletes increased 69% in the Contextual/Procedure-based Learning Group. Time to report concussion was significantly lower for participants in the Contextual/Procedure-based Learning Group, but this result was specific only to male student-athletes. This study indicates a contextual/procedural-based learning approach to concussion education may positively influence reporting and reduce time to report when compared to a more traditional lecture-based approach to concussion education.

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Knowledge, Attitudes, and Behaviors Regarding Hydration and Fluid Replacement of Collegiate Athletes

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.15.5.515 ◽

2005 ◽

Vol 15 (5) ◽

pp. 515-527 ◽

Cited By ~ 31

Author(s):

Phillip E. Nichols ◽

Satya S. Jonnalagadda ◽

Christine A. Rosenbloom ◽

Marvin Trinkaus

Keyword(s):

Sports Medicine ◽

Collegiate Athletes ◽

Fluid Replacement ◽

Team Meetings ◽

Attitudes And Behaviors ◽

Significant Difference ◽

The Mean ◽

And Behaviors ◽

National Athletic Trainers Association ◽

And Behavior

The purpose of this study was to determine collegiate athletes’ knowledge, attitudes, and behaviors concerning hydration and fluid replacement. A survey containing questions pertaining to demographics and knowledge, attitude, and behavior on hydration and fluid replacement was distributed to the athletes during team meetings and practices. A total of 139 out of 171 (81.3%) athletes participated in the study. The mean age of the athletes was 19.8 y. The mean score for knowledge, attitude, and behavior was 13.9 ± 1.8, 9.8 ± 2.2, and 12.4 ± 2.5, respectively, with higher scores indicating positive hydration knowledge, attitudes, and behaviors. Significant positive correlation was observed between knowledge, attitude, and behavior scores (P < 0.05). Significant difference (P < 0.05) was observed in the reported hydration behaviors between skilled (11.79 ± 2.08) and endurance (12.71 ± 2.63) athletes. Most athletes correctly answered the general hydration questions on the survey, but the majority did not correctly answer statements in regards to National Athletic Trainers’ Association (NATA) and the American College of Sports Medicine (ACSM) position stands and lacked knowledge regarding appropriate use of sports drink. The results of this study identify specific areas of education for athletes with regards to hydration.

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Bilateral Pulmonary Emboli in a Collegiate Gymnast: A Case Report

Journal of Athletic Training ◽

10.4085/1062-6050-44.6.666 ◽

2009 ◽

Vol 44 (6) ◽

pp. 666-671 ◽

Cited By ~ 5

Author(s):

Leamor Kahanov ◽

Tarah Daly

Keyword(s):

Pulmonary Embolism ◽

Emergency Room ◽

Health Care Providers ◽

Sports Medicine ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Renal Calculi ◽

Student Athlete ◽

Pulmonary Emboli ◽

Care Providers

Abstract Objective: To characterize the diagnosis of pulmonary embolism in collegiate student-athletes and to raise awareness among sports medicine providers of the possibility of this potentially fatal disease in the student-athlete population. Background: An 18-year-old, previously healthy National Collegiate Athletic Association Division I female gymnast complained of intense pain, bilaterally, deep in her chest. The athlete was referred to her team physician, who identified normal vital signs but referred her to the emergency room because of significant pain. The student-athlete was diagnosed with bilateral pulmonary emboli in the emergency room. Differential Diagnosis: Pneumonia, renal calculi, upper urinary tract infection, intercostal muscle strain or rib fracture, pancreatitis, gall bladder disease, gastritis, ulceration, esophagitis, infection, tumor, pulmonary embolism. Treatment: The student-athlete was immediately placed on anticoagulants for 6 months. During that time, she was unable to participate in gymnastics and was limited to light conditioning. Uniqueness: Documented cases of female student-athletes developing a pulmonary embolism are lacking in the literature. Two cases of pulmonary embolism in male high school student-athletes have been documented, in addition to many cases in elderly and sedentary populations. Conclusions: All health care providers, including sports medicine professionals, should be aware that this condition may be present among student-athletes. During the initial evaluation, prescreening should include questions about any previous or family history of pulmonary embolism or other blood clots. Athletes who answer positively to these questions may have a higher likelihood of pulmonary embolism and should be referred for testing.

