title: Understanding athletic trainers' beliefs toward a multifacted sport-related concussion approach: application of the theory of planned behavior.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A Web link with a survey was e-mailed to 1000 randomly selected members of the National Athletic Trainers' Association (NATA).
  
  
  METHODS
  A total of 221 certified ATs working in secondary school/clinic, high school, and college/university settings.
  
  
  METHODS
  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, R(2) = 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, R(2) = 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.
authors.affiliation: Department of Exercise Sciences, Brigham Young University, Provo, UT;
authors.forename: Justin
authors.initials: J
authors.lastname: Rigby
authors.forename: Luzita
authors.initials: L
authors.lastname: Vela
authors.forename: Jeff
authors.initials: J
authors.lastname: Housman
mesh_terms: D056352:Athletes; D001265:Athletic Injuries / Q000628:therapy; D032763:Behavior Control / Q000379:methods*; D001924:Brain Concussion / Q000628:therapy*; D003430:Cross-Sectional Studies; D005178:Faculty; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017410:Practice Guidelines as Topic; D013177:Sports; D011795:Surveys and Questionnaires