Applying the Common-Sense Self-Regulation Model to Understand Illness Representations of Mild Traumatic Brain Injury in College Students.

OBJECTIVE: The Common Sense Model (CSM) describes cognitive, emotional, and psychosocial factors that influence how health threats are processed and subsequently inform health-related decisions or actions. The purpose of this study was to examine psychosocial factors influencing coherence, or usefulness, of mild traumatic brain injury (mTBI) representations and their relationship to health-related decisions and actions. SETTING: Public university. PARTICIPANTS: There were 458 graduate and undergraduate college students who participated in a web-based survey (mean age = 22 years; SD = 3.6). DESIGN: A mixed-methods design randomized participants into 2 groups to examine perceptions of mTBI across differing injury mechanisms, or causes, by comparing actions recommended to a friend (Other; n = 214) with those generated for self (Self; n = 244). MAIN MEASURES: Seven common injury mechanisms representative of university student mTBI experiences were presented as vignettes (cause). Each vignette included open- and closed-ended questions framed from CSM constructs (identity, consequences, action plans, timeline, and social context). Data were analyzed using a series of chi-square tests and multiple analysis of variance. Post hoc analysis identified differences in the injury vignettes. RESULTS: Students were more likely to identify the injury as mTBI ( = 8.62, P = .035) and recommend immediate healthcare (F1,415 = 316.89, P < .001) for all causes if the injury occurred to a friend as compared with themselves. Action plans also varied by cause, with post hoc analysis revealing a higher likelihood of healthcare seeking for motor vehicle crashes and assault and a lower likelihood for falls while intoxicated. Students were generally more likely to talk to closest confidants than doctors (F8,398 = 33.66, P < .001). CONCLUSION: Cause appears to be a key construct in generating illness representations and associated action plans for seeking care, with lower perceived severity causes (eg, falls) resulting in little to no health-seeking action. In addition, social support appears to be important for college students when making decisions about their health.

A theory-based exploration of psychosocial factors influencing concussion health seeking intentions in college students.

Objective: This mixed method study examined how psychosocial factors from the Theory of Planned Behavior and Reasoned Action (TPB/RA) influence health-seeking behaviors after concussion, expanding from student-athlete TPB/RA research to assess the influence of psychosocial factors within a general college population. Participants: Two hundred and forty-four students participated from a large Southeastern public university. Methods: A concurrent nested mixed-methods approach involving closed- and constructed- response survey questions. Results: Subjective norms (direct: B = .499, p = .002; indirect: B = .023, p = .046) and attitude (indirect: B = .034, p = .041) were significant predictors of intention to seek medical care after a hypothetical concussion. Open-ended responses were coded by anticipated post-injury behaviors. Only 36.2% of the sample indicated intention to seek medical care. The most common response (38.3%) was students would self-treat a suspected concussion. Conclusions: Subjective norms and indirect attitudes are important to understanding how general college students seek care after a concussion, particularly how the influence of others are important in the decision to seek healthcare.