View in EDS HTML Full Text PDF Full Text

Parent Influence on Concussion Reporting in First-Year Collegiate Athletes

Saved in:
Bibliographic Details
Title: Parent Influence on Concussion Reporting in First-Year Collegiate Athletes
Language: English
Authors: Fuller, Natalie Joan (ORCID 0000-0003-4978-5323), Kroshus, Emily (ORCID 0000-0002-7484-2601), Hall, Eric E. (ORCID 0000-0002-3590-5390), Ketcham, Caroline J. (ORCID 0000-0002-6713-130X)
Source: Journal of American College Health. 2022 70(5):1518-1527.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 10
Publication Date: 2022
Document Type: Journal Articles
Reports - Research
Tests/Questionnaires
Education Level: Higher Education
Postsecondary Education
Descriptors: Athletes, College Athletics, Head Injuries, Self Disclosure (Individuals), Parent Influence, College Freshmen, Parent Child Relationship, Student Attitudes, Intention
DOI: 10.1080/07448481.2020.1809430
ISSN: 0744-8481
1940-3208
Abstract: Objective: To assess the relationship between sport-parenting practices and concussion reporting intentions of collegiate athletes across two levels of competition. Participants: Entering first-year student-athletes (varsity and club) at a mid-sized university in the Southeast region of the United States (n = 327). Methods: Written surveys were completed prior to the start of the 2015 academic year. Structural equation modeling was used to test a model predicting concussion-reporting intentions. Results: College athletes were more likely to intend to report a suspected concussion when they believed their parents wanted them to report (B=-0.88, SD = 0.94), and when they experienced less sport achievement pressure from their parents (B=-0.12, SD = 8.07). Conclusions: Parents influence the concussion safety of entering collegiate athletes at both the varsity and club level. Lower pressure sport parenting prior to college entry may help foster safer concussion reporting behaviors and may be an appropriate target for future intervention development work.
Abstractor: As Provided
Entry Date: 2022
Accession Number: EJ1358367
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwEu4OtE9s0aVktd-8lXD64aAAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDHfMX2DXj5Iu5dGbbQIBEICBmwY0G3iVtx7rScJtDQe59Kftx5fpjXS2c7O7AFo_VqMVStutBB9d0mDzJ4Wme7FTi6-iJhWq5TpDjyEVjYyOECXZgS0ueHUIUr77JVLEQPYPjKlUMsHTnLkDJcbvfj7Dg7iF6rkffPal3c9abVPultwIErj9USNKPjthuhR1pQttUUT-n9jaFFY1WpPxx0oe1D8Nyh_iWNr8fx9Q
Text:
  Availability: 1
  Value: <anid>AN0157934505;acl01jul.22;2022Jul14.06:31;v2.2.500</anid> <title id="AN0157934505-1">Parent influence on concussion reporting in first-year collegiate athletes </title> <p>To assess the relationship between sport-parenting practices and concussion reporting intentions of collegiate athletes across two levels of competition. Entering first-year student-athletes (varsity and club) at a mid-sized university in the Southeast region of the United States (n = 327). Written surveys were completed prior to the start of the 2015 academic year. Structural equation modeling was used to test a model predicting concussion-reporting intentions. College athletes were more likely to intend to report a suspected concussion when they believed their parents wanted them to report (B=-0.88, SD = 0.94), and when they experienced less sport achievement pressure from their parents (B=-0.12, SD = 8.07). Parents influence the concussion safety of entering collegiate athletes at both the varsity and club level. Lower pressure sport parenting prior to college entry may help foster safer concussion reporting behaviors and may be an appropriate target for future intervention development work.</p> <p>Keywords: Concussion; concussion reporting; mild traumatic brain injury; sports parenting; student-athletes</p> <hd id="AN0157934505-2">Introduction</hd> <p>Participation in athletic activities is an integral part of the university experience for many U.S students, as evidenced by the approximately 9 million college students that participate in organized sports each year.[<reflink idref="bib1" id="ref1">1</reflink>],[<reflink idref="bib2" id="ref2">2</reflink>] The 460,000 college athletes who participate in intercollegiate sport administered by the National Collegiate Athletic Association (NCAA) comprise a well-studied minority of these students,[<reflink idref="bib2" id="ref3">2</reflink>] with the remaining 8.5 million playing for club and intramural teams.[<reflink idref="bib1" id="ref4">1</reflink>] While there are many documented health and psychosocial benefits of sport participation in adolescence and emerging adulthood,[<reflink idref="bib3" id="ref5">3</reflink>],[<reflink idref="bib4" id="ref6">4</reflink>] it also comes with risk of injury, with concussion an injury of particular concern in sports that involve contact and collision.[<reflink idref="bib5" id="ref7">5</reflink>] Competitive sports and recreational activities cause an estimated 1.6 to 3.8 million concussions per year in the United States.[<reflink idref="bib6" id="ref8">6</reflink>] College athletes at all levels of competition represent a noteworthy fraction of the population at risk for sport related concussion, based on the number of participants. Across 25 NCAA-sponsored sports, recent data suggests that an average of 4.5 concussions occur per 10,000 times an athlete is exposed to a game or practice.[<reflink idref="bib2" id="ref9">2</reflink>] While similar nationally representative data on concussion incidence across all collegiate club sports is lacking, a limited number of studies conducted in specific contact and collision club sports (football, rugby) finds concussion incidence rates that range between 10 and 38 per 10,000 exposures.[<reflink idref="bib7" id="ref10">7</reflink>],[<reflink idref="bib8" id="ref11">8</reflink>]</p> <p>Early identification and removal from play post-concussion is important for minimizing concussion-related harm. Continued play means that athletes who are experiencing a more serious brain injury (e.g., subdural hematoma) miss a critical window for early intervention.[<reflink idref="bib9" id="ref12">9</reflink>] In addition, post-concussion symptoms like confusion and lack of coordination can put athletes at a higher risk for sustaining musculoskeletal injuries if they continue to play.[<reflink idref="bib10" id="ref13">10</reflink>],[<reflink idref="bib11" id="ref14">11</reflink>] Players who stay in the game after sustaining a concussion take longer to recover than athletes who are removed and face greater risk for protracted recovery.[<reflink idref="bib12" id="ref15">12</reflink>],[<reflink idref="bib13" id="ref16">13</reflink>] Furthermore, concussion symptoms can interfere with academic studies and underreporting denies student athletes the opportunity to benefit from disability policies and graduated return-to-learn schedules post-injury.[<reflink idref="bib14" id="ref17">14</reflink>] Because many symptoms of concussion are not easily visible to external observers, athlete self-reporting (e.g., to medical personnel or coaches) of concussive symptoms is a critical precursor to early removal from gameplay.[<reflink idref="bib15" id="ref18">15</reflink>] However, estimates suggest that 12-43% of collegiate athletes have played through symptoms of a suspected concussion.[[<reflink idref="bib16" id="ref19">16</reflink>], [<reflink idref="bib18" id="ref20">18</reflink>]] Understanding the concussion reporting behavior of university students, especially the substantial majority who are not NCAA athletes, is a crucial step in developing effective intervention strategies.</p> <p>Prior research[<reflink idref="bib19" id="ref21">19</reflink>] has found that interpersonal pressures are among the most important correlates of intention to report a suspected concussion among NCAA athletes.[<reflink idref="bib16" id="ref22">16</reflink>],[[<reflink idref="bib20" id="ref23">20</reflink>], [<reflink idref="bib22" id="ref24">22</reflink>]] Specifically, players who feel pressure from multiple sources—including coaches, teammates and parents—are the most likely to intend to continue playing with symptoms of a suspected concussion.[<reflink idref="bib19" id="ref25">19</reflink>] A growing body of research has focused on understanding the pathways through which coaches and teammates influence the behavior of collegiate athletes, illuminating the importance of processes such as direct verbal communication[<reflink idref="bib19" id="ref26">19</reflink>] and misperceived group norms.[<reflink idref="bib20" id="ref27">20</reflink>],[<reflink idref="bib23" id="ref28">23</reflink>] However, there is as of yet a lack of theoretical understanding of how perceptions of parental pressure influence the reporting behavior of athletes at different levels of competition.</p> <p>Parents play an important role in developing children's attitudes about sport participation.[[<reflink idref="bib24" id="ref29">24</reflink>], [<reflink idref="bib26" id="ref30">26</reflink>]] Perceived parental support is associated with the amount of time spent by children in extracurricular activities and child enjoyment of sports, whereas parent pressure is negatively associated with child enjoyment of sport.[<reflink idref="bib24" id="ref31">24</reflink>] Some parent socialization approaches, including punitive behavior, controlling behavior, and high expectations for achievement, can contribute to child fear of failure in sport.