Page 93 - JSOM Fall 2020

TABLE 1 Recommendations for Institutions
Domain Statement
Content of concussion 1. Provide athletes/Servicemembers with education that addresses:
education for 2. The potential dilemma individuals face when deciding to disclose a concussion (e.g., tradeoffs, concerns about
athletes and military what might happen next, knowing how to report, etc.).
Servicemembers 3. Short-term benefits of early concussion symptom disclosure (e.g., athletic, academic, occupational).
4. What is known about possible long-term manifestations of concussion and head injury.
5. Concussion-related misperceptions (e.g., knowledge gaps).
6. Site-specific information regarding institutional concussion resources and policies (e.g., steps to take if an
individual suspects they have a concussion).
Dissemination of 7. Actively collaborate with organizational stakeholders (including coaches/commanders, primary health care
concussion education providers, athletes/Servicemembers, military chain of command) to select concussion education approaches
that are engaging, interactive, and that foster discussion.
8. Share messaging about concussion symptom disclosure on a regular basis and in a variety of ways (e.g., formal
education, informal conversation, posters).
9. Integrate messaging about the importance of complete concussion symptom disclosure throughout the recovery
process.
Concussion education 10. Provide coaches/leaders in the military chain of command with evidence-based concussion education that is
for other stakeholders aimed at supporting athletes/Servicemembers in concussion symptom disclosure.
11. Provide sports medicine/front line medical staff with strategies about how to engage coaches/leaders in the
military chain of command in supporting athletes/Servicemembers in concussion symptom disclosure.
12. Provide easily accessible information to parents/guardians about how to support athlete/Servicemember
concussion symptom disclosure.
13. Provide easily accessible information to other key site-specific stakeholders (e.g., student-life administrators,
faculty athletic representatives, leadership, chain of command) about how to support athlete/Servicemember
concussion symptom disclosure.
Team- and unit-level 14. Provide athletes/Servicemembers with education that addresses the role they can play in encouraging peers to
processes disclose possible concussion symptoms (e.g., share evidence-based bystander education programming).
15. Provide opportunity for team members and coaches/leaders in the military chain of command to discuss and
establish team values that are supportive of concussion symptom disclosure.
Organizational 16. Actively collaborate with organizational stakeholders (including coaches/leaders in the military chain of
processes command, primary health care providers, athletes/Servicemembers) to identify and address organizational
barriers to concussion symptom disclosure.
17. Evaluate the effectiveness of institutionally selected concussion education approaches in changing athlete/
Servicemember concussion symptom disclosure behavior.
18. Communicate in a deliberate manner institutional values that emphasize safety and its importance in athletic
performance/military readiness.

and consequences of disclosure at a given time in their setting. educational approaches and tools for student-athletes and mil-
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Information can then be provided about the potential results itary Servicemembers are developed and evaluated, guidance
of early, and honest care-seeking can shape decision-making should be provided to institutions about those that address
processes towards disclosure. This information should focus content as recommended above and that have demonstrated
on benefits to the individual (e.g., rather than using fear tac- efficacy in improving disclosure behaviors.
tics) and emphasize short-term outcomes (e.g. “seeking care
for a concussion will help you feel better sooner”). While Domain 2: Dissemination of concussion education
there are a growing number of approaches to concussion ed- • Recommendation 6: Actively collaborate with organi-
ucation, 27,28 few, if any, address all of the content domains zational stakeholders (including coaches/commanders,
listed above. Critically, these content domains do not need to primary health care providers, athletes/Servicemembers,
be addressed in a single educational program, session or set military chain of command) to select concussion edu-
of materials. Rather, they could be addressed through a com- cation approaches that are engaging, interactive, and
bination of approaches including team discussions and other foster discussion.
daily interactions. Because of the localized nature of some of • Recommendation 7: Share messaging about concussion
the recommendations (institutional policies and resources, and symptom disclosure on a regular basis and in a variety
misperceptions), providing concussion education consistent of ways (e.g., formal education, informal conversation,
with these recommendations will require the engagement of posters).
institutional stakeholders to tailor these recommendations to • Recommendation 8: Integrate messaging about the im-
their setting. Institutional stakeholder teams should use this portance of complete concussion symptom disclosure
list to review their planned approach to education to ensure throughout the recovery process.
that, in sum across all modalities and time points of education,
all relevant content areas are being addressed. This may mean Concussion education, no matter the content, will not be ef-
supplementing a resource such as the NCAA’s Concussion fective in changing behavior if the athlete or military service
Fact Sheet for Athletes (which addresses short-term benefits academy cadet is not attentive, 16,30 underscoring the impor-
of disclosure, what is known about possible long-term mani- tance of selecting engaging, interactive and population-rele-
festations of concussion and head injury) with a discussion led vant educational modalities. 17,31 Critically, lack of attention to
by medical personnel, in conjunction with coaches or leaders dissemination strategies can result in learning environments
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in the military chain of command. Such a discussion could that undermine educational messaging. The three listed
focus on the disclosure decision, providing site-specific infor- recommendations related to dissemination of educational
mation on the actions to take to report symptoms. As more messaging (Recommendations 6, 7, and 8) represent both a
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Concussion Education From NCAA-Department of Defense | 91