Education is necessary but not sufficient for addressing disparities in concussion knowledge, attitudes, and perceptions

ABSTRACT Introduction Concussion leads to immediate cognitive, physiological, psychological, and emotional consequences that, if left untreated, may persist resulting in longer-term effects. Concussion education programs provide students with the knowledge necessary for them to make an informed decision to seek care should an injury occur. Methods In this observational cohort study, youth participating in public middle or high school athletics in a suburban county in Pennsylvania were asked to complete a survey to assess their concussion knowledge, attitudes, and perceptions before and after concussion education. Results All students increased scores from pre- to posteducation (mean difference, 0.08 to 0.67). Students from noncontact sports, higher grades, and higher Child Opportunity Index (COI) schools tended to have higher scores both before and after concussion education compared to students from contact sports, lower grades, or lower COI schools. Discussion Disparities were identified before and after the educational intervention between sport participation, grade level, and schools with different COI. Although concussion education was successful, with students showing improvement in all questions related to concussion knowledge, attitudes, and perceptions, this study identifies a need for the development of more equitable educational support systems. Understanding these differences may provide opportunities for targeted educational strategies, which might result in improved outcomes for younger athletes, those participating in contact sports, and those from lower COI schools.