[<reflink idref="bib27" id="ref32">27</reflink>] Such socialization occurs through both direct verbal communication and indirect development of emotions toward sport, shaping child cognitions about the expected consequences of participation and their overall affective experience. These processes may generalize to the ways in which parents influence attitudes about concussion reporting behavior. Prior research among youth soccer players found variability in whether or not parents talk to their child about concussion safety, with a decreased probability amongst parents who placed more pressure on their child related to sport achievement.[<reflink idref="bib28" id="ref33">28</reflink>]</p> <p>In conjunction with this variability in direct parent communication about concussion safety, an athlete's goal orientation may potentially function as a mediator of the association between pressure from parents and concussion reporting behavior. Goal orientation is a motivational model that categorizes individuals as task or ego oriented based on their beliefs about success.[<reflink idref="bib29" id="ref34">29</reflink>] Task oriented individuals place a higher value on the experience of learning and personal improvement whereas ego oriented individuals prioritize tangible outcomes such as winning and demonstrating superior ability. Ego orientation is positively associated with status and recognition-related motives for sport participation whereas task orientation is positively associated with skill development motives.[<reflink idref="bib30" id="ref35">30</reflink>] Goal orientation may be shaped by external pressures, and particularly by parent pressures.[<reflink idref="bib31" id="ref36">31</reflink>],[<reflink idref="bib32" id="ref37">32</reflink>] In sport settings, parents may transmit their goal orientation directly, through modeling or verbal instruction, and indirectly, through the reinforcement they provide for different sport-related behaviors or outcomes. An athlete's ego-orientation may be both the result of, and reinforced by, positive feedback from parents for tangible athletic achievements. Critically, an individual's goal orientation may influence the extent to which they value different potential outcomes of concussion reporting or continued play while symptomatic. The outcome-focused mindset of ego-oriented individuals may heighten the subjective value of measurable and public elements of sport success like playing time and roster spot—both of which might be jeopardized by taking time away from their sport to recover from a concussion. Ego oriented players may thus have more negative concussion reporting related expectancies than task oriented players. However, there is as-yet no empirical data about whether parental pressure related to sport influences ego orientation, and whether increased parental pressure predicts differences in concussion reporting behavior.</p> <p>At the college level, a key determinant of parent sport pressure may be the athlete's level of competition (e.g., club vs. NCAA).[<reflink idref="bib35" id="ref38">35</reflink>],[<reflink idref="bib36" id="ref39">36</reflink>] Talented youth athletes who go on to high levels of sport success often have substantial parental involvement.[<reflink idref="bib35" id="ref40">35</reflink>] Structural factors like scholarship status and roster position have the potential to influence the reinforcement that athletes experience from their parents for different sport-related outcomes. This may contribute to differences in goal orientation by level of competition. Beyond parenting, it is possible that the differing contextual pressures, goals, and support structures of club and varsity athletes may also shape the extent to which goal orientation is associated with concussion reporting behavior. Varsity players spend significantly more time training and competing than do club athletes, so the potential losses associated with concussion reporting may be appraised differently and may feel more salient as compared to club sport athletes. More broadly, club and NCAA athletes are provided with drastically different health and safety resources that may contribute to differences in continued play while symptomatic post-concussion. For example, not only do NCAA teams receive school funding, but they also benefit from NCAA policy related to concussion education. Current best practice guidance by the NCAA includes annual education of athletes and coaches about concussion.[<reflink idref="bib36" id="ref41">36</reflink>] Although specific institutions may provide education to club athletes, there is no similar governing body that sets policy related to athlete health and safety at a national level for club athletes. NCAA athletes may also benefit from the support of athletic medicine staff who can assist in identifying potentially symptomatic athletes for removal from play for medical evaluation.[<reflink idref="bib37" id="ref42">37</reflink>] In contrast, club teams are typically self-funded and may also be player coached, meaning there are likely fewer trained individuals on the sidelines who could help identify possible concussions that require further medical evaluation.[<reflink idref="bib38" id="ref43">38</reflink>] However, it is also possible that the lower stakes club environment is beneficial. Club athletes tend to practice and play less than their NCAA counterparts, so their overall exposure to concussion risk is lower. Additionally, it is possible that club athletes experience fewer external pressures to underreport concussion symptoms in order to continue playing given the lower rewards associated with athletic achievement in their setting.</p> <p>The goal of the present study was to compare concussion-reporting intentions of first year club sport athletes and NCAA athletes, assessing whether differences were explained by differences in two parental factors (parental pressure related to sport achievement and perceived parent beliefs about concussion reporting). First year college students are an important population in which to study parent pressure it may be of heightened salience given their recent time living at home. Stratification by level of competition was motivated by the relative lack of extant research regarding concussion reporting in club athletes, and the theorized pathways through which parent pressure might be different by level of competition. Secondarily, we assessed whether athlete goal orientation and expectancies about the athletic achievement-related outcomes of concussion reporting mediated the association between parent factors and concussion reporting intentions (see Figure 1). We hypothesized that among club sport athletes parental pressure would be lower, perceived parental beliefs more supportive of reporting, and that ego orientation and athletic expectancies of reporting would be less strong as compared to varsity sport athletes. We expected that the relationships between these variables would be stronger among varsity athletes as compared to club athletes. The results of this study can inform our thinking about whether parents are an appropriate target for concussion reporting interventions at the college level, and whether there are salient differences between club and varsity sport athletes that can inform tailored approaches to parent-focused intervention.</p> <p>Graph: Figure 1. Final model (Model 3) explaining pathways influencing concussion reporting intention among first-year collegiate athletes. Note: structural coefficients constrained.</p> <hd id="AN0157934505-3">Method</hd> <p></p> <hd id="AN0157934505-4">Participants</hd> <p>Participants were entering first year varsity and club student-athletes at a mid-sized university located in the Southeast region of the United States. At the time of their pre-season compliance and medical clearance activities, participants were provided information about the study invited to participate on a voluntary basis. A total of 327 athletes consented to participate (98% participation rate).</p> <hd id="AN0157934505-5">Measures</hd> <p>When available, instruments with prior evidence of reliability and validity in similar populations were used. For instruments with more than one item that measured a latent construct, internal consistency reliability was assessed via Cronbach's alpha using Stata.. Certain variables of interest required adaption of existing instruments. Two of these were measured via a single item drawn from source literature ("Perceived parental beliefs...", "Motivation to comply..."). Another two were measured using an adapted selection of items from source literature ("Concussion reporting intention" and "Behavioral beliefs..."). In these cases, exploratory factor analysis was performed in Stata to verify item appropriateness and establish a final item set.</p> <hd id="AN0157934505-6">Demographic characteristics</hd> <p>Participants indicated their sex, year in school, level of competition, and primary sport.</p> <hd id="AN0157934505-7">Concussion reporting intention</hd> <p>Participants indicated their expected likelihood of continuing play or disclosing their symptoms in four potentially challenging situations. Scenarios drawn from Rosenbaum & Arnett's Concussion Attitude Index,[<reflink idref="bib39" id="ref44">39</reflink>] and an example scenario was "Athlete H suffered a concussion and has a game later in the day. He is still experiencing symptoms of concussion. However, Athlete H knows that if he tells his coach about the symptoms, his coach will keep him out of the game." Participants indicated how likely they would be to engage in the reporting behavior described, with responses elicited on a seven-point Likert scale ranging from "strongly disagree" (<reflink idref="bib1" id="ref45">1</reflink>) to "strongly agree" (<reflink idref="bib7" id="ref46">7</reflink>). Scores on two negatively worded questions were reversed and the total of all four questions was summed to create score from 4-28, where higher scores indicate stronger intent to report a suspected concussion. Exploratory factor analysis was conducted and all items loaded strongly onto a single construct (factors loadings >0.56; Eigenvalues = 1.81, 0.10, −0.08, −0.23; Chi-square p < 0.001). Internal consistency in the present sample was adequate (Cronbach's alpha = 0.77).</p> <hd id="AN0157934505-8">Perceived parental beliefs about concussion reporting</hd> <p>Participants indicated what they thought their parents would want them to do when it comes to concussion reporting, using Register-Mihalik's[<reflink idref="bib20" id="ref47">20</reflink>] single normative beliefs component of the indirect subjective norms related to concussion reporting scale. The item read: "My parents think I...," which was scored on a 7-point Likert scale ranging from "Should report" (<reflink idref="bib1" id="ref48">1</reflink>) to "Should not report" (<reflink idref="bib7" id="ref49">7</reflink>).</p> <hd id="AN0157934505-9">Motivation to comply with referent</hd> <p>Participants indicated their motivation to comply with parent beliefs using Register-Mihalik's[<reflink idref="bib20" id="ref50">20</reflink>] single motivation to comply component of the indirect subjective norms. The item read: parents: "How much do you care what your parents think?" which was scored on a 7-point Likert scale ranging from "Not at all" (<reflink idref="bib1" id="ref51">1</reflink>) to "Very much" (<reflink idref="bib7" id="ref52">7</reflink>).</p> <hd id="AN0157934505-10">Behavioral beliefs about concussion reporting</hd> <p>Participants completed a four-item adaption of Register-Mihalik's[<reflink idref="bib20" id="ref53">20</reflink>] behavioral beliefs component of indirect attitudes. The items included were those that pertained specifically to potential short-term athletic expectancies of seeking care for a suspected concussion. Responses were scored on a seven-point Likert scale ranging from "strongly disagree" (<reflink idref="bib1" id="ref54">1</reflink>) to "strongly agree" (<reflink idref="bib7" id="ref55">7</reflink>). Five items related to sport performance expectancies were initially selected based on theorized conceptual relevance; however one item ("Reporting will improve my athletic performance") was removed due to poor factor loading (-0.27), potentially attributable to the ambiguous timeframe to which the item refers. The remaining four items ("Reporting will cause me to lose my position on the team," "Reporting will cause me to lose playing time," "Reporting will cause me to miss out on team activities," and "Reporting will let my teammates down") were summed to create a score from 4-28. Exploratory factor analysis was conducted and the final four items loaded strongly onto a single construct (factors loadings >0.63; Eigenvalues = 1.71, −0.03, −0.05, −0.23; Chi-square p < 0.001). Internal consistency in the present sample was adequate (Cronbach's alpha = 0.77).</p> <hd id="AN0157934505-11">Outcome evaluations about concussion reporting</hd> <p>How participants feel about the expected athletic outcomes of concussion reporting was assessed using Register-Mihalik's[<reflink idref="bib20" id="ref56">20</reflink>] model for assessing the outcome evaluation component of the indirect attitudes. For each of the items included in the behavioral beliefs about concussion reporting scale (e.g., "Losing playing time is ..."), participants indicated their evaluation of that potential outcome. Responses were scored on a seven-point Likert scale ranging from "Extremely good" (<reflink idref="bib1" id="ref57">1</reflink>) to "Extremely bad" (<reflink idref="bib7" id="ref58">7</reflink>) and summed to create a score from 4-28, where higher scores indicate a more negative evaluation of the expected outcomes of concussion reporting. Internal consistency was very good (Cronbach's alpha = 0.83).</p> <hd id="AN0157934505-12">Ego orientation</hd> <p>Ego orientation was assessed using items related to ego orientation behaviors from the Task and Ego Orientation in Sport Questionnaire.[<reflink idref="bib40" id="ref59">40</reflink>],[<reflink idref="bib41" id="ref60">41</reflink>] Participants responded to the following prompt: "I feel really successful at my sport when..." by indicating their level of agreement in eight sport achievement scenarios. An example item was "I'm the only one who can do the skill." Responses to each item were elicited on a five-point Likert scale and summed to create a score from 8-40, where higher scores indicate stronger ego orientation. Internal consistency in the present sample was adequate (Cronbach's alpha = 0.95).</p> <hd id="AN0157934505-13">Parent sport pressure</hd> <p>Participant experiences of parental pressure related to sport participation were measured using Babkes and Weiss's[<reflink idref="bib42" id="ref61">42</reflink>] sport adaptation of Yoon's[<reflink idref="bib43" id="ref62">43</reflink>] parental pressure scale. Participants indicated how frequently seven statements about parental pressure related to sport participation were true for them. An example item was "My parents get upset with me when I don't do well at sports." Item responses were elicited on a seven-point Likert scale ranging from "Almost never" (<reflink idref="bib1" id="ref63">1</reflink>) to "All of the time" (<reflink idref="bib7" id="ref64">7</reflink>), and summed to create a score from 7-49 where higher scores indicate greater experiences of parental pressure. Internal consistency in the present sample was adequate (Cronbach's alpha = 0.88).</p> <hd id="AN0157934505-14">Analysis</hd> <p>Descriptive statistics are reported for all measured variables for the sample as a whole and separately by level of competition (club, varsity). Pairwise correlations between all variables to be included in the baseline structural equation model variables were calculated, with Bonferroni adjustments for multiple comparisons (p-value set to 0.05). The significant differences between club and varsity athletes indicated that a multi-group model could be appropriate. Structural equation modeling was used to assess the theorized associations between parent pressure, ego orientation, perceived parental beliefs, personal significance of parental opinion, concussion reporting expectancy beliefs, personal significance of reporting expectancies, and reporting intention (see Figure 1). Little's MCAR was not significant (0.96), so missing data was assumed completely at random and maximum likelihood estimation including missing values was utilized.[<reflink idref="bib44" id="ref65">44</reflink>] A series of three models were tested, with fit statistics and a chi-square difference tests used to select the model that best fit the data. To determine close model fit the following thresholds were used: CFI >0.95, TLI >0.95, RMSEA <0.06 and chi2 p value >0.05.[<reflink idref="bib45" id="ref66">45</reflink>] The baseline model was first estimated for the sample as a whole. The second model was estimated for two groups (club athletes, varsity athletes). Group invariance was assessed, and this indicated the appropriateness of estimating a third model with controlled variance of structural parameters across groups. Direct, indirect, and total effects are reported for this final model.</p> <hd id="AN0157934505-15">Results</hd> <p>Approximately one-third of the participants were competing at the varsity level (n = 102, 31%), with the rest competing at the club level (n = 225, 69%). Participants were predominantly Caucasian (84%), and were evenly distributed between males (n = 167, 51%) and females (n = 160, 49%). Additional descriptive statistics for the sample are presented in Table 1.</p> <p>Table 1. Descriptive Statistics.