{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:23:47Z","timestamp":1790900627390,"version":"4.1.0"},"reference-count":46,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T00:00:00Z","timestamp":1631923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012676","name":"National Collegiate Athletic Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012676","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sport and Health Science"],"published-print":{"date-parts":[[2023,5]]},"DOI":"10.1016\/j.jshs.2021.09.006","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T01:14:17Z","timestamp":1632100457000},"page":"388-397","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":22,"title":["Factors and expectations influencing concussion disclosure within NCAA Division I athletes: A mixed methodological approach"],"prefix":"10.1016","volume":"12","author":[{"given":"Melissa C.","family":"Kay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Hennink-Kaminski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary Y.","family":"Kerr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Gildner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany M.","family":"Ingram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth L.","family":"Cameron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan N.","family":"Houston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Linnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Y.","family":"Peck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johna K.","family":"Register-Mihalik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jshs.2021.09.006_bib0001","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.15585\/mmwr.mm6448a2","article-title":"College sports-related injuries\u2013United States, 2009\u201310 through 2013\u201314 academic years","volume":"64","author":"Kerr","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.jshs.2021.09.006_bib0002","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2015-4635","article-title":"Seattle Sports Concussion Research Collaborative. Sports- and recreation-related concussions in US youth","volume":"138","author":"Bryan","year":"2016","journal-title":"Pediatrics"},{"key":"10.1016\/j.jshs.2021.09.006_bib0003","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1177\/0363546514530091","article-title":"National high school athlete concussion rates from 2005\u20132006 to 2011\u20132012","volume":"42","author":"Rosenthal","year":"2014","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0004","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/jamapediatrics.2015.0210","article-title":"Incidence of concussion during practice and games in youth, high school, and collegiate American football players","volume":"169","author":"Dompier","year":"2015","journal-title":"JAMA Pediatr"},{"key":"10.1016\/j.jshs.2021.09.006_bib0005","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1177\/1090198115599380","article-title":"Concussion education in U.S. collegiate sport: What is happening and what do athletes want?","volume":"43","author":"Kroshus","year":"2016","journal-title":"Health Educ Behav"},{"key":"10.1016\/j.jshs.2021.09.006_bib0006","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s40621-014-0028-x","article-title":"Association between concussion and mental health in former collegiate athletes","volume":"1","author":"Kerr","year":"2014","journal-title":"Inj Epidemiol"},{"key":"10.1016\/j.jshs.2021.09.006_bib0007","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/01.jsm.0000432853.77520.3d","article-title":"Concussion reporting rates at the conclusion of an intercollegiate athletic career","volume":"24","author":"Llewellyn","year":"2014","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0008","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1177\/1049732316669339","article-title":"Concussions and risk within cultural contexts of play","volume":"27","author":"Torres Col\u00f3n","year":"2017","journal-title":"Qual Health Res"},{"key":"10.1016\/j.jshs.2021.09.006_bib0009","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/JSM.0000000000000112","article-title":"Why university athletes choose not to reveal their concussion symptoms during a practice or game","volume":"25","author":"Delaney","year":"2015","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0010","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport: The 5th International Conference on Concussion in Sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0011","doi-asserted-by":"crossref","first-page":"62","DOI":"10.70252\/BJJV1021","article-title":"The lived experience of an in-season concussion amongst NCAA Division I student-athletes","volume":"7","author":"Moreau","year":"2014","journal-title":"Int J Exerc Sci"},{"key":"10.1016\/j.jshs.2021.09.006_bib0012","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/0363546515612082","article-title":"Motivations associated with nondisclosure of self-reported concussions in former collegiate athletes","volume":"44","author":"Kerr","year":"2016","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0013","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/JSM.0000000000000349","article-title":"Relationship between concussion history and concussion knowledge, attitudes, and disclosure behavior in high school athletes","volume":"27","author":"Register-Mihalik","year":"2017","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0014","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1123\/ijsc.2017-0120","article-title":"Using the disclosure decision-making model to understand high school football players\u2019 disclosures of concussion symptoms","volume":"11","author":"Cranmer","year":"2018","journal-title":"Int