title: Social norms theory and concussion education.
abstract: Secondary prevention of harm from sport-related concussion is contingent on immediate removal from play post-injury. To-date, educational efforts to reduce the prevalent risk behavior of continued play while symptomatic have been largely ineffective. Social norms theory may hold promise as a foundation for more effective concussion education aimed at increasing concussion reporting. The primary objective of this study was to assess whether perceived team concussion reporting norms would be less supportive of an individual's safe concussion symptom reporting behavior than objective team norms. Participants were 328 male and female US collegiate athletes. Written surveys were completed in person during the spring of 2014. Among both male and female athletes, team concussion reporting norms were significantly misperceived, with athletes tending to think that they themselves have safer attitudes about concussion reporting than their teammates. Perceived norms were associated with symptom reporting intention, independent of the team's objective reporting norm. A social norms approach to concussion education, in which misperceived group norms are corrected and shifted in the direction of safety, is an important avenue for program development and evaluation research aimed at the secondary prevention of harm from concussion. Implications for the design of this type of educational programming are discussed.
authors.affiliation: Department of Pediatrics, University of Washington, Center for Child Health, Behavior, and Development, Seattle Children's Research Institute and Harborview Injury Prevention Research Center, Seattle, WA, USA, ekroshus@u.washington.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Kroshus
authors.affiliation: Department of Education, University of Vermont, College of Education and Social Services, Burlington, VT, USA.
authors.forename: Bernice R
authors.initials: BR
authors.lastname: Garnett
authors.affiliation: Interfaculty Initiative in Health Policy, Harvard University and Division of Sports Medicine, Boston Children's Hospital, Cambridge, MA, USA and.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Baugh
authors.affiliation: Department of Pediatrics, Harvard Medical School and Division of Adolescent & Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Jerel P
authors.initials: JP
authors.lastname: Calzo
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000523:psychology*; D001924:Brain Concussion / Q000523:psychology*; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D019221:Mandatory Reporting; D012449:Safety; D066262:Social Norms; D013177:Sports; D055815:Young Adult