</p> <p> <ephtml> <table><thead><tr><td /><td>Club (n = 225)</td><td>Varsity (n = 102)</td><td>Total</td><td>p</td><td>Cohen's <italic>d</italic></td></tr></thead><tbody valign="top"><tr><td>Gender</td><td /><td /><td /><td char="." /><td char="." /></tr><tr><td><italic>Male</italic></td><td>47.55%</td><td>58.82%</td><td>51.07%</td><td char="." /><td char="." /></tr><tr><td><italic>Female</italic></td><td>52.44%</td><td>41.11%</td><td>48.92%</td><td char="." /><td char="." /></tr><tr><td>Ethnicity</td><td /><td /><td /><td char="." /><td char="." /></tr><tr><td><italic>White or Caucasian</italic></td><td>87.11%</td><td>77.22%</td><td>84.04%</td><td char="." /><td char="." /></tr><tr><td><italic>Black or African American</italic></td><td>1.33%</td><td>14.85%</td><td>5.52%</td><td char="." /><td char="." /></tr><tr><td><italic>Hispanic/Latino</italic></td><td>5.33%</td><td>5.94%</td><td>5.52%</td><td char="." /><td char="." /></tr><tr><td><italic>Asian</italic></td><td>2.22%</td><td>0.99%</td><td>1.84%</td><td char="." /><td char="." /></tr><tr><td><italic>Native Hawaiian or Pacific Islander</italic></td><td>0.88%</td><td>0%</td><td>0.61%</td><td char="." /><td char="." /></tr><tr><td><italic>American Indian or Alaska Native</italic></td><td>0%</td><td>0.99%</td><td>0.30%</td><td char="." /><td char="." /></tr><tr><td><italic>Other</italic></td><td>0.44%</td><td>0%</td><td>0.30%</td><td char="." /><td char="." /></tr><tr><td><italic>Multiple</italic></td><td>2.26%</td><td>0%</td><td>1.84%</td><td char="." /><td char="." /></tr><tr><td>Ego orientation</td><td>27.41 (0.60)</td><td>30.11 (0.90)</td><td>28.28 (0.50)</td><td char=".">0.028</td><td char=".">−0.26</td></tr><tr><td>Parent sport pressure</td><td>12.93 (0.51)</td><td>15.86 (0.92)</td><td>13.88 (0.46)</td><td char=".">0.002</td><td char=".">−0.37</td></tr><tr><td>Behavioral beliefs about concussion reporting</td><td>15.62 (0.39)</td><td>15.73 (0.62)</td><td>15.66 (0.33)</td><td char=".">0.892</td><td char=".">−0.01</td></tr><tr><td>Outcome evaluations about concussion reporting</td><td>22.56 (0.31)</td><td>24.91 (0.38)</td><td>23.33 (0.25)</td><td char="."><0.001</td><td char=".">−0.56</td></tr><tr><td>Perceived parental beliefs about concussion reporting</td><td>1.20 (0.06)</td><td>1.32 (0.11)</td><td>1.24 (0.05)</td><td char=".">0.374</td><td char=".">−0.10</td></tr><tr><td>Motivation to comply with referent</td><td>6.19 (0.09)</td><td>6.61 (0.09)</td><td>6.32 (0.07)</td><td char=".">0.003</td><td char=".">−0.36</td></tr><tr><td>Concussion reporting intention</td><td>25.21 (0.51)</td><td>24.67 (0.37)</td><td>25.03 (0.20)</td><td char=".">0.267</td><td char=".">0.13</td></tr></tbody></table> </ephtml> </p> <p>Concussion reporting intention was lower among males (r = 0.23, p < 0.001), athletes with a stronger ego orientation (r=-0.22, p = 0.001), and athletes who perceived less safe parental concussion reporting attitudes (r=-0.28, p < 0.001). Athletes with a stronger ego orientation were more likely to be male (r=-0.39, p < 0.001) and to perceive higher levels of parental pressure related to sport participation (r = 0.25, p < 0.001). The only significant difference between varsity and club responses was in evaluations of the expected outcomes of concussion reporting, with varsity athletes believing the athletic outcomes of reporting would be more negative than club athletes (r = 0.25, p < 0.001). However, due to relatively small effect sizes, the clinical significance of these group differences may be limited. All correlations are reported in Table 2.</p> <p>Table 2. Pairwise correlations between model variables.</p> <p> <ephtml> <table><thead><tr><td>Variable</td><td char=".">1</td><td char=".">2</td><td char=".">3</td><td char=".">4</td><td char=".">5</td><td char=".">6</td><td char=".">7</td><td char=".">8</td><td char=".">9</td></tr></thead><tbody valign="top"><tr><td>1. Gender (female)</td><td>–</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td>2. Level (varsity)</td><td char=".">−0.10</td><td>–</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td>3. Ego orientation</td><td char=".">−0.39***</td><td char=".">0.12</td><td>–</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td>4. Parent sport pressure</td><td char=".">0.18<xref ref-type="table-fn" rid="tfn1">*</xref></td><td char=".">0.17</td><td char=".">0.25***</td><td>–</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td>5. Behavioral beliefs about concussion reporting</td><td char=".">−0.24***</td><td char=".">−0.00</td><td char=".">0.24***</td><td char=".">0.29***</td><td>–</td><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td>6. Outcome evaluations about concussion reporting</td><td char=".">−0.13</td><td char=".">0.25***</td><td char=".">0.23***</td><td char=".">0.04</td><td char=".">0.03</td><td>–</td><td char="." /><td char="." /><td char="." /></tr><tr><td>7. Perceived parental beliefs about concussion reporting</td><td char=".">−0.12</td><td char=".">0.04</td><td char=".">0.05</td><td char=".">0.03</td><td char=".">0.09</td><td char=".">−0.13</td><td>–</td><td char="." /><td char="." /></tr><tr><td>8. Motivation to comply with referent</td><td char=".">0.07</td><td char=".">0.16</td><td char=".">−0.03</td><td char=".">−0.01</td><td char=".">0.02</td><td char=".">0.00</td><td char=".">−0.04</td><td>–</td><td char="." /></tr><tr><td>9. Concussion reporting intention</td><td char=".">0.23***</td><td char=".">−0.06</td><td char=".">−0.22**</td><td char=".">−0.28***</td><td char=".">−0.33***</td><td char=".">0.51</td><td char=".">−0.28***</td><td char=".">−0.08</td><td>–</td></tr></tbody></table> </ephtml> </p> <p>1 *<emph>p</emph> < 0.05, **<emph>p</emph> < 0.01, ***<emph>p</emph> < 0.001</p> <p>Structural equation models were used to identify direct and indirect effects on concussion reporting intention. Fit statistics for all models tested are presented in Table 3, with comparisons of fit made between nested models. We first estimated a single group model inclusive of both varsity and club athletes) (Model 1). Next, a multi-group model was estimated, with structural parameters and means allowed to vary by level of competition (varsity, club) (Model 2). This unconstrained multi-group model was a worse fit for the data than the single group model, explaining 3% of the variance in concussion reporting intentions (coefficient for determination = 0.03). In the multi-group model (Model 2), joint testing for variance of parameters by level of competition indicated that means (p < 0.001) but not structural coefficients were not significantly different by group (p = 0.710). Thus, a third model was estimated where structural parameters were held constant between groups but means were allowed to vary. Chi-square difference testing showed that while Model 1 was a better fit for the data than Model 2 (p = 0.038), neither Model 1 nor Model 2 fit significantly better fit than Model 3. Therefore Model 3 was selected as the final model. This final model explained around 15.6% of the variance in concussion reporting intentions (coefficient for determination = 0.156). Figure 1 depicts this final model, reporting direct associations between variables. Direct, indirect, and total effects are reported in Table 4. Parent sport pressure was associated with concussion reporting intentions both directly (B=-0.07), and indirectly (B=-0.04). The indirect path between parental pressure and intentions included significant direct effects between parent pressure and ego orientation and outcome beliefs about concussion reporting (B = 0.18), and between ego orientation and outcome beliefs and concussion reporting intentions. The largest standardized association in the model was the direct pathway between perceived parental beliefs about concussion reporting and intent to report concussion (B = 0.88). See Table 4 for all associations.</p> <p>Table 3. Goodness of fit statistics.</p> <p> <ephtml> <table><thead><tr><td>Model</td><td>Degrees of Freedom</td><td>x<sup>2</sup></td><td><italic>P</italic> Value</td><td>Comparative Fit Index</td><td>Tucker-Lewis Index</td><td>Root Mean Square of Error Approximation</td><td>Difference Test</td><td><italic>P</italic> Value</td></tr></thead><tbody valign="top"><tr><td>3</td><td char=".">28</td><td char=".">37.18</td><td char=".">0.1148</td><td char=".">0.94</td><td char=".">0.915</td><td char=".">0.045</td><td>–</td><td>–</td></tr><tr><td>2</td><td char=".">16</td><td char=".">28.19</td><td char=".">0.03</td><td char=".">0.921</td><td char=".">0.802</td><td char=".">0.069</td><td char=".">0.703<xref ref-type="table-fn" rid="tfn2">*</xref></td><td>–</td></tr><tr><td>1</td><td char=".">8</td><td char=".">11.89</td><td char=".">0.1563</td><td char=".">0.975</td><td char=".">0.938</td><td char=".">0.039</td><td char=".">0.038**</td><td char=".">0.190***</td></tr></tbody></table> </ephtml> </p> <p>2 *<emph>model 2 vs model 3,</emph> **<emph>model 1 vs model 2,</emph> ***<emph>model 1 vs model 3</emph></p> <p>Table 4. Model 3 direct, indirect, and total effects.</p> <p> <ephtml> <table><thead><tr><td><italic>Causal variable</italic></td><td><italic>Endogenous variables</italic></td></tr><tr><td /><td>Concussion reporting intention</td><td>Perceived parental beliefs about concussion reporting</td><td>Behavioral beliefs about concussion reporting</td><td>Outcome evaluations about concussion reporting</td><td>Ego orientation</td></tr><tr><td>Unst.</td><td>SE</td><td>St.</td><td>Unst.</td><td>SE</td><td>St.</td><td>Unst.</td><td>SE</td><td>St.</td><td>Unst.</td><td>SE</td><td>St.</td><td>Unst.</td><td>SE</td><td>St.</td></tr></thead><tbody valign="top"><tr><td>Perceived parental beliefs about concussion reporting</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td> Direct effect</td><td>−0.88</td><td char=".">0.19</td><td char=".">−0.21***</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.25***</td></tr><tr><td> Indirect effect</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td> Total effect</td><td>−0.88</td><td char=".">0.19</td><td char=".">−0.21***</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.25***</td></tr><tr><td>Motivation to comply with referent</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td> Direct effect</td><td char=".">0.24</td><td char=".">0.14</td><td char=".">0.09</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">0.06</td></tr><tr><td> Indirect effect</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td>Total effect</td><td char=".">0.24</td><td char=".">0.14</td><td char=".">0.09</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">0.06</td></tr><tr><td>Behavioral beliefs about concussion reporting</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td> Direct effect</td><td>−0.14</td><td char=".">0.03</td><td char=".">−0.24***</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.23***</td></tr><tr><td> Indirect effect</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td>Total effect</td><td>−0.14</td><td char=".">0.03</td><td char=".">−0.24***</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.23***</td></tr><tr><td>Outcome evaluations about concussion reporting</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td>Direct effect</td><td char=".">0.06</td><td char=".">0.04</td><td char=".">0.07</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">0.06</td></tr><tr><td> Indirect effect</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td>Total effect</td><td char=".">0.06</td><td char=".">0.04</td><td char=".">0.07</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">0.06</td></tr><tr><td>Ego orientation</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td> Direct effect</td><td>−0.05</td><td char=".">0.02</td><td char=".">−0.12<xref ref-type="table-fn" rid="tfn3">*</xref></td><td>–</td><td>–</td><td>–</td><td char=".">0.12</td><td char=".">0.03</td><td char=".">0.18**</td><td char=".">0.10</td><td char=".">0.03</td><td char=".">0.20***</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.12<xref ref-type="table-fn" rid="tfn3">*</xref></td><td char=".">0.18**</td><td char=".">0.25***</td></tr><tr><td> Indirect effect</td><td>−0.01</td><td char="."><0.01</td><td char=".">−0.02</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.02</td></tr><tr><td>Total effect</td><td>−0.06</td><td char=".">0.02</td><td char=".">−0.15**</td><td>–</td><td>–</td><td>–</td><td char=".">0.12</td><td char=".">0.03</td><td char=".">0.18**</td><td char=".">0.10</td><td char=".">0.03</td><td char=".">0.20***</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">−0.15**</td><td char=".">0.18**</td><td char=".">0.25***</td></tr><tr><td>Parent sport pressure</td><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /><td char="." /></tr><tr><td> Direct effect</td><td>−0.07</td><td char=".">0.02</td><td char=".">−0.15**</td><td char="."><0.01</td><td char="."><0.01</td><td char=".">0.03</td><td char=".">0.18</td><td char=".">0.03</td><td char=".">0.23***</td><td>−0.01</td><td char=".">0.03</td><td char=".">−0.02</td><td char=".">0.25</td><td char=".">0.05</td><td char=".">0.21***</td></tr><tr><td char=".">−0.18**</td><td char=".">0.03</td><td char=".">0.28***</td><td char=".">0.14</td><td char=".">0.26***</td></tr><tr><td> Indirect effect</td><td>−0.04</td><td char="."><0.01</td><td>−0.11*** −0.12***</td><td>–</td><td>–</td><td>–</td><td char=".">0.03</td><td char=".">0.01</td><td char=".">0.03**</td><td char=".">0.02</td><td char="."><0.01</td><td char=".">0.04**</td><td>–</td><td>–</td><td>–</td></tr><tr><td char=".">0.04**</td><td char=".">0.06**</td></tr><tr><td>Total effect</td><td>−0.12</td><td char=".">0.02</td><td>−0.25*** −0.30***</td><td char="."><0.01</td><td char="."><0.01</td><td char=".">0.03</td><td char=".">0.21</td><td char=".">0.03</td><td char=".">0.27***</td><td char="."><0.01</td><td char=".">0.03</td><td char=".">0.01</td><td char=".">0.25</td><td char=".">0.05</td><td char=".">0.21***</td></tr><tr><td char=".">0.03</td><td char=".">0.33***</td><td char=".">0.02</td><td char=".">0.26***</td></tr></tbody></table> </ephtml> </p> <p>3 *p < 0.05, **p < 0.01, ***p < 0.001</p> <hd id="AN0157934505-16">Discussion</hd> <p>Despite recent sport policy changes and educational mandates, unreported concussions remain a significant health concern at all levels of athletic competition. The present study found similar intentions about concussion reporting among varsity athletes and club athletes. The number of club athletes in the US, their risk of concussion, and the lack of standardized approach to concussion education and management in this population suggests they are an important target for both research and intervention to improve concussion safety. Although concussion reporting intentions were not significantly different between varsity and club athletes, factors influencing their reporting intentions were different, suggesting the potential utility of level-tailored approaches to intervention.</p> <p>The significant direct and indirect associations between parent sport pressure and concussion reporting intentions provide a more nuanced understanding of how parents may influence their athletes' decision to report a concussion. Parent involvement is often a critical factor in childhood sport participation, with the potential to create a complex relationship between parents and athletes. Parents of children in competitive leagues often sacrifice much of their free time and discretionary income, and may construe this resource allocation as an investment in their children's future.[<reflink idref="bib46" id="ref67">46</reflink>] The payoff of such investments—namely college scholarships—relies on visible child sport achievement. Children may interpret parent allocation of time and resources to sport as pressure related to achievement, even if this pressure is never communicated verbally. Relatedly, the emotionally charged environment surrounding sports can lead parents to behave in ways that may not reflect what they would describe, in less physiologically aroused moments, as their values about their child's sport participation. Such verbal and non-verbal sideline behavior may in part be a product of parent difficulty disentangling personal athletic identity and goals from concrete child sport achievement.[<reflink idref="bib47" id="ref68">47</reflink>]</p> <p>Athletes who experienced more parent pressure had a stronger ego orientation, with this pathway explaining part of the relationship between parent sport pressure and concussion reporting. Greater parent pressure was also associated with more negative evaluation of the sport consequences of concussion reporting, and these associations were present among both club and varsity athletes. Parents who put pressure on their athletes to succeed may be focusing on the tangible elements of sport success: winning games, scoring goals, and receiving playing time. Consistent with models suggesting ego orientation is shaped indirectly via parental reinforcement of achievement behaviors,[<reflink idref="bib32" id="ref69">32</reflink>] children who receive parental approval for meeting conventional measures of success in sport may be receiving positive reinforcement for ego orientation. An alternative sport parenting strategy would be to reinforce effort, which prior research suggests children prefer.[<reflink idref="bib48" id="ref70">48</reflink>]</p> <p>Compared to club athletes, varsity athletes were significantly more ego-oriented and felt significantly more parent sport pressure. It is possible that this difference in pressure is a function of differences in the types of interactions that club and varsity athletes anticipate having in college with their parents (e.g., potentially greater planned attendance at games or conversation about sport outcomes among parents of varsity athletes). It could also reflect differences in pressure over the course of their athletic career (e.g., greater parental engagement in sport or reinforcement for outcomes during pre-college years).[<reflink idref="bib49" id="ref71">49</reflink>] Differences in ego orientation by level of competition may also be a product of other influences, such as exposure to higher pressure coaching during pre-college years (e.g. varsity vs. junior varsity), or perceived expectations from recruitment contact with college coaches. Prior research among families of interscholastic, recreational, and club athletes aged 11-13 finds that a coach created ego-oriented motivational climate is associated with greater parental pressure relative to child sport achievement, with coaching and parenting behaviors both contributing to the child's experience of pressure.[<reflink idref="bib50" id="ref72">50</reflink>] Differences in ego orientation by level of competition could also be a product of external pressures to achieve (e.g., to maintain scholarships), or self-selection of athletes more focused on achievement into varsity sport. Given the negative correlation of ego orientation on concussion reporting intention, it may be an appropriate target for future intervention—with parents potential partners in such efforts. Targeting ego-orientation would theoretically have benefits more diffuse than just concussion safety as there are numerous other negative correlates of ego orientation, such as burnout, anxiety, unsportsmanlike conduct, antisocial behavior.[<reflink idref="bib30" id="ref73">30</reflink>],[<reflink idref="bib35" id="ref74">35</reflink>]</p> <p>Taken together, these results suggest the potential importance of engaging parents of collegiate athletes at all levels of competition in concussion reporting supportive interventions. Research suggests that parent concussion knowledge is sub-optimal in many sport communities.[[<reflink idref="bib51" id="ref75">51</reflink>], [<reflink idref="bib53" id="ref76">53</reflink>]] Most college students communicate with their parents at least several days a week, which creates ample opportunity for parent-child dialogue relating to safe concussion attitudes and general support of athletic pursuits.[<reflink idref="bib23" id="ref77">23</reflink>] At present, the NCAA provides educational materials about concussion to athletes and coaches, however their recent consensus document suggests that institutions should ensure that educational materials about concussion are made available to a broader subset of stakeholders, including parents.[<reflink idref="bib54" id="ref78">54</reflink>] There is thus need to understand what information parents of college students require to address knowledge deficits about concussion, and to support their motivation and ability to talk their child about concussion safety. However, given the role that parents play in socializing attitudes about sport participation pre-college, interventions may also be appropriately initiated during youth sports. Youth athletic clubs and leagues are promising platforms for providing both general concussion information and programs designed to support parents in healthy sport parenting, seemingly discrete educational targets that the present results suggest may be closely linked. [<reflink idref="bib55" id="ref79">55</reflink>] Some group level interventions focused on spectator behavior among parents of youth athletes, such as "Silent Sundays," can help parents behave in the manner preferred by their children.[<reflink idref="bib48" id="ref80">48</reflink>] Such interventions would likely be difficult to implement in collegiate athletics settings. More research is needed to determine the specific pathways (e.g. spectator behavior, conversations post-game, resource allocation to sport) through which athletes internalize parent pressure related to sport participation, and through which parents decide how to act. This can help ensure that appropriate parent behaviors and cognitions are targeted in interventions.</p> <hd id="AN0157934505-17">Limitations</hd> <p>The primary limitation of the present paper is the cross-sectional nature of the data, meaning that we cannot determine the direction of the correlations presented in this paper. Accordingly, variables were treated as observed, and therefore apparent associations may be diminished due to inherent instrument measurement error. Moreover, surveys were only completed by athletes, meaning that responses about parents must be interpreted as athlete experiences of parent pressure rather than an objective assessment of parenting behaviors. Further research is needed to understand what parents are saying and doing when it comes to concussion safety, and how this being interpreted by athletes. Additionally, participants in the study were all first-year students at a single US college, with relatively homogenous racial characteristics, meaning that the results may not be generalizable to collegiate athletes more broadly or to athletes at other ages. Importantly, because data were collected at the start of the academic year, participants had limited exposure to their new coaches and teammates. It is possible that this biased differences in concussion reporting intentions by level of competition toward the null. Additionally, we do not have information about participants' family structure and socioeconomic status (SES). Future research is needed to understand how the pathways elucidated in the present study vary in different types of families.</p> <hd id="AN0157934505-18">Conclusions</hd> <p>The present findings suggest that reducing pressure from parents related to sport achievement may increase athlete willingness to report concussion symptoms. Moreover, goal orientation is an important mediator in the relationship between parent pressure and concussion reporting intention. Building on these results, there is a need for parent-focused interventions that aim to shape a healthy motivational climate for sport participation at all levels of competition. Such interventions should theoretically benefit concussion-reporting behavior, in addition to fostering a more positive sport experience.</p> <hd id="AN0157934505-19">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States and received approval from the Institutional Review Board of Elon University.</p> <hd id="AN0157934505-20">Appendix 1. Selected items for modified instruments</hd> <p></p> <hd id="AN0157934505-21">Concussion reporting intention</hd> <p>The following items and scenarios selected from Rosenbaum & Arnett's Concussion Attitude Index:[<reflink idref="bib39" id="ref81">39</reflink>]</p> <p>Please read each of the following scenarios and rate how strongly you agree or disagree with the statements that follow.</p> <p> <emph>Scenario 1</emph> Player R suffers a concussion during a game. Coach A decides to keep Player R out of the game. Player R's team loses the game.</p> <p></p> <ulist> <item> I feel that Coach A made the right decision to keep Player R out of the game</item> </ulist> <p> <emph>Scenario 2</emph> Athlete M suffered a concussion during the first game of the season. Athlete O suffered a concussion of the same severity during the semifinal playoff game. Both athletes had persisting symptoms.</p> <p></p> <ulist> <item> I feel that Athlete M should have returned to play during the first game of the season</item> <p></p> <item> I feel that Athlete O should have returned to play during the semifinal playoff game</item> </ulist> <p> <emph>Scenario 3</emph> Athlete H suffered a concussion and has a game later in the day. He is still experiencing symptoms of concussion. However, Athlete H knows that if he tells his coach about the symptoms, his coach will keep him out of the game.</p> <p></p> <ulist> <item> I feel that Athlete H should tell his coach about the symptoms</item> </ulist> <hd id="AN0157934505-22">Behavioral beliefs about concussion reporting</hd> <p>The following items were selected from Register-Mihalik's[<reflink idref="bib20" id="ref82">20</reflink>] behavioral beliefs component of indirect attitudes related to concussion reporting scale:</p> <p>Please answer the following questions related to participation in sports at your college and your feelings about reporting of concussion, should you experience one.</p> <p></p> <ulist> <item> Reporting will cause me to lose my position on the team</item> <p></p> <item> Reporting will cause me to lose playing time</item> <p></p> <item> Reporting will cause me to miss out on team activities</item> </ulist> <p>Reporting will let my teammates down</p> <ref id="AN0157934505-23"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Brown ML. Describing the Prevalence and Awareness of Sport-Related Concussion in University Intramural and Club Sport Participants. Health, Human Performance and Recreation. 2015;</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> Zuckerman SL, Kerr ZY, Yengo-Kahn A, Wasserman E, Covassin T, Solomon GS. Epidemiology of sports-related concussion in NCAA athletes from 2009-2010 to 2013-2014: incidence, recurrence, and mechanisms. Am J Sports Med. 2015; 43 (11): 2654 – 2662. doi: 10.1177/0363546515599634.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref5" type="bt">3</bibl> <bibtext> Eime RM, Young JA, Harvey JT, Charitie MJ, Payne WR. A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport. Int J Behav Nutr Phys Act. 2013; 10 (98): 98 doi: 10.1186/1479-5868-10-98.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref6" type="bt">4</bibl> <bibtext> Jewett R, Sabiston CM, Brunet J, O'Loughlin EK, Scarapicchia T, O'Loughlin J. School Sport Participation During Adolescence and Mental Health in Early Adulthood. J Adolesc Health. 2014; 55 (5): 640 – 644. doi: 10.1016/j.jadohealth.2014.04.018.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref7" type="bt">5</bibl> <bibtext> Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions Among united states high school and collegiate athletes. J Athl Train. 2007; 42 (4): 495 – 503.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref8" type="bt">6</bibl> <bibtext> Harmon KG, Drezner JA, Gammons M, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013; 47 (1): 15 – 26. doi: 10.1136/bjsports-2012-091941.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref10" type="bt">7</bibl> <bibtext> Willigenburg NW, Borchers JR, Quincy R, Kaeding CC, Hewett TE. Comparison of injuries in American collegiate football and club rugby: a prospective cohort study. Am J Sports Med. 2016; 44 (3): 753 – 760. doi: 10.1177/0363546515622389.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref11" type="bt">8</bibl> <bibtext> Marshall SW, Spencer RJ. Concussion in rugby: the hidden epidemic. J Athl Train. 2001; 36 (3): 334 – 338.</bibtext> </blist> <blist> <bibl id="bib9" idref="ref12" type="bt">9</bibl> <bibtext> Bailes JE, Hudson V. Classification of sport-related head trauma: a spectrum of mild to severe injury. J Athl Train. 2001; 36 (3): 236 – 243.</bibtext> </blist> <blist> <bibtext> Brooks MA, Peterson K, Biese K, Sanfilippo J, Heiderscheit BC, Bell DR. Concussion increases odds of sustaining a lower extremity musculoskeletal injury after return to play among collegiate athletes. Am J Sports Med. 2016; 44 (3): 742 – 747. doi: 10.1177/0363546515622387.</bibtext> </blist> <blist> <bibtext> Brown JA, Dalecki M, Hughes C, Macpherson AK, Sergio LE. Cognitive-motor integration deficits in young adult athletes following concussion. BMC Sports Sci Med Rehabil. 2015; 7 : 25.</bibtext> </blist> <blist> <bibtext> Asken BM, McCrea MA, Clugston JR, Snyder AR, Houck ZM, Bauer RM. Playing through it": delayed reporting and removal from athletic activity after concussion predicts prolonged recovery. J Athl Train. 2016; 51 (4): 329 – 335. doi: 10.4085/1062-6050-51.5.02.</bibtext> </blist> <blist> <bibtext> Elbin RJ, Sufrinko A, Schatz P, et al. Removal from play after concussion and recovery time. Pediatrics. 2016; 138 (3): e20160910 – e20160910. doi: 10.1542/peds.2016-0910.</bibtext> </blist> <blist> <bibtext> Hall EE, Ketcham CJ, Crenshaw CR, Baker MH, McConnell JM, Patel K. Concussion management in collegiate student-athletes: return-to-academics recommendations. Clin J Sport Med Off J Canadian Acad Sport Med. 2015; 25 (3): 291 – 296. doi: 10.1097/JSM.0000000000000133.</bibtext> </blist> <blist> <bibtext> McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 2004; 14 (1): 13 – 17. doi: 10.1097/00042752-200401000-00003.</bibtext> </blist> <blist> <bibtext> Kerr ZY, Register-Mihalik JK, Marshall SW, Evenson KR, Mihalik JP, Guskiewicz KM. Disclosure and non-disclosure of concussion and concussion symptoms in athletes: review and application of the socio-ecological framework. Brain Inj. 2014; 28 (8): 1009 – 1021. doi: 10.3109/02699052.2014.904049.</bibtext> </blist> <blist> <bibtext> Torres DM, Galetta KM, Phillips HW, et al. Sports-related concussion: Anonymous survey of a collegiate cohort. Neurol Clin Pract. 2013; 3 (4): 279 – 287. doi: 10.1212/CPJ.0b013e3182a1ba22.</bibtext> </blist> <blist> <bibtext> Llewellyn TT, Burdette GB, Joyner AA, Buckley T. Concussion reporting rates at the conclusion of an intercollegiate athletic career. Clin J Sport Med. 2014; 24 (1): 76 – 79. doi: 10.1097/01.jsm.0000432853.77520.3d.</bibtext> </blist> <blist> <bibtext> Kroshus E, Garnett B, Hawrilenko M, Baugh CM, Calzo JP. Concussion under-reporting and pressure from coaches, teammates, fans, and parents. Soc Sci Med. 2015; 134 : 66 – 75. doi: 10.1016/j.socscimed.2015.04.011.</bibtext> </blist> <blist> <bibtext> Register-Mihalik JK, Linnan LA, Marshall SW, Valovich McLeod TC, Mueller FO, Guskiewicz KM. Using theory to understand high school athletes' intentions to report sport-relation concussion: implications for concussion education initiatives. Brain Inj. 2013; 27 (7-8): 878 – 886. doi: 10.3109/02699052.2013.775508.</bibtext> </blist> <blist> <bibtext> Kroshus E, Baugh CM, Daneshvar D, Viswanath K. Understanding concussion reporting using a model based on the theory of planned behavior. J Adolescent Health. 2014; 54 (3): 269 – 274. doi: 10.1016/j.jadohealth.2013.11.011.</bibtext> </blist> <blist> <bibtext> Kerr ZY, Register-Mihalik JK, Kroshus E, Baugh CM, Marshall SW. Motivations associated with nondisclosure of self-reported concussions in former collegiate athletes. Am J Sports Med. 2016; 44 (1): 220 – 225. doi: 10.1177/0363546515612082.</bibtext> </blist> <blist> <bibtext> Small ML, Morgan N, Abar C, Maggs JL. Protective effects of parent-college student communication during the first semester of college. J Am Coll Health. 2011; 59 (6): 547 – 554. doi: 10.1080/07448481.2010.528099.</bibtext> </blist> <blist> <bibtext> Knight CJ, Berrow SR, Harwood CG. Parenting in sport. Curr Opin Psychol. 2017; 16 : 93 – 97. doi: 10.1016/j.copsyc.2017.03.011.</bibtext> </blist> <blist> <bibtext> Anderson JC, Funk JB, Elliott R, Smith PH. Parental support and pressure and children's extracurricular activities: relationships with amount of involvement and affective experience of participation. Appl Dev Psychol. 2003; 24 (2): 241 – 257. doi: 10.1016/S0193-3973(03)00046-7.</bibtext> </blist> <blist> <bibtext> Amado D, Sánchez-Oliva D, González-Ponce I, Pulido-González JJ, Sánchez-Miguel PA. Incidence of parental support and pressure on their children's motivational processes towards sport practice regarding gender. PLoS One. 2015; 10 (6): e0128015. doi: 10.1371/journal.pone.0128015.</bibtext> </blist> <blist> <bibtext> Sagar SS, Lavallee D. The developmental origins of fear of failure in adolescent athletes: Examining parental practices. Psychol Sport Exercise. 2010; 11 (3): 177 – 187. doi: 10.1016/j.psychsport.2010.01.004.</bibtext> </blist> <blist> <bibtext> Kroshus E, Babkes Stellino M, Chrisman SP, Rivara F. Threat, pressure, and communication about concussion safety: implications for parent concussion education. Health Educ Behav. 2018; 45 (2): 254 – 261. doi: 10.1177/1090198117715669.</bibtext> </blist> <blist> <bibtext> Duda JL, White SA. Goal orientation and beliefs about the causes of sport success among elite skiers. Sport Psychol. 1992; 6 (4): 334 – 343. doi: 10.1123/tsp.6.4.334.</bibtext> </blist> <blist> <bibtext> Biddle S, Wang CKJ, Kavussanu M, Spray C. Correlates of achievement goal orientations in physical activity: A systematic review of research. Euro J Sport Sci. 2003; 3 (5): 1 – 20. doi: 10.1080/17461390300073504.</bibtext> </blist> <blist> <bibtext> White SA, Kavussanu M, Tank KM, Wingate JM. Perceived parental beliefs about the causes of success in sport: relationship to athletes' achievement goals and personal beliefs. Scand J Med Sci Sports. 2004; 14 (1): 57 – 66. doi: 10.1111/j.1600-0838.2003.00314.x.</bibtext> </blist> <blist> <bibtext> Schwebel FJ, Smith RE, Smoll FL. Measurement of perceived parental success standards in sport and relations with athletes' self-esteem, performance anxiety, and achievement goal orientation: comparing parental and coach influences. Child Dev Res. 2016; 2016 : 1 – 13. doi: 10.1155/2016/7056075.</bibtext> </blist> <blist> <bibtext> McCuen E, Svaldi D, Breedlove K, et al. Collegiate women's soccer players suffer greater cumulative head impacts than their high school counterparts. J Biomech. 2015; 48 (13): 3720 – 3723., doi: 10.1016/j.jbiomech.2015.08.003.</bibtext> </blist> <blist> <bibtext> Rosene JM, Raksnis B, Silva B, et al. Comparison of concussion rates between NCAA division I and division III men's and women's ice hockey players. Am J Sports Med. 2017; 45 (11): 2622 – 2629. doi: 10.1177/0363546517710005.</bibtext> </blist> <blist> <bibtext> Haralabos K, Ioannis A, Evaggelos B, Athanasios L. The effect of task and ego orientation to athletic identity and anti social behavior of students and athletes. jhse. 2016; 11 (2): 311 – 318. doi: 10.14198/jhse.2016.112.04.</bibtext> </blist> <blist> <bibtext> Interassociation Consensus: Diagnosis and Management of Sport-Related Concussion Best Practices. 2017. June 16). NCAA Sport Science Institute.</bibtext> </blist> <blist> <bibtext> Wallace J, Covassin T, Nogle S, Gould D, Kovan J. Knowledge of concussion and reporting behaviors in high school athletes with or without access to an athletic trainer. J Athletic Train. 2017; 52 (3): 228 – 235. doi: 10.4085/1062-6050-52.1.07.</bibtext> </blist> <blist> <bibtext> Lifschutz L. Club Sports: Maximizing positive outcomes and minimizing risks. Recreational Sports J. 2012; 36 (2): 104 – 112. doi: 10.1123/rsj.36.2.104.</bibtext> </blist> <blist> <bibtext> Rosenbaum A, Arnett P. The development of a survey to examine knowledge about and attitudes toward concussion in high-school students. J Clin Exp Neuropsychol. 2010; 32 (1): 44 – 55. doi: 10.1080/13803390902806535.</bibtext> </blist> <blist> <bibtext> Duda JL. The relationship between goal perspectives, persistence and behavioral intensity among male and female recreational sport participants. Leisure Sc. 1988; 10 (2): 95 – 106. doi: 10.1080/01490408809512180.</bibtext> </blist> <blist> <bibtext> Li F, Harmer P, Duncan TE, Duncan SC, Acock A, Yamamoto T. Confirmatory factor analysis of the task and ego orientation in sport questionnaire with cross-validation. Res Q Exerc Sport. 1998; 69 (3): 276 – 283. doi: 10.1080/02701367.1998.10607694.</bibtext> </blist> <blist> <bibtext> Babkes ML, Weiss MR. Parental Influence on Children's Cognitive and affective responses to competitive soccer participation. Pediatric Exercise Sci. 1999; 11 (1): 44 – 62. doi: 10.1123/pes.11.1.44.</bibtext> </blist> <blist> <bibtext> Yoon KS. Exploring children's motivation for instrumental music. Biennal Meeting of the Society for Research in Child Development, 4. 1997.</bibtext> </blist> <blist> <bibtext> Enders CK, Bandalos DL. The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Struct Equation Model Multidiscip J. 2001; 8 (3): 430 – 457. doi: 10.1207/S15328007SEM0803_5.</bibtext> </blist> <blist> <bibtext> Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Eq Model Multidiscip J. 1999; 6 (1): 1 – 55. doi: 10.1080/10705519909540118.</bibtext> </blist> <blist> <bibtext> Harwood C, Knight C. Stress in youth sport: a developmental investigation of tennis parents. Psychol Sport Exercise. 2009; 10 (4): 447 – 456. doi: 10.1016/j.psychsport.2009.01.005.</bibtext> </blist> <blist> <bibtext> Lisinskiene A, May E, Lochbaum M. The initial questionnaire development in measuring of coach-athlete-parent interpersonal relationships: results of two qualitative investigations. Int J Environ Res Public Health. 2019; 16 (13): 2283. doi: 10.3390/ijerph16132283.