{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:14:01Z","timestamp":1784178841716,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;amp;R"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Efforts to assess concussion\u2010reporting efficacy face logistical challenges relying on behavioral intentions. Self\u2010report surveys often lack correlation with actual behavior. Simulated in\u2010game behavioral observation may offer a better evaluation method when data on actual behavior are not feasibly collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between concussion\u2010reporting intentions and concussion\u2010reporting behavior in a novel simulated in\u2010game experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      This study was performed as a secondary analysis of a larger study that assessed the efficacy of concussion education in concussion\u2010reporting intention among high school athletes. High school football players (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009313) from seven Colorado high schools completed reporting intention questionnaires. Athletes were randomized to either receive standard concussion education from the Centers for Disease Control and Prevention (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009167) or not (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009146). Subsequently, all participants were given a baseline assessment in which they were asked to assess concussion\u2010reporting intention. To test concussion\u2010reporting behavior, all participants watched a novel first\u2010person, 2\u2010minute video in which a simulated concussion occurred. When the simulated concussion occurs, participants are then asked whether they would like to seek evaluation or continue playing. Logistic regression assessed the relationship between concussion\u2010reporting intention and concussion\u2010reporting behavior during the simulated game experience.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Athletes who reported their concussion in the simulated game had higher baseline concussion\u2010reporting intention (\n                      <jats:italic>U<\/jats:italic>\n                      \u2009=\u20098669.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Across both the educated and noneducated groups, each one\u2010point increase in baseline reporting intention was associated with 1.99\u00d7 (95% confidence interval [CI]: 1.11\u20133.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.02) and 1.53\u00d7 (95% CI: 1.07\u20132.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.026) increased odds of reporting the simulated concussion, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Concussion\u2010reporting behavior in a novel, first\u2010person simulated in\u2010game experience is higher among individuals with higher baseline concussion\u2010reporting intention. This approach may offer promise for evaluating concussion\u2010reporting intention and concussion\u2010reporting behavior via interactive video simulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.13441","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T08:23:07Z","timestamp":1752222187000},"page":"281-287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between concussion\u2010reporting intention and reporting behavior in a simulated game setting"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-8229","authenticated-orcid":false,"given":"Niki","family":"Konstantinides","sequence":"first","affiliation":[{"name":"Harvard T.H. Chan School of Public Health Harvard University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9340-6338","authenticated-orcid":false,"given":"Christine M.","family":"Baugh","sequence":"additional","affiliation":[{"name":"Center for Bioethics and Humanities University of Colorado Denver Anschutz Medical Campus  Aurora Colorado USA"},{"name":"Division of General Internal Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-3556","authenticated-orcid":false,"given":"Amy","family":"Bugwadia","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Kroshus","sequence":"additional","affiliation":[{"name":"Center for Child Health, Behavior and Development Seattle Children's Research Institute  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Schowalter","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School; Boston  Charlestown Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Hainline","sequence":"additional","affiliation":[{"name":"New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy D.","family":"Pea","sequence":"additional","affiliation":[{"name":"David Jacks Professor of Learning Sciences and Education Graduate School of Education, Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D.","family":"Zafonte","sequence":"additional","affiliation":[{"name":"University of Missouri School of Medicine  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piya","family":"Sorcar","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine; Stanford Graduate School of Education  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3691-9513","authenticated-orcid":false,"given":"Daniel H.","family":"Daneshvar","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School  Boston Massachusetts USA"},{"name":"Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Spaulding Rehabilitation Hospital  Boston Massachusetts USA"},{"name":"Chronic Traumatic Encephalopathy Center Boston University  Charlestown Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20104635"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2010.08.006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102012\u2010091941"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.19.2549"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2377960820938498"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.11.011"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000137"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.4085\/509\u201020"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00044"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.08.010"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00979"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/neur.2021.0033"},{"key":"e_1_2_7_14_1","unstructured":"TeachAids \u2010 CrashCourse free concussion education products. 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