Concussion Knowledge and Reporting Behaviors in Collegiate Equestrian Athletes: Implications for Health Promotion

Purpose Most equestrian programs lack mandated injury care access despite an elevated risk of concussive injury. Thus, this research evaluated relationships between equestrian and non-equestrian sport participation and relationships to concussion education on perception of concussion injury and reporting behaviors among female collegiate athletes. Secondly, accessibility to athletic trainers (ATs) and impacts on willingness to report concussion injury was determined. Design Quantitative, cross-sectional study. Setting Collegiate Athletics. Sample 135 female athletes with 67% equestrians. Measures A survey was built by integrating constructs of education, reporting perceptions, and reporting behaviors adapted from prior injury reporting tools and constructs. The items included concussion education (4 items), concussion perception (9 items) and reporting behavior (6 items), with each scored as a summed composite. Analysis Inferential statistics included t-tests for group mean differences and chi-square tests for categorical relationships. Results Equestrian athletes reported less willingness to disclose concussion during high-stakes events ( P = 0.036), and lower scores on key reporting behaviors ( P = 0.08) than non-equestrians. Formal concussion education significantly improved both perception ( P = 0.002) and reporting scores ( P = 0.001), among equestrians. Access to ATs varied by race and ethnicity ( P = 0.024), and team sport participants were more likely to report concussion symptoms than individual sport athletes ( P = 0.033). Conclusion Collegiate equestrian athletes showed strong understanding of concussion symptoms, yet they demonstrated lower likelihood of reporting in competitive environments compared with non-equestrian peers. ATs are key facilitators of education and care, especially in decentralized or club sports. Adopting systems which encourage empowerment and reduce perceived punitive outcomes may reduce untreated injuries and improve long-term health outcomes.