On SAGE Insight: Concussion beliefs in varsity athletes: Identifying the good, the bad and the ugly

From Journal of Concussion

Concussion injury is a serious and prevalent problem in sports that has gained worldwide attention. Despite years of awareness campaigns around risk and long-term consequences, many athletes engage in high-risk behaviour and persist in competing without proper recovery following concussion. Coaches and fellow athletes may influence concussion reporting behaviours. Athlete beliefs and attitudes towards concussion prevention and management may also orient their behaviour away from proper management and towards riskier behaviour. Better targeting the athletes holding such beliefs may help to reduce the impact of concussion The challenge lies in identifying which athletes and which beliefs to target. Our research set out to respond to this challenge.

Two key findings emerged from our survey-based study of concussion attitudes and intentions among 175 varsity athletes. First, a considerable proportion (28%) of athletes had ambivalent attitudes towards managing a concussion by following the return to play guidelines or proactively reducing concussion risk. These athletes were more accepting of concussion risk and held lower beliefs about the importance of following established the return to play protocols. Not surprisingly, these athletes had double the risk of concussion of other athletes in the sample.

Second, athletes in the sample held problematic beliefs. For example, a large proportion of athletes believed that protective equipment (e.g., helmets) is effective in reducing the likelihood of sustaining a concussion, despite the fact it does not. In addition, beliefs that protective equipment can reduce risk were positively related to participants feeling safer taking risks when wearing protective equipment. The co-occurrence of such beliefs and attitudes is problematic because athletes might see equipment as a way to ‘up the ante’ when it comes to aggressive, high-risk behaviour.

Our take-home message is that, in order to be more effective, concussion programs need to understand the athletes they are trying to influence and the attitudes and beliefs that are barriers to better prevention and management.  Subgroups of athletes are positive towards prevention and management behaviours; others are more reluctant. Despite efforts at education, erroneous beliefs persist. These beliefs can be problematic if athletes are taking more risks as a consequence. Athletes holding negative or erroneous beliefs may require different persuasion strategies and/or more individualized attention to safety. We also need to build a culture of respect within sports where participation and player welfare are prime concerns and coaching and rules support safe play.

By Hugo Lehmann, Fergal O’Hagan and Michael Jorgensen, Trent University, Peterborough, ON, Canada


Objective: Identify and describe attitudes and intentions towards personal concussion risk and protective behaviours among varsity athletes. Determine subgroups of athletes characterized by problematic intentions towards concussion prevention and management behaviours. Design: Cross-sectional survey. Main outcome measures: Varsity athletes (N ¼ 175; 60% male; 55.4% contact athletes; 56.6% history of concussion) completed a survey examining attitudes and intentions towards personal risk and concussion-management behaviours. Cluster and discriminant analyses were used to identify athlete risk response subgroups on intention items. The clusters were examined for differences in attitudes towards concussion prevention behaviours, demographics and concussion exposure. Results: A substantially problematic subgroup of athletes (28% of the sample) reported low intent to engage in post concussion management practices or primary prevention behaviours. These individuals reported high concussion-risk acceptance and very low belief in the efficacy of concussion-management behaviours. They were also more likely to have sustained a concussion. Two other clusters demonstrated more acceptable behavioural intentions towards concussion prevention and management, with one holding model attitudes and intentions. Conclusions: Varsity athletes exhibit one of three different patterns of intentions and attitudes towards concussion prevention and management behaviours. Athletes in one of these groups are at much greater risk of concussion injury and poorly follow recommended treatments. Intervention programmes need to target and aim to change these problematic intentions and attitudes to improve the effectiveness of concussion prevention and injury management.

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Article details
Concussion beliefs in varsity athletes: Identifying the good, the bad and the ugly
Michael P Jorgensen, Fergal T O’Hagan, Hugo Lehmann
First Published October 3, 2017
DOI: 10.1177/2059700217730257
From Journal of Concussion






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