title: Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes.
abstract: BACKGROUND
  The benefit of preseason concussion education on athletes' knowledge, attitudes, and behaviors is unclear. The purpose of the study was to determine the influence of preseason concussion education on knowledge and self-reported attitudes and reporting behaviors. We hypothesized that preseason education would lead to better knowledge and self-reported attitudes and better reporting of concussion symptoms during the season.
  
  
  METHODS
  This study involved a prospective cohort comparing the benefits of a preseason lectured-based concussion education session at one high school with a control school. Participants included males and females age 13 years to 18 years from two community high schools who were participating in higher concussion risk, fall or winter sports (football, soccer, wrestling, and basketball). The education school and control school included 234 and 262 participants, respectively. Outcomes were a preseason and postseason survey assessing knowledge and self-reported attitudes about concussions and an end-of-season questionnaire assessing concussion reporting behaviors during the season.
  
  
  RESULTS
  Total scores on the combined (p < 0.0001), knowledge-based (p = 0.016), and behavioral-based (p < 0.0001) questions demonstrated statistically significant improvement in the education group. Scores peaked immediately after education but dissipated at the end of the season. There was a lower proportion in the education school (72%) compared with the control school (88%) that reported continued play despite having concussion symptoms during the season (p = 0.025). A similar proportion of athletes diagnosed with concussion during the season in the education (27%) and control schools (23%) reported returning to play before symptoms resolved (p = 0.81).
  
  
  CONCLUSIONS
  These findings suggest that a didactic-based preseason concussion education likely has minimal benefits. Other factors besides knowledge are likely influencing student-athlete concussion reporting behavior. Future research focused on changing the culture of concussion reporting is needed.
  
  
  METHODS
  Therapeutic study, level III.
authors: From the Divisions of Physical Medicine and Rehabilitation (B.G.K.), and Emergency Medicine (W.J.P., M.H., M.A.G.), Department of Pediatrics, and Comprehensive Children's Injury Center (B.G.K., W.J.P., C.S., M.A.G.), Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors: Brad G
authors: BG
authors: Kurowski
authors: Wendy J
authors: WJ
authors: Pomerantz
authors: Courtney
authors: C
authors: Schaiper
authors: Mona
authors: M
authors: Ho
authors: Michael A
authors: MA
authors: Gittelman
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000517:prevention & control*; D001924:Brain Concussion / Q000517:prevention & control*; D016022:Case-Control Studies; D004521:Educational Measurement; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires