{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T14:25:41Z","timestamp":1770992741248,"version":"3.50.1"},"reference-count":30,"publisher":"National Athletic Trainers' Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Mandated concussion education has aimed to improve student-athlete knowledge; however, some collegiate student-athletes continue to not disclose concussion. Concussion knowledge may not be the only factor influencing reporting, as student-athlete sex, sport, and pressure from external stakeholders (eg, coaches, teammates, fans, parents or family) have all been documented as influencing collegiate concussion-reporting behavior.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine factors associated with concussion nondisclosure in collegiate student-athletes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Four National Collegiate Athletic Association Division I and two Division II universities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>A total of 1125 collegiate student-athletes completed the survey, and 741 provided viable responses and were included for data analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>We used a 10- to 15-minute electronic or paper-and-pencil survey that asked about personal and sport demographics, diagnosed concussions and nondisclosed concussion history, concussion knowledge, and level of agreement regarding pressure to play after a head impact experienced during collegiate sport participation. Significant univariable factors were entered into a multivariable logistic regression analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sex (P = .005), sport-risk type (P &amp;lt; .001), diagnosed concussion history (P &amp;lt; .001), concussion knowledge (P = .017), and pressure from coaches (P &amp;lt; .001), teammates (P &amp;lt; .001), fans (P = .024), and parents or family (P = .003) were factors associated with concussion nondisclosure in individual univariable logistic regressions. After we conducted multivariable analyses, male sex (P = .001), high concussion-risk sport participation (P = .048), diagnosed concussion history (P &amp;lt; .001), increased concussion knowledge (P = .013), and experiencing pressure from coaches to continue playing after sustaining a hit to the head (P = .002) were factors associated with concussion nondisclosure in collegiate student-athletes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results suggest that concussion-education programs should go beyond the identification of signs and symptoms to include the dangers of continuing to play, long-term consequences, and transparency about concussion protocols. Comprehensive concussion-education programs should involve coaches and athletes to improve the reporting culture.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-0102-20","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T23:33:14Z","timestamp":1613863994000},"page":"157-163","source":"Crossref","is-referenced-by-count":41,"title":["Factors Associated With Concussion Nondisclosure in Collegiate Student-Athletes"],"prefix":"10.4085","volume":"56","author":[{"given":"Morgan","family":"Anderson","sequence":"first","affiliation":[{"name":"Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle M.","family":"Petit","sequence":"additional","affiliation":[{"name":"Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Wallace","sequence":"additional","affiliation":[{"name":"University of Alabama, Tuscaloosa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey","family":"Covassin","sequence":"additional","affiliation":[{"name":"Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Beidler","sequence":"additional","affiliation":[{"name":"Duquesne University, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"2021021722094922800_i1062-6050-56-2-157-b01","doi-asserted-by":"crossref","unstructured":"Zuckerman\n              SL,\n            \n            \n              Kerr\n              ZY,\n            \n            \n              Yengo-Kahn\n              A,\n            \n            \n              Wasserman\n              E,\n            \n            \n              Covassin\n              T,\n            \n            \n              Solomon\n              GS.\n            \n          \n          Epidemiology of sports-related concussion in NCAA athletes from 2009-2010 to 2013-2014: incidence, recurrence, and mechanisms\n          [published correction appears in Am J Sports Med. 2016;44(1):NP5].\n          \n            Am J Sports Med. 2015;\n          43\n          (11):\n\t\t\t\t\t2654\u2013\n\t\t\t\t\t2662.\n\t\t\t\t\tdoi:10.1177\/0363546515599634","DOI":"10.1177\/0363546515599634"},{"key":"2021021722094922800_i1062-6050-56-2-157-b02","doi-asserted-by":"crossref","unstructured":"Bryan\n              MA,\n            \n            \n              Rowhani-Rahbar\n              A,\n            \n            \n              Comstock\n              RD,\n            \n            \n              Rivara\n              F\n            ;\n\t\t\t\t\t\n          Seattle Sports Concussion Research Collaborative. 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