Investigation of strategies to improve concussion reporting in American football.

While research on sport-related concussion has increased dramatically over the past decade, research investigating concussion reporting is in its early stages. The purpose of this project was to assess concussion reporting and work with stakeholders to develop and assess strategies to improve reporting. We used a multi-site, repeated measures design with three NCAA Division I football programs, including 223 athlete participants. A modified community-based participatory research (CBPR) approach was used to develop intervention strategies (Fall 2017 season) with stakeholders designed to increase concussion reporting intentions. Preseason and postseason surveys were administered to determine effectiveness. Main outcome measures included concussion knowledge, intervention effectiveness, and reporting intention measures. For all three programs, concussion knowledge was unrelated to reporting intentions. Two of the three programs implemented the intervention strategies and for these programs there was evidence that the interventions were effective. Specifically, athletes from these two programs perceived more support from coaches about reporting (P< 0.05; t= 2.83), received education more frequently (P< 0.05; t= 2.67), and reported being more likely to report concussion symptoms (P< 0.05; t= 2.14). Our study demonstrates that working with stakeholders to develop site-specific strategies to improve concussion reporting is an effective approach to help improve reporting behaviours.

Psychosocial experiences of concussed collegiate athletes: The role of emotional support in the recovery process.

Objective: Understand from whom concussed football players seek and receive emotional support, and whether this support is associated with injury perceptions. Participants: Football players (N = 26) from three NCAA Division I programs. Methods: With approval from the head athletic trainer, concussed athletes (2017 season) completed short surveys within 4-6 days of diagnosis and when cleared to return. Results: Concussed athletes perceived their injury as a normal consequence of playing football, not serious, and reported little, if any, depression and anxiety. Athletes reported the most support from athletic trainers; the least from coaches and teammates. Emotional support was associated with fewer adverse psychosocial reactions, more sport-injury related growth, and greater intentions to report future concussion symptoms. Conclusion: Results from this pilot study suggest that emotional support during the concussion recovery process should be understood and fostered by university officials charged with the health and well-being of collegiate football players.

Relationship of athletic and academic identity to concussion reporting intentions.

BACKGROUND: Understanding concussed athletes' motivations for reporting concussion symptoms is important for health care professionals who are charged with the care, management, and prevention of future injury. OBJECTIVES: To examine if athletic and academic identity predict concussion symptom reporting intentions above and beyond traditional socio-cognitive predictors. DESIGN: Cross-sectional study using self-report measures during the 2016 collegiate football season. METHOD: In a sample of National Collegiate Athletic Association (NCAA) Division I American football athletes (N = 205) we examined the relationship of athletic and academic identity with three indices of symptom reporting behavior: reporting during a game, reporting 24 h after a game, and reporting on behalf of a teammate. We used descriptive statistical analyses, correlations, and linear regression to examine hypotheses. RESULTS: Controlling for traditional predictors, athletic identity was associated with a lower likelihood to report symptoms during a game (ß = -0.22, t = -3.28, p < .001) or within 24 h (ß = -0.28, t = -4.12, p < .001). Academic identity was positively associated with reporting intentions during a game (ß = 0.12, t = 1.68, p < .05), 24 h later (ß = 0.13, t = 1.85, p < .05), and on behalf of a teammate (ß = 0.22, t = -3.36, p < .001). CONCLUSIONS: Athletic and academic identities offer additional insight into athletes' motivation for concussion symptom reporting intentions, above and beyond traditional socio-cognitive predictors. Discussion focuses on the benefit of incorporating these important self-identities into educational health interventions to improve their impact.

A Simple Field-Based Tool to Assess Concussion Symptom Reporting Behavior.

