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News — How can we teach high school football players about concussion risks to prevent delays in reporting, diagnosing and treating this serious medical condition? The “CrashCourse” program appears more effective than older approaches when it comes educating teen athletes on the urgency of reporting concussion symptoms, according to a new study presented this week at the Association of Academic Physiatrists Annual Meeting.

Concussion underreporting may lead to delays in diagnosis and treatment, and prolonged recovery. High school athletes who play contact sports like football may be at risk for concussion, but these teens need to know why it’s important to report possible symptoms and receive prompt evaluation. This study compared three concussion education programs to see which one was most effective at improving student-athletes’ intention to report concussion symptoms.

“Because concussions are largely invisible injuries, making sure that athletes report their own concussions is the key to ensuring safety in sports,” said Dan Daneshvar, MD, PhD, a physical medicine and rehabilitation physician on the faculty at Harvard Medical School and Spaulding Rehabilitation Hospital. “As a result, educational programs target youth concussion reporting, but no previous studies have had a side-by-side comparison of how effective these most commonly used concussion education programs actually are.”

The randomized controlled trial was conducted from August-October 2018, and included assessment before, immediately after and one month after education about concussion. Participants were 118 male football players from three California high schools randomly assigned to take one of three concussion education courses: CrashCourse, video education from the U.S. Centers for Disease Control and Prevention (CDC), or the CDC’s written educational materials. The study’s primary outcome was the players’ intention to report concussion at the three time points. Secondary outcomes included examination of players’ concussion knowledge and attitudes, and their self-perceived reporting style and behavioral control.

Athletes across all three groups showed significant improvement in their intention to report concussion symptoms both immediately and one month after education. Athletes across all three education formats also showed improvements in concussion knowledge, attitudes about concussion reporting, and self-perceived behavioral control about concussion reporting.

However, the researchers found significant differences between education programs when it came to intention to report concussions, with athletes taking CrashCourse showing increased concussion-reporting intention levels immediately after education, or 15% improvement for CrashCourse compared to 9.4% for the CDC video and -3.4% for the CDC written materials. These differences between education programs were not significant one month later. Secondary analyses showed significant differences between the interventions in knowledge and attitudes about concussion reporting.

All players showed improved intent to report concussions, increased concussion knowledge, better concussion attitudes and more perceived behavioral control both immediately and one month after concussion education. However, those who took the CrashCourse showed greater intent to report concussion, more concussion knowledge and improved concussion-reporting attitudes when compared to the CDC video or written programs, according to the study’s results.

“Unless properly treated, concussed athletes face increased risks of injury, both to their brain, but also to the rest of their body,” said Dr. Daneshvar. “We are also learning more about the long-term effects of repeated concussions. Given these risks, even a small improvement in concussion reporting would result in major public health benefits given the millions of athletes that experience concussions every year.”

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The Association of Academic Physiatrists (AAP) is a professional society with a mission to create the future of academic physiatry through mentorship, leadership, and discovery. Its members are leading physicians, researchers, educators and in-training physiatrists from over 40 countries. The AAP holds an Annual Meeting, produces a leading medical journal in rehabilitation: , and leads a variety of programs and activities that support and enhance academic physiatry. On February 9-13, 2021, the AAP is hosting its first-ever virtual Annual Meeting, Physiatry ‘21. To learn more about the association, the specialty of physiatry and Physiatry ‘21, visit  and follow us on Twitter at @AAPhysiatrists.