Neither Personal or Teammate Concussion Experience Influences Collegiate Athletes' Attitude or Knowledge of Concussions.

Many athletes continue choosing not to report symptoms of a concussion. While modifiable factors like attitudes and knowledge are targeted to improve reporting, evidence of their actual influence on behaviour is mixed. One purpose was to examine if a concussed player's injury influenced their own knowledge and attitudes about concussions. The second purpose was to determine the influence of a current concussion on the knowledge and attitudes of both athletes and their teammates. A longitudinal study recruited 133 collegiate varsity athletes (64 females, 69 males) from contact sports at one Canadian university, completing 201 surveys across two seasons (some completed multiple surveys: pre-season, post-season, post-concussion). Participants used a validated survey (14 attitude, 35 knowledge items). Non-parametric tests (Kruskal-Wallis, chi-squared, Wilcoxon's, McNemar) analyzed data, with P<0.05 significance. For direct concussion experience, overall attitude and knowledge scores did not differ. Attitude scores did not differ for the shared concussion experience but one knowledge item, 'bleeding from the nose' as a false symptom significantly decreased from 75% pre-season to 52.5% post-season (Cohen's g = 0.41). These findings indicate that direct or shared concussion experiences have limited impact on overall knowledge and attitudes. Coaches must become aware of athletes whose attitude toward concussion is negative or deteriorating, i.e. difficulty or reluctance to report symptoms. While low aggregate scores imply that overall education is ineffective, a negative shift in knowledge of a specific knowledge item, like 'bleeding from the nose' in teammates, further highlights the need for modified concussion education strategies.