INTRODUCTION: Prevention and treatment of sport-related concussions is an important public health issue and has led to increased research on concussion symptom reporting behavior. To date, there is neither a common understanding of what constitutes concussion symptom reporting behavior nor measures that capture key features of concussion symptom reporting behavior. Concussion symptom reporting behavior can be initiated by an athlete, an athletic trainer, coach, or teammate and can occur in competition, practice, or days after symptoms appear. Follow-up diagnostics range from asking athletes initial questions about their symptoms to conducting rapid standardized sideline assessments to conducting full comprehensive concussion screens. Currently, for athletes who are not formally diagnosed with concussion, no information about concussion symptom reporting behavior sources, screening methods, or context is collected. METHODS: Pilot data were collected from four National Collegiate Athletic Association Division I football programs. Athletic trainers recorded data about key concussion symptom reporting behavior features during the 2016 and 2017 football seasons. The 2016 data were analyzed in Spring 2017 and the reporting form was adapted for the Fall 2017 season. Two programs completed records during the 2017 season. These records were analyzed in Spring 2018. RESULTS: Concussion symptom reporting behavior is most often initiated by athletes in practice contexts, followed by athletic trainers in game contexts. The 2017 data revealed that, regardless of source, 45% of initial screens received a comprehensive screen and about 25% of comprehensive screens originated by athlete or athletic trainer concussion symptom reporting behavior resulted in concussion diagnosis. Results led to development of a brief concussion symptom reporting behavior recording tool that can be used in practice, game, and athletic training room settings. CONCLUSIONS: The smartphone-supported Concussion Symptom Reporting Tool provides a rapid and easy way to record concussion symptom reporting behavior as well as estimate program-specific data for stakeholders interested in understanding concussion symptom reporting behavior.

Leader-member exchange and work-family interactions: the mediating role of self-reported challenge- and hindrance-related stress.

The authors examined the relations among 4 components of the leader-member exchange (LMX) relationship (i.e., contribution, affect, loyalty, and professional respect) and the level of work-family conflict and work-family facilitation that an employee experiences. Further, the authors examined the mediating role of challenge- and hindrance-related self-reported stress on relations. In doing this, the authors linked positive and negative aspects of LMX, stressors, work-family conflict, and work-family facilitation. Data from a sample of full-time employed individuals support some hypothesized relations between components of LMX and work-family interactions. Also, results support the mediating role of hindrance-related stress in the relation between (a) the affect and loyalty components of LMX and (b) work-family conflict. The authors discuss the implications and limitations of their findings.

The impact of deployment length and experience on the well-being of male and female soldiers.

This study examined the effects of stressor duration (deployment length) and stressor novelty (no prior deployment experience) on the psychological health of male and female military personnel returning from a peacekeeping deployment. The sample consisted of men (n = 2,114) and women (n = 1,225) surveyed for symptoms of depression and posttraumatic stress. The results confirmed the hypotheses. Longer deployments and 1st-time deployments were associated with an increase in distress scores. However, the relationship between deployment length and increased distress was found only for male soldiers. The findings demonstrate the importance of considering the impact of exposure to long-term occupational stressors and confirm, in part, previous research that has demonstrated a different stress response pattern for men and women.

Psychological screening program overview.

This article reviews the literature on health surveillance conducted during military deployments, focusing on models for assessing the impact of operational deployments on peacekeepers. A discussion of the stressors and potential mental health consequences of peacekeeping operations follows with relevant examples of findings from U.S. and international military forces. Psychological screening in different peacekeeping operations conducted in U.S. Army-Europe is reviewed. The review begins with the redeployment screening of military personnel deployed to Bosnia mandated under the Joint Medical Surveillance Program, and continues through the present screening of units deployed to Kosovo. The detailed description of the screening program includes a discussion of procedures and measures and demonstrates the evolution of the program. A summary of key findings from the screening program and a discussion of future research directions are provided.

The impact of commuter war on military personnel.

BACKGROUND: The U.S. armed forces recently experienced a reduction in forces along with an increase in operational tempo. The Air Force and other branches supporting its mission share this common military burden and also experience a unique stressor. The Air Force has developed a military force that can fight by night and return home by day. The relatively new phenomenon of "commuter war" was especially evident during Operation Allied Force over Kosovo. METHODS: Military personnel (N = 540) participating in Operation Allied Force were administered a survey measuring morale, wellness behaviors, and work-family conflict. RESULTS: The deployment had adverse effects on wellness behaviors of permanent party and temporary duty assignment populations. Additionally, levels of morale and motivation varied between the two groups. Permanent party personnel also reported increased rates of work-family conflict. CONCLUSIONS: Commuter war affects wellness behaviors, morale, and work-family conflicts of military personnel.