Concussion Health Expectations in College (CHECk): Perceptions of Identification of Concussion and Subsequent Healthcare Decisions

Research Objectives: To examine the Common Sense Model (CSM) construct “identity” between anticipated healthcare decisions for self or for other following various mechanisms of injury for concussion.

Design: Mixed-Method Cross-Sectional Survey

Setting: University; virtual setting

Participants: 481 students enrolled in at least one credit at a large public university completed the study.

Interventions: The College Health and Concussion Knowledge (CHeCK) survey was designed to include vignettes describing seven common concussion mechanisms of injury (e.g., falls, struck by/against, motor vehicle crash, etc.). Participants were randomized into two groups, one for health decisions for themselves (Self), and another for healthcare advice for a friend (Other). After each injury vignette, participants described what action they would take or advise a friend to take.

Main Outcome Measures: Open-ended responses were inductively coded into 5 domains based on common action responses: contact family/friends, contact healthcare/emergency services, self-treat, do nothing, or something else.

Results: A series of chi-square tests of independence with post-hoc analysis assessed the relationship between group and action recommended. In all seven vignettes, the Other group was more likely to recommend healthcare services to others than those in the Self group would seek for themselves (all p<.001). In contrast, participants in the Self group were more likely to reach out to family/friends in four vignettes (fall, fall while intoxicated, motor vehicle crash, hit/by against; all p>.001). Self participants were also more likely to do nothing following injury in three vignettes (sports, fall while intoxicated, and hit/by against; all p>.001) as compared to the Other group.

Conclusions: Participants in the Other group recommended healthcare services more frequently than those in the Self group, revealing differences between injury identification and subsequent healthcare decisions when deciding for oneself compared to advising a friend. Such results are consistent with the Common Sense Model, in that individuals conceptualize concussions based on identity and then choose an action.

Author(s) Disclosures: None