What Do Secondary School Rugby Players Think About Concussion?

Abstract

Traumatic Brain Injury (TBI) is a dominant and growing public health concern globally. Sport is an arena in which people are at high risk of TBI. In New Zealand the popular sport of rugby is played by many, particularly during school years. These school aged players are at particular risk of TBI because of the contact nature of the sport and the maturational stage of the brain which is still developing during the teenage years. Moves to increase safety depend on an awareness of what these players know about TBI and their attitude towards TBI. A sample of 456 secondary school rugby players in New Zealand were surveyed to gather information about their knowledge of, and attitude towards concussion. Rugby union and rugby league playing participants were mainly recruited through direct contact with schools. Participants were invited to access the survey online or could complete a paper copy. The survey was made up of items which had already been used in previous studies and this allowed for a comparison of findings with previous research. Some items related to knowledge of concussion while others related to attitude towards concussion, in particular attitudes to returning to play following concussion. Participants had good knowledge of symptoms, and almost all participants knew there was a risk to long term health and a risk of death if a second concussion was sustained before a first concussion had healed. However, there were some gaps in knowledge about treatment and recovery time. Participants self-reported attitudes to concussion were consistently and significantly safer than the attitudes they predicted ‘most players’ would hold. More than half of the participants had a relatively safe attitude to all but one of the items relating to concussion attitude. The least safe attitudes were around who should make a decision to returning to play after concussion and the safety of attitudes declined as the importance of a rugby match increased. Ethnicity consistently influenced knowledge and attitude on all the measures used within the survey. Those identifying as Māori ethnicity scored lower on all knowledge and attitude scales than those identifying as Pakeha ethnicity. Self-rated knowledge of concussion and the number of concussions experienced also had a positive effect on knowledge of concussion. There are several educational tools and regulatory documents aimed at minimising the incidence, severity and outcome of concussion in rugby but there is little research guiding how these resources are tailored to their intended audience in the secondary school population. Also, little is known about the gaps in knowledge and understanding of concussion in this population. It is tentatively stated that the findings from this study could be used to inform strategies which are aimed at increasing knowledge and making attitudes safer in secondary school rugby players in New Zealand.