Predicting Barriers to Performing Concussion Education: Identifying Opportunities for Change
Abstract
Background: There are many barriers that impact effective delivery of sport-related concussion education which can be described through the Capability, Opportunity, Motivation Behavior (COM-B) model of behavior change. Barriers may be predicted by factors like school levels, sports medicine access at school, and the educator’s professional experience or gender. Athletic trainers (ATs), medical professionals often employed in school athletics, usually provide concussion-related education. Therefore, the aim of this study was to explore factors that influence ATs’ barriers to providing concussion education.
Methods: The National Athletic Trainers’ Association distributed an electronic survey to 9,997 member ATs working in secondary schools (SSs) or colleges/universities. It included a validated COM-B survey containing six Likert-type items with a scale of 0-10 (labeled Strongly Disagree - Strongly Agree, respectively) asking about ATs' barriers to delivering concussion education. We performed separate ordinal regression analyses to predict each of the six COM-B constructs (psychological capability, physical capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation). Predictive factors included the AT’s setting (SS or college/university; private or public SS), percent of employment hours spent at their school, years certified, or gender (α=.05).
Results: Three hundred and sixty-five ATs (41.12±12.7 years-old, 52.1% female-identifying) practicing in the SS (62.7%) or college/university (37.3%) setting completed the survey. Relative to college/university, SS ATs more strongly endorsed barriers related to providing concussion education in four COM-B constructs: psychological capability (ORadj=1.983; 95%CI:1.254-3.136; p=.009), social opportunity (ORadj=2.581; 95%CI:1.718-3.876; padj=2.628; 95%CI:1.746-3.957; padj=1.694; 95%CI:1.120-2.561; p=.018). Percent hours on-site, years certified, gender, and SS funding source (i.e., private or public) were not significant predictors in any model (p>.05).
Conclusion: SS ATs face challenges with their psychological capability, social and physical opportunity, and automatic motivation to provide concussion education. Future research should identify solutions to improve concussion education delivery in SS settings.
Keywords
Injury prevention, healthcare access, athletics, health education
Predicting Barriers to Performing Concussion Education: Identifying Opportunities for Change
Background: There are many barriers that impact effective delivery of sport-related concussion education which can be described through the Capability, Opportunity, Motivation Behavior (COM-B) model of behavior change. Barriers may be predicted by factors like school levels, sports medicine access at school, and the educator’s professional experience or gender. Athletic trainers (ATs), medical professionals often employed in school athletics, usually provide concussion-related education. Therefore, the aim of this study was to explore factors that influence ATs’ barriers to providing concussion education.
Methods: The National Athletic Trainers’ Association distributed an electronic survey to 9,997 member ATs working in secondary schools (SSs) or colleges/universities. It included a validated COM-B survey containing six Likert-type items with a scale of 0-10 (labeled Strongly Disagree - Strongly Agree, respectively) asking about ATs' barriers to delivering concussion education. We performed separate ordinal regression analyses to predict each of the six COM-B constructs (psychological capability, physical capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation). Predictive factors included the AT’s setting (SS or college/university; private or public SS), percent of employment hours spent at their school, years certified, or gender (α=.05).
Results: Three hundred and sixty-five ATs (41.12±12.7 years-old, 52.1% female-identifying) practicing in the SS (62.7%) or college/university (37.3%) setting completed the survey. Relative to college/university, SS ATs more strongly endorsed barriers related to providing concussion education in four COM-B constructs: psychological capability (ORadj=1.983; 95%CI:1.254-3.136; p=.009), social opportunity (ORadj=2.581; 95%CI:1.718-3.876; padj=2.628; 95%CI:1.746-3.957; padj=1.694; 95%CI:1.120-2.561; p=.018). Percent hours on-site, years certified, gender, and SS funding source (i.e., private or public) were not significant predictors in any model (p>.05).
Conclusion: SS ATs face challenges with their psychological capability, social and physical opportunity, and automatic motivation to provide concussion education. Future research should identify solutions to improve concussion education delivery in SS settings.
