title: Racial Disparities in Concussion Knowledge and Symptom Recognition in American Adolescent Athletes.
abstract: The purpose of this study was to identify if knowledge of concussion differences exists between communities that service underserved, African-American athletes compared to white athletes, and to explore differences in concussion knowledge between African-American and white athletes with and without access to an athletic trainer.
  
  
  
  Five hundred seventy-seven adolescent athletes ranging in age from 13 to 18 from 14 schools in the USA completed a one-time pencil and paper survey instrument. Data were collected from September 2014 to April 2015. All athletes included in the study received concussion education implemented (i.e., Centers for Disease Control and Prevention (CDC) Heads UP documents) by state concussion law. Knowledge of concussion scores were determined by summing the total correct responses to the 35 questions. Race (white or African-American) and access to an athletic trainer were the independent variables explored.
  
  
  
  White high school athletes have increased concussion knowledge compared to African-American athletes (p < 0.001). African-American athletes less frequently recognized all correct signs and symptoms of concussion compared to white athletes. African-American athletes with access to an athletic trainer have more knowledge than African-American athletes without access to an athletic trainer (p = 0.003).
  
  
  
  White athletes had more concussion knowledge than African-American athletes; however, African-Americans that had access to an athletic trainer at their respective school were more likely to identify the signs and symptoms of concussion compared to African-Americans that did not have access to an athletic trainer. This further accentuates the health disparity that occurs in high school athletics, in regard to the presence of an athletic trainer and their influence on an athlete's health and safety.
authors.affiliation: Youngstown State University, 1 University Plaza, 307L Beeghly Center, Youngstown, OH, 44512, USA. jwallace02@ysu.edu.
authors.forename: Jessica
authors.identifier: 0000-0003-1359-2124
authors.initials: J
authors.lastname: Wallace
authors.affiliation: Michigan State University, 105 IM Sports Circle, East Lansing, MI, 48824, USA.
authors.forename: Tracey
authors.initials: T
authors.lastname: Covassin
authors.affiliation: North Dakota State University, Bentson/Bunker Fieldhouse, Room 1, Dept 2620, PO Box 6050, Fargo, ND, 58101, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Moran
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D056352:Athletes / Q000706:statistics & numerical data*; D001924:Brain Concussion; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D014481:United States; D044465:White People / Q000706:statistics & numerical data*
keywords: Adolescents; African-American; Concussion; Symptoms of concussion