Health-seeking behaviors following concussion: An examination of the Theory of Reasoned Action and Planned Behavior

Research Objectives: To assess the influence of psychosocial factors from the Theory of Reasoned Action and Planned Behavior on health-seeking behaviors after concussions.

Design: Mixed method cross-sectional survey

Setting: University; virtual platform

Participants: 432 college students enrolled at least one college credit.

Interventions: Participants completed a 30-minute online survey to examine factors contributing to health-seeking behaviors after concussions in college. Participants were randomized into two health scenario groups, one for healthcare decisions for themselves (Self), and another for healthcare advice for a friend (Other). Each group answered open and closed-ended questions about actions and expected outcomes from injury scenarios and then completed a questionnaire about personal attitudes, perceived behavioral control, and healthcare access and use.

Main Outcome Measures: The Theory of Reasoned Action and Planned Behavior (TRA/TPB) constructs of attitudes, perceived behavioral control (PBC; including perceptions about access), subjective norms (SN), and intention to seek healthcare after a concussion informed survey design. All participants responded to TRA/TPB questions about themselves, but intention was answered based on participant group (Self vs. Other).

Results: Indirect subjective norms and indirect perceived behavior control were associated with the intention to seek healthcare after a concussion. Two items in indirect SN were associated with intention to seek healthcare for self. Specifically, students who care what professors think tend to not seek healthcare (B=-.16, p=.03), while students who care about doing well in school have greater likelihood to report their concussions (B=.71, p=.04). Two items in indirect PBC were associated with intention to encourage others to seek healthcare: pressure from family (B=.39, p=.005) and to maintain academic performance (B=-.62, p=.03), and one item in indirect SN: to avoid disappointing family (B=.45, p=.02).

Conclusions: Results show only indirect subjective norms were associated with intention to seek healthcare for the self. Conversely, indirect perceived behavioral control and indirect subjective norms were related to encouraging others to seek care. Individuals’ health-seeking decisions following concussion differ based on the person injured.

Author(s) Disclosures: None