Middle School Sport Parents’ Reported Norms Concerning Youth Athlete Concussion Care-seeking And Playing Behaviors: Implications For Concussion Prevention

Understanding parental norms concerning youth athlete care-seeking and playing behaviors can inform concussion prevention interventions. PURPOSE: 1) Examine youth sport parents’ reported norms for athlete care-seeking and playing behaviors; 2) Compare norms by parent sex. METHODS: Parents of youth sport athletes (n = 796; mean age = 40 ± 10 years) from a United States-based, national sample pool completed a cross-sectional questionnaire on concussion-related perceived norms around youth athlete concussion care-seeking and playing behaviors. The exploratory variable was parent sex. Main outcomes included parental indication of ever witnessing a youth athlete: 1) tell an adult he/she may have a concussion; and 2) engage in playing behaviors to reduce head impact. Also, 5-point Likert scales assessed parent approval for: 1) praising, 2) looking down upon (discounting), and 3) saying/doing nothing when these two types of events occurred. Chi-square and Wilcoxon Rank-Sum tests compared sex differences. RESULTS: Most respondents were women (60%) and White/non-Hispanic (52%). Children of participating parents commonly played basketball (46%), soccer (36%), baseball (29%), and football (20%). Overall, 31% of parents reported a concussion history and 23% reported child concussion history. Higher proportions of men reported witnessing a youth athlete tell an adult he/she may have a concussion (men: 40% vs. women: 27%, P < 0.001). No sex difference was found for witnessing a youth athlete engage in playing behaviors to reduce head impact (men: 42% vs. women: 36%, P = 0.07). Wilcoxon-Rank sum tests indicated sex differences in approval for discounting athletes for self-reporting potential concussions [men Median (interquartile range): 3 (2-5) vs. women: 4 (3-5), P < 0.001] and athletes engaging in possible head impact reducing playing behaviors [men: 3 (2-5) vs. women: 4 (3-5), P < 0.001]. Higher approval in men was found for not saying anything when these events occurred (P < 0.005). No sex differences were found for praising athletes. CONCLUSIONS: Findings indicate male parents more often approved of behaviors that negatively impact concussion care-seeking behaviors and outcomes. Sex-specific approaches for interventions for youth sport parents may be appropriate.