Association Of Current Health-Promoting Behaviors On Wellbeing In Adolescent Football Athletes: Implications Beyond Concussion History

PURPOSE: A study on former NFL players found that while concussion history was associated with poorer function, health-promoting behaviors such as physical activity (PA), diet, and adequate sleep showed a stronger association with reduced depressive and anxiety symptoms, improved emotional control, and enhanced cognitive function. Adolescence is a critical period of development, making wellbeing prioritization essential. Thus, this study aims to examine the association between concussion history and health-promoting behaviors (PA and sleep duration) with measures of wellbeing in adolescent football athletes. METHODS: A retrospective cohort design analyzed 267 pre-season questionnaires from adolescent (age = 15.68 ± 1.15) football athletes. Exposures included concussion history, PA (Patient-Reported Outcomes Measurement Information System PA), and average sleep duration (Pittsburgh Sleep Quality Index - 4a). Wellbeing was the main outcome measured by the Engagement Perseverance Optimism Connectedness Happiness Measure of Adolescent Wellbeing scale, with items rated from 1 (almost never) to 5 (almost always). Scores were averaged across five domains: engagement, perseverance, optimism, connectedness and happiness. A linear regression model was run for each outcome of wellbeing, with significance set at p < 0.05. RESULTS: Health-promoting behaviors are significantly associated with all domains of adolescent wellbeing. Increases in PA was significantly associated with increased engagement (β = 0.02; p = 0.01), perseverance (β = 0.07; p = 0.002), optimism (β = 0.07; p < 0.001), and connectedness (β = 0.05; p = 0.005). Increased sleep duration was significantly associated with increases in perseverance (β = 0.11; p = 0.0002), optimism (β = 0.08; p = 0.007), connectedness (β = 0.10; p = 0.002), and happiness (β = 0.13; p = 0.002). History of concussion was not significantly associated with any domain of adolescent wellbeing. CONCLUSIONS: In football, concussions are a topic of concern. However, these findings show that health-promoting behaviors, regardless of concussion history, significantly impacts an individual’s wellbeing. This emphasizes that while concussions are often harmful, an individual's wellbeing is more strongly associated with behaviors within their control.