Reasons for concussion under-reporting in varsity athletes: a mixed methods approach

Sport-related concussion is an increasing challenge for student-athletes, medical staff, and faculties to manage in post-secondary institutions. Delayed assessment and management leads to increased time away from class and sport, and low reporting rates among athletes contribute to poor recovery rates and potential long-term consequences. The purpose of this study was to utilize a mixed-methods approach to examine concussion education, attitudes, and reporting intention and behaviour, to explore reasons why varsity athletes fail to report concussions. Results indicated that athlete knowledge of signs and symptoms of concussion is very high, but that decision-making process that athletes undergo to report concussions leads to unsafe reporting behaviours. Themes of knowledge, non-reporting influences, and high thresholds to report create complex inter- and intra-personal messages that over-ride education and lead to non-reporting of concussions. The results of this study suggest that education programs need to address the influence of sport-culture, personal attitudes and beliefs, and external messages that varsity athletes receive in order to improve reporting rates