{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T03:21:59Z","timestamp":1764645719706,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Athletic Trainers\u2019 Association Research and Education Foundation","award":["1718DGP02"],"award-info":[{"award-number":["1718DGP02"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Concussions are a common sport-related injury that require appropriate initial care. Athletic trainers, often a primary source of healthcare for student-athletes, are key individuals involved in initial concussion diagnostic and management decisions. Challenges exist within the athletic environment that may hinder the consistency, efficacy, and\/or effectiveness of concussion-related decision-making by athletic trainers, thereby impacting secondary concussion prevention and patient health. The purpose of this study was to identify factors that impact the intentions of athletic trainers to make appropriate concussion-related decisions under various circumstances. Overall, 1029 participants completed a survey examining educational precursors (quantity and quality of healthcare communication educational focus), demographic precursors (age, gender, educational degree, and employment setting), theory-based mediators (attitudes, perceived norms, and personal agency), and external mediators (knowledge, salience, and communication\/collaboration practices) on appropriate concussion-related decision-making intentions. Data were analyzed using a two-step structural equation modeling approach. Quality of healthcare communication educational focus indirectly impacted appropriate concussion-related decision-making intentions via perceived behavioral control and communication\/collaboration practices. Additionally, several factors impacted intentions to make appropriate concussion-related decisions directly including employment setting, self-efficacy, and general attitudes towards decision-making and concussions. Concussion prevention is aided by the initial and appropriate action taken by a healthcare professional to reduce immediate consequences; however, this action may be influenced by stakeholder relationships. These influential factors of decision-making may place athletes at further injury risk and negatively impact overall athlete health. As such, a sound theoretical framework incorporating the complexity of factors that may influence decision-making is needed.<\/jats:p>","DOI":"10.3390\/ijerph21010082","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T05:24:12Z","timestamp":1704950652000},"page":"82","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Concussion-Related Decision-Making by Certified Athletic Trainers: Implications for Concussion Prevention and Care"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6653-1363","authenticated-orcid":false,"given":"Melissa K.","family":"Kossman","sequence":"first","affiliation":[{"name":"School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA"},{"name":"Sports Medicine and Community Health Research Lab, University of Southern Mississippi, Hattiesburg, MS 39406, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1423-1259","authenticated-orcid":false,"given":"Zachary Yukio","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Matthew Gfeller Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. D.","family":"DeFreese","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Center for Study of Retired Athletes, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen L.","family":"Kucera","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"National Center for Catastrophic Sport Injury Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith A.","family":"Petschauer","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3318-8524","authenticated-orcid":false,"given":"Kurt M.","family":"Ribisl","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johna K.","family":"Register-Mihalik","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Matthew Gfeller Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"STAR Heel Performance Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20192180","DOI":"10.1542\/peds.2019-2180","article-title":"Concussion Incidence and Trends in 20 High School Sports","volume":"144","author":"Kerr","year":"2019","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.csm.2020.08.013","article-title":"Epidemiology of Sport-Related Concussion","volume":"40","author":"Pierpoint","year":"2021","journal-title":"Clin. 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