An Educational Intervention Improves Bystanders' Willingness To Intervene After Winessing A Sports-Related Concussion

Injury prevention education has demonstrated reducing barriers and increasing feelings of responsibility to intervene after witnessing a medical emergency, but the effects have not been explored in the context of sports-related concussion (SRC). Early SRC recognition and medical care improve injury outcomes, therefore it is important that all bystanders act, especially if a medical provider is not present. PURPOSE: To determine if a novel online concussion education intervention changes bystanders’ perceived barriers and responsibilities to intervene after witnessing a SRC. METHODS: Potential bystanders to a SRC completed a 26 7-point Likert item electronic survey immediately before and after completing an online concussion education intervention. Items were grouped into 7 Bystander Intervention Models domains about perceived barriers and responsibilities to intervene in an emergency. Bystanders included sports medicine professionals (SMP, n = 28), parents/guardians (parents, n = 26), and coaches (n = 35). We averaged responses within each domain. Lower scores reflect fewer barriers and stronger perceived responsibility. We log transformed response data due to non-normal distribution and performed a generalized linear mixed model for time and role, and report the time main effect, interaction effect and post-hoc bystander role pre-post comparisons (α < .05). RESULTS: Eighty-nine individuals from 2 NCAA universities enrolled (52% female; 39.0 ± 11.3 years). Median change scores and their respective time comparison p-values are reported in Table 1. - Table 1. Pre- post-intervention changes in median response for each Bystander Intervention Model domain for all participants and within bystander role groups (sports medicine professionals, parents/guardians, and coaches) with associated p-values. Bystander Intervention Model Domain Time main effectmedian score change (p value) Interaction effect p value Median score change (p value) Sports Medicine Professionals Parents/ Guardians Coaches Barriers to Intervening Skills Deficit -1.00 (< .001*) .013* 0.00 (.539) -0.38 (< .001*) -0.25 (< .001*) Audience Inhibition 0.00 (.077) .900 0.00 (.482) 0.00 (.197) 0.00 (.284) Failure to Notice -0.50 (< .001*) .437 0.00 (.018*) -0.50 (< .001*) -0.50 (.002*) Identify as High Risk -0.38 (< .001*) .770 -0.06 (.058) -0.50 (.018*) -0.38 (.003*) Responsibility to Intervene Diffusion of Responsibility -0.33 (< .001*) .364 0.00 (.249) 0.00 (.004*) -0.33 (.023*) Worthiness of Their Action -0.25 (< .001*) .492 0.00 (.223) -0.25 (.039*) -0.38 (.003*) Relationship with Athlete 0.00 (.017*) .668 0.00 (.145) 0.00 (.506) 0.00 (.031*) Note: Lower scores reflect fewer barriers and stronger perceived responsibility. *statistically significant improvement in perceived barriers or responsibility to intervene after completing the intervention (p < .05) CONCLUSIONS: Following the intervention, parents’ and coaches’ perceived barriers and responsibility to intervene after witnessing a SRC significantly improved in 5 and 6 domains, respectively, while SMPs improved in 1. This suggests that the intervention improved perceived barriers and responsibility in parents and coaches. Additional efforts are needed to address audience inhibition. Supported by: This project was conducted with support from the National Collegiate Athletic Association-Department of Defense Research Grand Challenge: Changing Attitudes about Concussions in Young and Emerging Adults