A Latent Profile Analysis to Categorize and Describe Athletes Based on Factors Related to Concussion Disclosure.

CONTEXT: Collegiate student-athletes continue competing after experiencing symptoms of a concussion. Self-report of concussion symptoms is a critical element of the recovery process. Identifying factors related to concussion disclosure can aid in encouraging self-reporting. OBJECTIVE: To use latent profile analysis to categorize and describe athletes based on factors related to concussion disclosure. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 2 881 (52.4% female; 65.3% in-season; 40% collision sport) student-athletes from 16 National Collegiate Athletic Association member institutions. MAIN OUTCOME MEASURE(S): Student-athlete concussion expectations, attitudes, and norms were the profile variables and reporting intentions served as the distal outcome variable. We conducted latent profile analysis using select profile variables to determine the optimal number of classes. Differences in concussion-reporting intentions by profile assignment were then examined. Lastly, the extent to which a student-athlete's sex, season status, and level of contact predicted his or her intentions to report a concussion within each profile was investigated. RESULTS: Five unique student-athlete profiles emerged, including 1 profile that was most risky and another that was least risky. Females had significantly higher odds of being in the least risky profile. Those participating in collision sports had significantly higher odds of being in the top 2 most risky profiles. Contact-sport and in-season athletes were less likely to be in the least risky profile. CONCLUSIONS: With a better understanding of student-athlete profiles, athletic trainers have an opportunity to encourage concussion disclosure. Prompt disclosure would allow student-athletes to begin the return-to-play protocol in a more timely manner.

Using the Integrated Behavioral Model to Determine Sport-Related Concussion Reporting Intentions Among Collegiate Athletes.

PURPOSE: A significant proportion of sport-related concussions goes unreported among adolescents, which can result in irreversible brain damage. It is critical to identify and intervene on factors that significantly impact concussion reporting. METHODS: This study tests factors associated with collegiate athletes' intentions to (1) self-report concussion symptoms; (2) report another athlete's concussion symptoms; and (3) encourage others to report. Drawing on the Integrated Behavioral Model, predictors at the athlete level included perceived norms (bystander descriptive norms, injunctive norms, and subjective norms), attitudes (positive and negative expectancies about reporting and playing through a concussion and concussion reporting attitudes), personal agency (self-efficacy to recognize symptoms and communicate), and perceived coach communication. At the team level, coaches' self-reported communication was also included. Athletes (N = 1,858) and coaches (N = 254) at 16 colleges and universities completed Web-based surveys in 2016. Multilevel modeling accounted for the nesting of athletes within athletic team. RESULTS: Bystander descriptive norms, positive reporting expectancies, concussion reporting attitudes, self-efficacy to communicate about a concussion, and athletes' perceptions of their coach's communication were positively associated with all three outcomes. By contrast, subjective norms were only positively associated with intentions to self-report and bystander reporting intentions, negative reporting expectancies were only associated with intentions to self-report, and positive and negative expectancies for playing through a concussion were only associated with intentions to self-report and bystander encouragement. CONCLUSIONS: In sum, multiple factors within the Integrated Behavioral Model predict reporting intentions and underscore the complexity of athletes' concussion reporting behaviors and offer guidance for the development of prevention strategies.

Performance Against WELCOA's Worksite Health Promotion Benchmarks Across Years Among Selected US Organizations.

PURPOSE: The purpose of this study was to quantify the performance of organizations' worksite health promotion (WHP) activities against the benchmarking criteria included in the Well Workplace Checklist (WWC). DESIGN: The Wellness Council of America (WELCOA) developed a tool to assess WHP with its 100-item WWC, which represents WELCOA's 7 performance benchmarks. SETTING: Workplaces. PARTICIPANTS: This study includes a convenience sample of organizations who completed the checklist from 2008 to 2015. The sample size was 4643 entries from US organizations. MEASURES: The WWC includes demographic questions, general questions about WHP programs, and scales to measure the performance against the WELCOA 7 benchmarks. ANALYSIS: Descriptive analyses of WWC items were completed separately for each year of the study period. RESULTS: The majority of the organizations represented each year were multisite, multishift, medium- to large-sized companies mostly in the services industry. Despite yearly changes in participating organizations, results across the WELCOA 7 benchmark scores were consistent year to year. Across all years, benchmarks that organizations performed the lowest were senior-level support, data collection, and programming; wellness teams and supportive environments were the highest scoring benchmarks. CONCLUSION: In an era marked with economic swings and health-care reform, it appears that organizations are staying consistent in their performance across these benchmarks. The WWC could be useful for organizations, practitioners, and researchers in assessing the quality of WHP programs.