title: Using theory to understand high school aged athletes' intentions to report sport-related concussion: implications for concussion education initiatives.
abstract: OBJECTIVE
  To assess the influence of psychosocial determinants from the Theory of Reasoned Action and Planned Behaviour (TRA/TPB) on concussion-reporting intentions.
  
  
  METHODS
  The present study employed the TRA/TPB to develop a cross-sectional survey to examine contributors to intention to report concussion symptoms. High school athletes (n = 167, age = 15.7 ± 1.4) completed this survey. The TRA/TPB constructs of attitude (perceptions about concussion reporting), subjective norm (perception of important social referents beliefs about concussion reporting), perceived behavioural control (perceived control over concussion reporting) and intention to report concussion symptoms served as the independent variables. Linear regression models were used to predict intention to report concussion symptoms. Binomial regression models were used to predict concussion-reporting behaviours from intention.
  
  
  RESULTS
  Direct attitude, subjective norm and direct perceived behavioural control were all associated with intention to report concussion. Intention was associated with decreased prevalence of participating in practices and games while symptomatic from concussion.
  
  
  CONCLUSIONS
  Favourable attitudes toward reporting and social referents' beliefs have the greatest impact on intention to report concussion symptoms. Reporting intention may not always be an indicator of concussion-reporting behaviours. Concussion education initiatives should focus on improving attitudes and beliefs among athletes, coaches and parents to promote better care-seeking behaviours among young athletes.
authors.affiliation: Clinical Research Unit, Emergency Services Institute, WakeMed Health and Hospitals, Raleigh, NC 27610, USA. jmihalik@wakemed.org
authors.forename: Johna K
authors.initials: JK
authors.lastname: Register-Mihalik
authors.forename: Laura A
authors.initials: LA
authors.lastname: Linnan
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Marshall
authors.forename: Tamara C
authors.initials: TC
authors.lastname: Valovich McLeod
authors.forename: Frederick O
authors.initials: FO
authors.lastname: Mueller
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Guskiewicz
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000523:psychology* / Q000706:statistics & numerical data*; D001265:Athletic Injuries / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D001924:Brain Concussion / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D012574:Schools; D057566:Self Report; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology