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

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