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Factors associated with concussion-symptom knowledge and attitudes toward concussion care seeking in a national survey of parents of middle-school children in the US
Authors:Zachary Y Kerr  Aliza K Nedimyer  Melissa C Kay  Avinash Chandran  Paula Gildner  K Hunter Byrd  Juliet K Haarbauer-Krupa  Johna K Register-Mihalik
Abstract:BackgroundDeveloping appropriate concussion prevention and management paradigms in middle school (MS) settings requires understanding parents’ general levels of concussion-related knowledge and attitudes. This study examined factors associated with concussion-symptom knowledge and care-seeking attitudes among parents of MS children (aged 10–15 years).MethodsA panel of 1224 randomly selected U.S. residents, aged ≥ 18 years and identifying as parents of MS children, completed an online questionnaire capturing parental and child characteristics. The parents’ concussion-symptom knowledge was measured using 25 questions, with possible answers being “yes”, “maybe”, and “no”. Correct answers earned 2 points, “maybe” answers earned 1 point, and incorrect answers earned 0 point (range: 0–50; higher scores = better knowledge). Concussion care-seeking attitudes were also collected using five 7-point scale items (range: 5–35; higher scores = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher scores. Models met proportional odds assumptions. Adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs) (excluding 1.00) were deemed statistically significant.ResultsMedian scores were 39 (interquartile range: 32–44) for symptom knowledge and 32 (interquartile range: 28–35) for care-seeking attitude. In multivariable models, odds of better symptom knowledge were higher in women vs. men (aOR = 2.28; 95%CI: 1.71–3.05), white/non-Hispanics vs. other racial or ethnic groups (aOR = 1.88; 95%CI: 1.42–2.49), higher parental age (10-year-increase aOR = 1.47; 95%CI: 1.26–1.71), and greater competitiveness (10%-scale-increase aOR = 1.24; 95%CI: 1.13–1.36). Odds of more positive care-seeking attitudes were higher in white/non-Hispanics vs. other racial or ethnic groups (aOR = 1.45; 95%CI: 1.06–1.99) and in older parental age (10-year-increase aOR = 1.24; 95%CI: 1.05–1.47).ConclusionCharacteristics of middle school children''s parents (e.g., sex, race or ethnicity, age) are associated with their concussion-symptom knowledge and care-seeking attitudes. Parents’ variations in concussion knowledge and attitudes warrant tailored concussion education and prevention.
Keywords:Pediatrics  Traumatic brain injury  Youth
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