To evaluate the effectiveness of a novel peer concussion education program designed to increase knowledge of concussions, reporting of concussive events, and attitudes for both teammates and individuals in high concussive sports.

Over 460,000 student-athletes compete in 24 NCAA sports every year. Concussions are estimated to occur between 0.43—.57 per 1000 athletic events for student-athletes (Covassin, et al., 2016; Daneshvar et al., 2011) but these rates rely in part on self-report, which is likely affected by factors including the culture surrounding athletics (IOM, 2013). The Institute of Medicine, NCAA, Department of Defense, and the CDC have all called for educational interventions to change the culture of competitive athletics pertaining to concussion so that reporting of concussion becomes the norm.  

A multi-site randomized controlled trial was conducted to evaluate the effectiveness of the program. Measures of concussion knowledge, knowledge of the return to play protocol, intention to report concussions, direct subjective norms, direct perceived behavioral control, and indirect perceived behavioral control were assessed at baseline, post-intervention, and at a one-month follow-up with the last four measuring perspectives for both self and teammate.

1614 male and female student-athletes from 60 teams (30 experimental, 30 control) belonging to 10 colleges/universities across all 3 NCAA Divisions completed the study. Results indicated that student-athletes who participated in the program demonstrated greater increases in concussion knowledge, intention to report concussion, understanding of the return to play protocol, direct subjective norms, direct perceived behavioral control, and indirect perceived behavioral control for both self and teammate compared to controls post-intervention and at the one-month follow-up. 

The novel peer-mediated approach to concussion education shows promise in increasing concussion knowledge, intention to report concussion, and for facilitating attitudinal changes that support reporting among student-athletes and in changing the norms of concussion reporting on a team.