Concussion reporting intention: a valuable metric for predicting reporting behavior and evaluating concussion education.

OBJECTIVE This study aimed to evaluate whether preseason concussion knowledge and reporting intention predicted in-season concussion reporting behavior. DESIGN Prospective cohort study. SETTING Collegiate athletic facility of each participating team. PARTICIPANTS National Collegiate Athletic Association Division I men's ice hockey players in 1 conference of competition (n = 116). INDEPENDENT VARIABLES Intention to report symptoms of a "minor" concussion and concussion knowledge were assessed at preseason. MAIN OUTCOME MEASURES Postseason recall of non-report of postimpact symptoms. RESULTS Preseason concussion knowledge was not significantly associated with in-season reporting behavior. Intention to report concussion symptoms was significantly related to in-season reporting behavior. There was a significant interaction between the number of different symptoms experienced and both preseason reporting intention and in-season reporting behavior. CONCLUSIONS Evaluations of concussion education programs tend to measure concussion knowledge. The present findings suggest that reporting intention may be more strongly predictive of reporting behavior than concussion knowledge and should be included in evaluations of concussion effectiveness. New concussion education initiatives should consider targeting psychosocial constructs that increase reporting intention. CLINICAL RELEVANCE Sports medicine clinicians who are involved in evaluating concussion education programs should measure constructs other than just concussion knowledge. Intention, to report symptoms or to continue play while experiencing symptoms of a concussion, seems to be an important and feasible construct to include as part of proximal evaluations of education effectiveness.