J Sport Commun"},{"key":"10.1016\/j.jshs.2021.09.006_bib0015","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.jsams.2018.11.003","article-title":"Determinants of intention to disclose concussion symptoms in a population of U.S. military cadets","volume":"22","author":"Register-Mihalik","year":"2019","journal-title":"J Sci Med Sport"},{"key":"10.1016\/j.jshs.2021.09.006_bib0016","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1037\/0003-066X.32.7.513","article-title":"Toward an experimental ecology of human development","volume":"32","author":"Bronfenbrenner","year":"1977","journal-title":"Am Psychol"},{"key":"10.1016\/j.jshs.2021.09.006_bib0017","doi-asserted-by":"crossref","first-page":"645","DOI":"10.4085\/1062-6050-48.3.20","article-title":"Knowledge, attitude, and concussion-reporting behaviors among high school athletes: A preliminary study","volume":"48","author":"Register-Mihalik","year":"2013","journal-title":"J Athl Train"},{"key":"10.1016\/j.jshs.2021.09.006_bib0018","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1037\/0022-0167.52.2.196","article-title":"Consensual qualitative research: An update","volume":"52","author":"Hill","year":"2005","journal-title":"J Couns Psychol"},{"key":"10.1016\/j.jshs.2021.09.006_bib0019","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/JSM.0000000000000557","article-title":"Concussion symptom underreporting among incoming national collegiate athletic association Division I college athletes","volume":"30","author":"Conway","year":"2020","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0020","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/23279095.2013.860604","article-title":"Limited knowledge of concussion symptoms in college athletes","volume":"22","author":"Fedor","year":"2015","journal-title":"Appl Neuropsychol Adult"},{"key":"10.1016\/j.jshs.2021.09.006_bib0021","doi-asserted-by":"crossref","DOI":"10.1177\/2050312117694794","article-title":"Factors affecting the concussion knowledge of athletes, parents, coaches, and medical professionals","volume":"5","author":"Cusimano","year":"2017","journal-title":"SAGE Open Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0022","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1080\/03634523.2018.1465988","article-title":"Mental health stigma and communication and their intersections with education","volume":"67","author":"Smith","year":"2018","journal-title":"Commun Educ"},{"key":"10.1016\/j.jshs.2021.09.006_bib0023","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.psychres.2014.05.017","article-title":"Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample","volume":"219","author":"Pedersen","year":"2014","journal-title":"Psychiatry Res"},{"key":"10.1016\/j.jshs.2021.09.006_bib0024","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jadohealth.2013.11.011","article-title":"Understanding concussion reporting using a model based on the theory of planned behavior","volume":"54","author":"Kroshus","year":"2014","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.jshs.2021.09.006_bib0025","doi-asserted-by":"crossref","first-page":"878","DOI":"10.3109\/02699052.2013.775508","article-title":"Using theory to understand high school aged athletes\u2019 intentions to report sport-related concussion: Implications for concussion education initiatives","volume":"27","author":"Register-Mihalik","year":"2013","journal-title":"Brain Inj"},{"key":"10.1016\/j.jshs.2021.09.006_bib0026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/15438627.2020.1719493","article-title":"Perceived social norms and concussion-disclosure behaviours among first-year NCAA student-athletes: Implications for concussion prevention and education","volume":"29","author":"Register-Mihalik","year":"2021","journal-title":"Res Sports Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0027","first-page":"1","article-title":"Gender differences in concussion-related knowledge, attitudes and reporting-behaviours among high school student-athletes","volume":"33","author":"Sullivan","year":"2018","journal-title":"Int J Adolesc Med Health"},{"key":"10.1016\/j.jshs.2021.09.006_bib0028","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.3109\/02699052.2014.904049","article-title":"Disclosure and non-disclosure of concussion and concussion symptoms in athletes: Review and application of the socio-ecological framework","volume":"28","author":"Kerr","year":"2014","journal-title":"Brain Inj"},{"key":"10.1016\/j.jshs.2021.09.006_bib0029","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.socscimed.2015.04.011","article-title":"Concussion under-reporting and pressure from coaches, teammates, fans, and parents","volume":"134","author":"Kroshus","year":"2015","journal-title":"Soc Sci Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0030","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.jadohealth.2012.10.271","article-title":"Qualitative study of barriers to concussive symptom reporting in high school athletics","volume":"52","author":"Chrisman","year":"2013","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.jshs.2021.09.006_bib0031","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1089\/neu.2018.6161","article-title":"College football players less likely to report concussions and other injuries with increased injury accumulation","volume":"36","author":"Baugh","year":"2019","journal-title":"J Neurotrauma"},{"key":"10.1016\/j.jshs.2021.09.006_bib0032","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2017-000317","article-title":"Psychosocial stress factors, including the relationship with the coach, and their influence on acute and overuse injury risk in elite female football players","volume":"4","author":"Pensgaard","year":"2018","journal-title":"BMJ Open Sport Exerc Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0033","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/j.1600-0838.2007.00705.x","article-title":"What makes coaches tick? The impact of coaches\u2019 intrinsic and extrinsic motives on their own satisfaction and that of their athletes","volume":"18","author":"Jowett","year":"2008","journal-title":"Scand J Med Sci Sports"},{"key":"10.1016\/j.jshs.2021.09.006_bib0034","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1080\/02640410400021427","article-title":"Fear of injury in gymnastics: Self-efficacy and psychological strategies to keep on tumbling","volume":"23","author":"Chase","year":"2005","journal-title":"J Sports Sci"},{"key":"10.1016\/j.jshs.2021.09.006_bib0035","first-page":"107","article-title":"College athletes\u2019 perceptions of social support provided by their coach before injury and after it","volume":"48","author":"Malinauskas","year":"2008","journal-title":"J Sports Med Phys Fitness"},{"key":"10.1016\/j.jshs.2021.09.006_bib0036","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40621-018-0159-6","article-title":"Dawn Comstock R. Injuries in girls\u2019 soccer and basketball: A comparison of high schools with and without athletic trainers","volume":"5","author":"Pierpoint","year":"2018","journal-title":"Inj Epidemiol"},{"key":"10.1016\/j.jshs.2021.09.006_bib0037","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2010.9.FOCUS10187","article-title":"A prospective study of concussion education in 2 junior ice hockey teams: Implications for sports concussion education","volume":"29","author":"Echlin","year":"2010","journal-title":"Neurosurg Focus"},{"key":"10.1016\/j.jshs.2021.09.006_bib0038","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3928\/19425864-20170109-03","article-title":"Presence of athletic trainers in a youth football organization: A single institution's experience","volume":"9","author":"Urban","year":"2017","journal-title":"Athl Train Sports Health Care"},{"key":"10.1016\/j.jshs.2021.09.006_bib0039","unstructured":"Phillips J. The relationship between the athlete and the athletic trainer and how it effects concusison reporting. Electronic Theses and Dissertations Paper 116. Georgia Southern University; Statesboro, Georgia. 2010."},{"key":"10.1016\/j.jshs.2021.09.006_bib0040","first-page":"1004","article-title":"Social norms theory and concussion education","volume":"30","author":"Kroshus","year":"2015","journal-title":"Health Educ Res"},{"key":"10.1016\/j.jshs.2021.09.006_bib0041","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/15438627.2020.1719493","article-title":"Perceived social norms and concussion-disclosure behaviours among first-year NCAA student-athletes: Implications for concussion prevention and education","volume":"29","author":"Register-Mihalik","year":"2021","journal-title":"Res Sports Med"},{"key":"10.1016\/j.jshs.2021.09.006_bib0042","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4085\/1062-6050-51.12.25","article-title":"Organizational infrastructure in the collegiate athletic training setting, part III: Benefits of and barriers in the medical and academic models","volume":"52","author":"Eason","year":"2017","journal-title":"J Athl Train"},{"key":"10.1016\/j.jshs.2021.09.006_bib0043","doi-asserted-by":"crossref","first-page":"23","DOI":"10.4085\/1062-6050-51.12.24","article-title":"Organizational infrastructure in the collegiate athletic training setting, part II: Benefits of and barriers in the athletics model","volume":"52","author":"Goodman","year":"2017","journal-title":"J Athl Train"},{"key":"10.1016\/j.jshs.2021.09.006_bib0044","doi-asserted-by":"crossref","first-page":"573","DOI":"10.4085\/1062-6050-0463-19","article-title":"Sports medicine staffing across national collegiate athletic association division I, II, and III schools: Vidence for the medical model","volume":"55","author":"Baugh","year":"2020","journal-title":"J Athl Train"},{"key":"10.1016\/j.jshs.2021.09.006_bib0045","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1123\/ijatt.17.4.1","article-title":"Patient-centered care and conflict of interests in sports medicine-athletic training","volume":"17","author":"Wilkerson","year":"2012","journal-title":"Int J Athl Ther Train"},{"key":"10.1016\/j.jshs.2021.09.006_bib0046","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1136\/bjsports-2020-102185","article-title":"Improving concussion education: Consensus from the NCAA\u2013Department of Defense Mind Matters Research and Education Grand Challenge","volume":"54","author":"Kroshus","year":"2020","journal-title":"Br J Sports Med"}],"container-title":["Journal of Sport and Health Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2095254621001034?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2095254621001034?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T21:42:36Z","timestamp":1761860556000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2095254621001034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":46,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["S2095254621001034"],"URL":"https:\/\/doi.org\/10.1016\/j.jshs.2021.09.006","relation":{},"ISSN":["2095-2546"],"issn-type":[{"value":"2095-2546","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Factors and expectations influencing concussion disclosure within NCAA Division I athletes: A mixed methodological approach","name":"articletitle","label":"Article Title"},{"value":"Journal of Sport and Health Science","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jshs.2021.09.006","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Published by Elsevier B.V. on behalf of Shanghai University of Sport.","name":"copyright","label":"Copyright"}]}}