</bibtext> </blist> <blist> <bibtext> Omli J, Wiese-Bjornstal DM. Kids speak: preferred parental behavior at youth sport events. Res Q Exerc Sport. 2011; 82 (4): 702 – 711. doi: 10.1080/02701367.2011.10599807.</bibtext> </blist> <blist> <bibtext> Knight CJ, Holt NL. Strategies used and assistance required to facilitate children's involvement in tennis: parents' perspectives. Sport Psychol. 2013; 27 (3): 281 – 291. doi: 10.1123/tsp.27.3.281.</bibtext> </blist> <blist> <bibtext> Dorsch TE, Smith AL, Dotterer AM. Individual, relationship, and context factors associated with parent support and pressure in organized youth sport. Psychol Sport Exercise. 2016; 23 : 132 – 141. doi: 10.1016/j.psychsport.2015.12.003.</bibtext> </blist> <blist> <bibtext> Sullivan SJ, Bourne L, Choie S, et al. Understanding of sport concussion by the parents of young rugby players: a pilot study. Clin J Sport Med. 2009; 19 (3): 228 – 230. May 1</bibtext> </blist> <blist> <bibtext> Mannings C, Kalynych C, Joseph MM, Smotherman C, Kraemer DF. Knowledge assessment of sports-related concussion among parents of children aged 5 years to 15 years enrolled in recreational tackle football. J Trauma Acute Care Surg. 2014; 77 (3): S18 – S22. Sep 1</bibtext> </blist> <blist> <bibtext> Gourley MM, McLeod TC, Bay RC. Awareness and recognition of concussion by youth athletes and their parents. Athletic Train Sports Health Care. 2010; 2 (5): 208 – 218. doi: 10.3928/19425864-20100524-03.</bibtext> </blist> <blist> <bibtext> NCAA, n.d. Mind Matters Challenge Executive Statements. [online] NCAA.org - The Official Site of the NCAA. Available at: <ulink href="http://www.ncaa.org/sport-science-institute/topics/mind-matters-challenge-executive-statements">http://www.ncaa.org/sport-science-institute/topics/mind-matters-challenge-executive-statements</ulink>. Accessed April 27, 2020.</bibtext> </blist> <blist> <bibtext> Hurley D, Allen MS, Swann C, Okely AD, Vella SA. The development, pilot, and process evaluation of a parent mental health literacy intervention through community sports clubs. J Child Fam Stud. 2018; 27 (7): 2149 – 2160. doi: 10.1007/s10826-018-1071-y.</bibtext> </blist> </ref> <aug> <p>By Natalie Joan Fuller; Emily Kroshus; Eric E. Hall and Caroline J. Ketcham</p> <p>Reported by Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref13"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref14"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref15"></nolink> <nolink nlid="nl4" bibid="bib13" firstref="ref16"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref17"></nolink> <nolink nlid="nl6" bibid="bib15" firstref="ref18"></nolink> <nolink nlid="nl7" bibid="bib16" firstref="ref19"></nolink> <nolink nlid="nl8" bibid="bib18" firstref="ref20"></nolink> <nolink nlid="nl9" bibid="bib19" firstref="ref21"></nolink> <nolink nlid="nl10" bibid="bib20" firstref="ref23"></nolink> <nolink nlid="nl11" bibid="bib22" firstref="ref24"></nolink> <nolink nlid="nl12" bibid="bib23" firstref="ref28"></nolink> <nolink nlid="nl13" bibid="bib24" firstref="ref29"></nolink> <nolink nlid="nl14" bibid="bib26" firstref="ref30"></nolink> <nolink nlid="nl15" bibid="bib27" firstref="ref32"></nolink> <nolink nlid="nl16" bibid="bib28" firstref="ref33"></nolink> <nolink nlid="nl17" bibid="bib29" firstref="ref34"></nolink> <nolink nlid="nl18" bibid="bib30" firstref="ref35"></nolink> <nolink nlid="nl19" bibid="bib31" firstref="ref36"></nolink> <nolink nlid="nl20" bibid="bib32" firstref="ref37"></nolink> <nolink nlid="nl21" bibid="bib35" firstref="ref38"></nolink> <nolink nlid="nl22" bibid="bib36" firstref="ref39"></nolink> <nolink nlid="nl23" bibid="bib37" firstref="ref42"></nolink> <nolink nlid="nl24" bibid="bib38" firstref="ref43"></nolink> <nolink nlid="nl25" bibid="bib39" firstref="ref44"></nolink> <nolink nlid="nl26" bibid="bib40" firstref="ref59"></nolink> <nolink nlid="nl27" bibid="bib41" firstref="ref60"></nolink> <nolink nlid="nl28" bibid="bib42" firstref="ref61"></nolink> <nolink nlid="nl29" bibid="bib43" firstref="ref62"></nolink> <nolink nlid="nl30" bibid="bib44" firstref="ref65"></nolink> <nolink nlid="nl31" bibid="bib45" firstref="ref66"></nolink> <nolink nlid="nl32" bibid="bib46" firstref="ref67"></nolink> <nolink nlid="nl33" bibid="bib47" firstref="ref68"></nolink> <nolink nlid="nl34" bibid="bib48" firstref="ref70"></nolink> <nolink nlid="nl35" bibid="bib49" firstref="ref71"></nolink> <nolink nlid="nl36" bibid="bib50" firstref="ref72"></nolink> <nolink nlid="nl37" bibid="bib51" firstref="ref75"></nolink> <nolink nlid="nl38" bibid="bib53" firstref="ref76"></nolink> <nolink nlid="nl39" bibid="bib54" firstref="ref78"></nolink> <nolink nlid="nl40" bibid="bib55" firstref="ref79"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1358367
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Parent Influence on Concussion Reporting in First-Year Collegiate Athletes
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Fuller%2C+Natalie+Joan%22">Fuller, Natalie Joan</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-4978-5323">0000-0003-4978-5323</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kroshus%2C+Emily%22">Kroshus, Emily</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-7484-2601">0000-0002-7484-2601</externalLink>)<br /><searchLink fieldCode="AR" term="%22Hall%2C+Eric+E%2E%22">Hall, Eric E.</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-3590-5390">0000-0002-3590-5390</externalLink>)<br /><searchLink fieldCode="AR" term="%22Ketcham%2C+Caroline+J%2E%22">Ketcham, Caroline J.</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-6713-130X">0000-0002-6713-130X</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2022 70(5):1518-1527.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 10
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2022
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research<br />Tests/Questionnaires
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Athletes%22">Athletes</searchLink><br /><searchLink fieldCode="DE" term="%22College+Athletics%22">College Athletics</searchLink><br /><searchLink fieldCode="DE" term="%22Head+Injuries%22">Head Injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Disclosure+%28Individuals%29%22">Self Disclosure (Individuals)</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Influence%22">Parent Influence</searchLink><br /><searchLink fieldCode="DE" term="%22College+Freshmen%22">College Freshmen</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Child+Relationship%22">Parent Child Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Intention%22">Intention</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2020.1809430
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: To assess the relationship between sport-parenting practices and concussion reporting intentions of collegiate athletes across two levels of competition. Participants: Entering first-year student-athletes (varsity and club) at a mid-sized university in the Southeast region of the United States (n = 327). Methods: Written surveys were completed prior to the start of the 2015 academic year. Structural equation modeling was used to test a model predicting concussion-reporting intentions. Results: College athletes were more likely to intend to report a suspected concussion when they believed their parents wanted them to report (B=-0.88, SD = 0.94), and when they experienced less sport achievement pressure from their parents (B=-0.12, SD = 8.07). Conclusions: Parents influence the concussion safety of entering collegiate athletes at both the varsity and club level. Lower pressure sport parenting prior to college entry may help foster safer concussion reporting behaviors and may be an appropriate target for future intervention development work.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2022
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1358367
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1358367
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/07448481.2020.1809430
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 1518
    Subjects:
      – SubjectFull: Athletes
        Type: general
      – SubjectFull: College Athletics
        Type: general
      – SubjectFull: Head Injuries
        Type: general
      – SubjectFull: Self Disclosure (Individuals)
        Type: general
      – SubjectFull: Parent Influence
        Type: general
      – SubjectFull: College Freshmen
        Type: general
      – SubjectFull: Parent Child Relationship
        Type: general
      – SubjectFull: Student Attitudes
        Type: general
      – SubjectFull: Intention
        Type: general
    Titles:
      – TitleFull: Parent Influence on Concussion Reporting in First-Year Collegiate Athletes
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Fuller, Natalie Joan
      – PersonEntity:
          Name:
            NameFull: Kroshus, Emily
      – PersonEntity:
          Name:
            NameFull: Hall, Eric E.
      – PersonEntity:
          Name:
            NameFull: Ketcham, Caroline J.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 0744-8481
            – Type: issn-electronic
              Value: 1940-3208
          Numbering:
            – Type: volume
              Value: 70
            – Type: issue
              Value: 5
          Titles:
            – TitleFull: Journal of American College Health
              Type: main
ResultId 1