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Understand mental health impact of pandemic on student‐athletes, sports medicine staff

College Athletics and the Law ◽

10.1002/catl.30870 ◽

2021 ◽

Vol 18 (2) ◽

pp. 6-8

Author(s):

Timothy Neal ◽

Eric Quandt ◽

James Thornton ◽

James Tucker

Keyword(s):

Mental Health ◽

Sports Medicine ◽

Student Athletes ◽

Health Impact

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Nutrition Knowledge of Collegiate Athletes in the United States and the Impact of Sports Dietitians on Related Outcomes: A Narrative Review

Nutrients ◽

10.3390/nu13061772 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1772

Author(s):

Aaron J. Riviere ◽

Rae Leach ◽

Haleigh Mann ◽

Samuel Robinson ◽

Donna O. Burnett ◽

...

Keyword(s):

United States ◽

Student Athletes ◽

Collegiate Athletes ◽

The United States ◽

Nutrition Knowledge ◽

Narrative Review ◽

Full Time ◽

Increased Risk ◽

And Behaviors ◽

The Impact

In the last decade, the number of full-time registered dietitians (RDs) serving intercollegiate athletes in the United States has more than quadrupled. However, many student athletes may be at increased risk of nutrition-related problems that impact physical and academic performance, which include inadequate macronutrients, inadequate micronutrients, and excessive macronutrients. This narrative review reports the current literature to date on nutrition-related knowledge in collegiate athletes and the impact of sports RDs on student athletes’ nutrition knowledge and behaviors. To date, only observational and quasi-experimental studies have been published with regard to changes in nutrition knowledge and behaviors in NCAA athletes. While these studies report benefits of the RD as a member of the interdisciplinary student athlete support team, more well-designed randomized control trials are warranted to determine benefits related to health outcomes and sport-specific performance outcomes.

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Influence of insurance type on rate and type of initial concussion-related medical visits among youth

BMC Public Health ◽

10.1186/s12889-021-11586-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chris Radlicz ◽

Kenneth Jackson ◽

Amanda Hautmann ◽

Junxin Shi ◽

Jingzhen Yang

Keyword(s):

Sports Medicine ◽

Private Insurance ◽

Urgent Care ◽

Care Utilization ◽

Care Seeking ◽

Medical Visits ◽

Insurance Type ◽

Publicly Insured ◽

Efficient Care ◽

Privately Insured

Abstract Background A growing number of studies report increased concussion-related health care utilization in recent years, but factors impacting care-seeking behaviors among youth following a concussion are not well described. This study aimed to evaluate the influence of insurance type on the rate and type of initial concussion visits and the time from injury to the initial visit in youth. Methods We extracted and analyzed initial concussion-related medical visits for youth ages 10 to 17 from electronic health records. Patients must have visited Nationwide Children’s Hospital’s (NCH) concussion clinic at least once between 7/1/2012 and 12/31/2017. We evaluated the trends and patterns of initial concussion visits across the study period using regression analyses. Results Of 4955 unique concussion visits included, 60.1% were males, 80.5% were white, and 69.5% were paid by private insurance. Patients’ average age was 13.9 years (SD = 3.7). The rate of the initial concussion visits per 10,000 NCH visits was consistently higher in privately insured than publicly insured youth throughout the study period (P < .0001). Privately insured youth had greater odds of initial concussion visits to sports medicine clinics (AOR = 1.45, 95% CI = 1.20, 1.76) but lower odds of initial concussion visits to the ED/urgent care (AOR = 0.74, 95% CI = 0.60, 0.90) than publicly insured youth. Days from injury to initial concussion visit significantly decreased among both insurance types throughout the study (P < .0001), with a greater decrease observed in publicly insured than privately insured youth (P = .011). Conclusions Results on the differences in the rate, type, and time of initial concussion-related visits may help inform more efficient care of concussion among youth with different types of insurance.

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Cardiovascular Screening Practices and Attitudes From the NCAA Autonomous “Power” 5 Conferences

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118775039 ◽

2018 ◽

Vol 10 (6) ◽

pp. 547-551 ◽

Cited By ~ 7

Author(s):

Christopher W. Miars ◽

Andreas Stamatis ◽

Grant B. Morgan ◽

Jonathan A. Drezner

Keyword(s):

Sports Medicine ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Physician Attitudes ◽

