Melissa K. Kossman1, Zachary Y. Kerr2, Kristen L. Kucera2, J.D. DeFreese2, Meredith A. Petschauer2, Johna K. Register-Mihalik2. 1University of Southern Mississippi, Hattiesburg, MS. 2University of North Carolina at Chapel Hill, Chapel Hill, NC.

PURPOSE: This study aimed to identify demographic variables relating to factors influencing concussion-related decision-making (CRDM) by certified athletic trainers (ATC). Understanding these factors will better inform interventions on improving the CRDM abilities of ATCs. METHODS: A cross-sectional study of ATCs (n=1,029; age = 26.0 ± 3.7) completed a validated questionnaire on demographic variables and theory-based (Integrated Behavior Model) factors about CRDM. Multivariable linear regression models (a priori alpha level = 0.05) estimated the effect of each independent variable (scales: knowledge - 25 to 100; attitudes - 14 to 98; perceived behavioral control - 3 to 21; self-efficacy - 2 to 14; intentions - -45 to 45). The predictive factors were: gender (male vs. female), race (non-Caucasian vs. Caucasian), years of experience as an ATC, employment setting (high school vs. college), and sport coverage responsibilities (non-collision vs. collision). Knowledge, attitudes, perceived behavioral control, and self-efficacy were also included as predictors in the model for intentions. RESULTS: Most participants were female (n=724, 70.2%), Caucasian (n=874, 84.7%), and recent graduates (mean = 3.1 ± 1.8 years of experience) and half were employed in high schools (n=519, 50.3%) and responsible for collision sport coverage (n=533, 51.6%). Demographic factors were not significantly related to factors associated with CRDM. However, safer attitudes were associated with better intentions to remove concussed individuals (β = 0.17; p<0.001). CONCLUSION: Intentions to make appropriate concussion-related decisions are a vital step in removing concussed individuals from play. ATCs may have diverse backgrounds and carry diverse professional responsibilities immersed in their own team cultures and experiences; however, these variables, as measured in this study, do not appear to impact their decision-making capabilities regardless of personal and professional background. There does not appear to be a need to develop specific initiatives for different types of ATCs. As such, it is important that educational initiatives focus on creating safer concussion-related attitudes and the need for appropriate decision-making of all ATCs. Supported in part by a NATA Research and Education Foundation Doctoral Grant.

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