New study finds that TeachAids’ CrashCourse is more effective at increasing intent to report concussions compared to other materials
Concussions are largely invisible injuries and difficult to diagnose unless athletes report their symptoms. However, concussions are often under-reported for many reasons, including that athletes may lack the knowledge about concussion symptoms, understanding of concussion severity, or do not feel comfortable reporting their concussions. It is therefore important to evaluate concussion education to determine how well it targets the factors responsible for concussion underreporting.
In this study, we evaluated three of the most popular concussion education programs: CrashCourse, and the current most commonly used video and written programs. We randomly assigned 118 football players to receive one of the three educational programs, to look for changes in factors that other studies have shown to be related to behavior change in adolescents, specifically: intent to report concussions, concussion knowledge, attitudes about concussion reporting, comfort in reporting concussions, and beliefs about whether teammates would report concussions. This study is unique because it is the first study to look at these factors for these educational programs in a randomized trial, which is the gold standard to determine differences between interventions.
The study found that athletes who received the most commonly used written materials did not show significant improvement across any of the factors related to concussion reporting, either immediately after the education or one-month later. The athletes who received the most commonly used video materials only had improvement in intention to report concussions, and only at one-month, but not immediately after education. However, athletes who received CrashCourse showed improvement in intent to report concussion, knowledge about concussion, and attitudes about reporting concussion immediately after education. Of note, the improvements in intent to report concussion and attitudes about reporting concussion were also maintained at one-month after CrashCourse.
“This study provides insight into how effective the three most commonly used education programs are in actually changing the factors associated with concussion reporting”, says Dr. Dan Daneshvar, Director of the Institute of Brain Research and Innovation at TeachAids and Faculty at Harvard University. “Even a small improvement in concussion reporting would yield important benefits given the millions of athletes that experience concussions every year.”
Athletes who received CrashCourse exhibited unique gains compared to the other education. There may be many explanations for these differences. The unique development of CrashCourse may be responsible; CrashCourse was developed iteratively with regular feedback and evaluation by hundreds of stakeholders, including athletes, coaches, athletic trainers, educators, scientists, and physicians. CrashCourse was also developed to target the interpersonal, team-based, and societal pressures that result in concussion underreporting, and the message was modified based on athlete feedback to ensure it “spoke the same language” as the athletes. CrashCourse also uses college football players to deliver the message, which may make the message more relatable. CrashCourse also uses an interactive scenario with a game-based decision to keep athletes interested and engaged; this enthusiasm for the education may be partially responsible for the differences between CrashCourse and the other educational programs. Of note, concussion reporting was measured indirectly by examining the factors previously shown to be most closely related to concussion reporting.
Contributing authors to this paper include luminaries such as Dr. Christine Baugh, Assistant Professor at the University of Colorado School of Medicine; Dr. Jamshid Ghajar, Director of the Stanford Brain Performance Center; Dr. Shelley Goldman, Associate Dean for Faculty Affairs and Professor Emerita (Teaching), Graduate School of Education, Stanford University; Dr. Gerald Grant, Division Chief of Pediatric Neurosurgery, Stanford University School of Medicine; Dr. Roy Pea, the David Jacks Professor of Education & Learning Sciences at Stanford University, School of Education, and Computer Science (courtesy); Dr. Lee Sanders, Division Chief of General Pediatrics, Stanford University School of Medicine; Dr. Maya Yutsis, Team Neuropsychologist, San Francisco 49ers; Dr. Ross Zafonte, Earle P. and Ida S. Charlton Professor and Chairman of the Department of Physical Medicine and Rehabilitation at Harvard Medical School, among others.