Sex Differences in High School Athletes' Knowledge of Sport-Related Concussion Symptoms and Reporting Behaviors

J Athl Train. 2017 Jul;52(7):682-688. doi: 10.4085/1062-6050-52.3.06. Epub 2017 May 31.


Context: Recent researchers have reported that athletes' knowledge of sport-related concussion (SRC) has increased but that athletes still lack knowledge of all the signs and symptoms of SRC. Understanding the signs and symptoms of SRC and the dangers of playing while symptomatic are critical to reporting behaviors in high school athletes.

Objective: To examine sex differences in knowledge of SRC symptoms and reasons for not reporting a suspected SRC to an authoritative figure in high school athletes.

Design: Cross-sectional study.

Setting: Survey.

Patients or other participants: A total of 288 athletes across 7 sports (198 males [68.8%] and 90 females [31.2%]).

Main outcome measure(s): A validated knowledge-of-SRC survey consisted of demographic questions, a list of 21 signs and symptoms of SRC, and reasons why athletes would not report their SRC. The independent variable was sex. Athlete knowledge of SRC symptoms was assessed by having participants identify the signs and symptoms of SRC from a list of 21 symptoms. Knowledge scores were calculated by summing the number of correct answers; scores ranged from 0 to 21, with a score closer to 21 representing greater knowledge. Reporting-behavior questions asked athletes to choose reasons why they decided not to report any possible SRC signs and symptoms to an authoritative figure.

Results: A sex difference in total SRC symptom knowledge was found (F286 = 4.97, P = .03, d = 0.26). Female high school athletes had more total SRC symptom knowledge (mean ± standard deviation = 15.06 ± 2.63; 95% confidence interval = 14.54, 15.57) than males (14.36 ± 2.76; 95% confidence interval = 13.97, 14.74). Chi-square tests identified significant relationships between sex and 8 different reasons for not reporting an SRC.

Conclusions: High school males and females had similar SRC symptom knowledge; however, female athletes were more likely to report their concussive symptoms to an authoritative figure.

Keywords: mild traumatic brain injuries; secondary school; sport culture.

MeSH terms

  • Adolescent
  • Athletes / statistics & numerical data*
  • Athletic Injuries / complications
  • Athletic Injuries / diagnosis*
  • Brain Concussion / diagnosis*
  • Brain Concussion / etiology
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Schools / statistics & numerical data*
  • Sex Factors
  • Students / statistics & numerical data*
  • United States
  • Young Adult