Level Of Evidence ◽

Cross Sectional ◽

Men's Basketball ◽

Screening Practices ◽

Cardiovascular Screening ◽

Screening Protocol

Background: The development of athlete-specific electrocardiogram (ECG) interpretation standards, along with recent rates of sudden cardiac death (SCD) in athletes being higher than previously estimated, has heightened the debate in the sports medicine community regarding cardiovascular screening of the college athlete, including whether certain high-risk subsets, such as male basketball athletes, should undergo more intensive screening. Hypothesis: ECG and/or echocardiography screening in National Collegiate Athletic Association Autonomous 5 Division I (A5DI) schools will be more common than previous reports, and there will be more frequent use of noninvasive cardiac screening for men’s basketball players than the general athlete population. Study Design: Cross-sectional, quantitative study. Level of Evidence: Level 4. Methods: The head team physician for each of the 65 schools in the A5DI conferences was contacted to complete an anonymous survey regarding cardiovascular screening practices at their institution. The survey inquired about current screening protocols, whether SCD epidemiology (SCD-E) was considered in establishing those practices, and whether awareness of present epidemiology altered physician attitudes toward screening. Results: A total of 45 of the 65 team physicians (69%) responded. All schools reported performing history and a physical evaluation. While 17 (38%) perform only history and physical, 26 (58%) also include an ECG, and 12 (27%) include echocardiography for all student-athletes. Specifically for male basketball athletes, 10 (22%) schools perform only history and physical, 32 (71%) include ECG, and 20 (45%) include echocardiography. Additionally, 64% reported using SCD-E in developing their screening protocol. Those that had not considered SCD-E indicated they were unlikely to change their screening protocol when presented with current SCD-E. Conclusion: The majority (62%) of A5DI institutions include ECG and/or echocardiography as part of their cardiovascular screening of all athletes, increasing to 78% when specifically analyzing male basketball athletes. Clinical Relevance: A5DI institutions, presumably with greater resources, have largely implemented more intensive cardiovascular screening than just history and physical for all student-athletes and specifically for men’s basketball—the athlete group at greatest risk.

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Predictors of postconcussion syndrome in collegiate student-athletes

Neurosurgical FOCUS ◽

10.3171/2016.1.focus15593 ◽

2016 ◽

Vol 40 (4) ◽

pp. E13 ◽

Cited By ~ 33

Author(s):

Scott L. Zuckerman ◽

Aaron M. Yengo-Kahn ◽

Thomas A. Buckley ◽

Gary S. Solomon ◽

Allen K. Sills ◽

...

Keyword(s):

Sports Medicine ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Public Health Problem ◽

Ice Hockey ◽

Surveillance Program ◽

Postconcussion Syndrome ◽

Convenience Sample ◽

Certified Athletic Trainers ◽

Patients Experience

OBJECTIVE Sport-related concussion (SRC) has emerged as a public health problem, especially among student-athletes. Whereas most concussions resolve by 2 weeks, a minority of patients experience postconcussion syndrome (PCS), in which symptoms persist for months. The objective of this study was to elucidate factors predictive of PCS among a sample of National Collegiate Athletic Association (NCAA) student-athletes in the academic years 2009–2010 to 2014–2015. METHODS The SRC data originated from the NCAA Injury Surveillance Program (ISP) in the 2009–2010 to 2014–2015 academic seasons. The NCAA ISP is a prospective database made up of a convenience sample of schools across all divisions. All SRCs are reported by certified athletic trainers. The PCS group consisted of concussed student-athletes with concussion-related symptoms that lasted ≥ 4 weeks. The non-PCS group consisted of concussed student-athletes with symptom resolution in ≤ 2 weeks. Those with symptoms that resolved in the intermediate area of 2–4 weeks were excluded. Odds ratios (ORs) were estimated using logistic regression. RESULTS During the 2009–2010 to 2014–2015 seasons, 1507 NCAA student-athletes sustained an SRC, 112 (7.4%) of whom developed PCS (i.e., concussion-related symptoms that lasted ≥ 4 weeks). Men's ice hockey contributed the largest proportion of concussions to the PCS group (28.6%), whereas men's football contributed the largest proportion of concussions in the non-PCS group (38.6%). In multivariate analysis, recurrent concussion was associated with increased odds of PCS (OR 2.08, 95% CI 1.28–3.36). Concussion symptoms that were also associated with increased odds of PCS included retrograde amnesia (OR 2.75, 95% CI 1.34–5.64), difficulty concentrating (OR 2.35, 95% CI 1.23–4.50), sensitivity to light (OR 1.97, 95% CI 1.09–3.57), and insomnia (OR 2.19, 95% CI 1.30–3.68). Contact level, sex, and loss of consciousness were not associated with PCS. CONCLUSIONS Postconcussion syndrome represents one of the most impactful sequelae of SRC. In this study of exclusively collegiate student-athletes, the authors found that recurrent concussions and various concussion-related symptoms were associated with PCS. The identification of initial risk factors for the development of PCS may assist sports medicine clinicians in providing timely interventions and treatments to prevent morbidity and shorten recovery time after SRC.

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