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Randomized controlled trial of a novel peer concussion-education program for collegiate athletes [with consumer summary]
Kneavel ME, Ernst W, McCarthy KS
Journal of Athletic Training 2020 May;55(5):456-468
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

CONTEXT: The National Collegiate Athletic Association and US Department of Defense have called for educational programs to change the culture of concussion reporting, increase reporting behavior, and enhance the safety of players and service members. OBJECTIVE: To evaluate the effects of a novel peer concussion-education program (PCEP) in changing knowledge, attitudes, and norms about concussion reporting among collegiate student-athletes and assess program implementation. DESIGN: Randomized controlled trial and qualitative analysis of interviews. SETTING: National Collegiate Athletic Association athletic teams from randomly selected colleges or universities. PATIENTS OR OTHER PARTICIPANTS: A total of 1614 male and female student-athletes from 60 teams at 10 colleges and universities and 8 athletic trainers. INTERVENTION(S): The PCEP intervention trains 2 peer concussion educators to provide 2 education modules to their teammates. Knowledge, attitudes (oneself and teammates), and concussion occurrence or reporting were assessed at baseline, postintervention, and 1 month later. Eight athletic trainers were interviewed about program implementation. RESULTS: Compared with the control group, the intervention group showed greater increases occurred postintervention and at 1 month in concussion knowledge (F[1,2648] = 51.3, P < 0.0001), intention to report (oneself F[2,2633] = 82.3, p < 0.0001; teammates F[2,2624] = 53.9, p < 0.0001), return-to-play protocol knowledge (F[2,2632] = 28.4, p < 0.0001), direct subjective norms (oneself F[2,2625] = 51.7, p < 0.0001; teammates F[2,2644] = 40.6, p < 0.0001), direct perceived behavioral control (oneself F[2,2628] = 53.7, p < 0.0001; teammates F[2,2615] = 68.2, p < 0.0001), and indirect attitudes (oneself F[2,2626] = 47.1, p < 0.001; teammates F[2,2623] = 40.9, p < 0.0001). Peer concussion-education program participants discussed concussion more often with a teammate (F[1,1396] = 13.96, p < 0.0001) or athletic staff (F[1,1396] = 6.62, p < 0.001). Qualitative program analysis revealed both positive aspects of the PCEP and areas for improvement. CONCLUSIONS: The PCEP showed promise in increasing concussion knowledge, intention to report concussion, reporting a teammate's concussion, and facilitating attitudinal changes that support reporting among student-athletes.

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