{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T03:00:15Z","timestamp":1772506815127,"version":"3.50.1"},"reference-count":36,"publisher":"National Athletic Trainers' Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n          <jats:title>Context<\/jats:title>\n          <jats:p>After sport-related concussion (SRC), immediate access to a certified athletic trainer (AT) is important to ensure proper treatment. However, resource allocation and coverage may differ between male and female youth sports.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Objective<\/jats:title>\n          <jats:p>To compare resource allocation between male and female sports in the following areas: (1) rates of immediate on-field evaluation by an AT at the time of injury, (2) time to general health care presentation, and (3) time to SRC clinic presentation.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Design<\/jats:title>\n          <jats:p>Retrospective cohort study.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Setting<\/jats:title>\n          <jats:p>Regional sports concussion center.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Patients or Other Participants<\/jats:title>\n          <jats:p>Athletes aged 14 to 18 years who presented to a regional sports concussion center from November 2017 to April 2022.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Main Outcome Measure(s)<\/jats:title>\n          <jats:p>The primary exposure of interest was sex (male or female). The primary outcome was immediate on-field evaluation by an AT (yes or no). Secondary outcomes included time to general health care and SRC clinic presentation. Descriptive statistics, \u03c7<jats:sup>2<\/jats:sup> analyses, and linear regressions were performed. Covariates included age, history of prior concussions, and statistically significant demographics.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results<\/jats:title>\n          <jats:p>A total of 832 patients with SRC were included (age = 16.2 \u00b1 1.2 years, 66.5% male). Female athletes had lower rates of attention-deficit\/hyperactivity disorder (\u03c7<jats:sup>2<\/jats:sup> = 10.404, <jats:italic>P<\/jats:italic> = .001) and higher rates of anxiety and depression (\u03c7<jats:sup>2<\/jats:sup> = 12.891, <jats:italic>P<\/jats:italic> &lt; .001) compared with male athletes. The average time to presentation to general health care and the SRC clinic did not differ between males and females, but AT on-field evaluation occurred more in male (40.3%) than female (32.3%) athletes (\u03c7<jats:sup>2<\/jats:sup> = 8.677, <jats:italic>P<\/jats:italic> = .013). Multivariable linear regression found that AT on-field evaluation was a significant predictor of time to general health care presentation (\u03b2 = \u2212.085, <jats:italic>P<\/jats:italic> = .015) but not SRC clinic presentation (\u03b2 = \u2212.055, <jats:italic>P<\/jats:italic> = .099). History of prior concussions was a significant predictor of time to initial health care contact (\u03b2 = .083, <jats:italic>P<\/jats:italic> = .018). History of anxiety and depression (\u03b2 = .136, <jats:italic>P<\/jats:italic> &lt; .001) and initial evaluation by emergency department or urgent care (\u03b2 = .305, <jats:italic>P<\/jats:italic> &lt; .001) were significant predictors of delayed time to SRC clinic presentation.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions<\/jats:title>\n          <jats:p>Among 832 concussed youth athletes, female athletes were evaluated less frequently by an AT immediately after injury. Furthermore, not being evaluated by an AT on field was significantly associated with a longer time to health care presentation. Future investigations should elucidate resource equity among male and female athletes.<\/jats:p>\n        <\/jats:sec>","DOI":"10.4085\/1062-6050-0280.23","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T14:31:22Z","timestamp":1702132282000},"page":"785-792","source":"Crossref","is-referenced-by-count":4,"title":["Sex Differences in Resource Allocation and Access to Care After Sport-Related Concussion"],"prefix":"10.4085","volume":"59","author":[{"given":"Olivia L.","family":"Prosak","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine S.","family":"Hajdu","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amad","family":"Amedy","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor J.","family":"Anesi","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Williams","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Jo","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, TN"},{"name":"Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"12","key":"i1938-162X-59-8-785-b01","series-title":"JAMA","first-page":"1180","article-title":"Prevalence of concussion among US adolescents and correlated factors","volume":"318","author":"Veliz","year":"2017","unstructured":"Veliz\n              P,\n            \n            \n              McCabe\n              SE,\n            \n            \n              Eckner\n              JT,\n            \n            \n              Schulenberg\n              JE.\n            \n          \n          Prevalence of concussion among US adolescents and correlated factors. 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J Athl Train. 2017;52(3):175\u2013185. doi:10.4085\/1062-6050-52.1.15"},{"issue":"13","key":"i1938-162X-59-8-785-b10","series-title":"J Neurotrauma","first-page":"2073","article-title":"Head impact locations in U.S. high school boys\u2019 and girls\u2019 soccer concussions, 2012\/13\u20132015\/16","volume":"36","author":"Kerr","year":"2019","unstructured":"Kerr\n              ZY,\n            \n            \n              Campbell\n              KR,\n            \n            \n              Fraser\n              MA,\n            \n            et al.\n          \n          Head impact locations in U.S. high school boys\u2019 and girls\u2019 soccer concussions, 2012\/13\u20132015\/16. 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Pediatrics. 2016;137(1):e20152447. doi:10.1542\/peds.2015-2447"},{"issue":"9","key":"i1938-162X-59-8-785-b30","series-title":"Am J Sports Med","first-page":"1798","article-title":"Epidemiology of severe injuries among United States high school athletes: 2005\u20132007","volume":"37","author":"Darrow","year":"2009","unstructured":"Darrow\n              CJ,\n            \n            \n              Collins\n              CL,\n            \n            \n              Yard\n              EE,\n            \n            \n              Comstock\n              RD.\n            \n          \n          Epidemiology of severe injuries among United States high school athletes: 2005\u20132007. Am J Sports Med. 2009;37(9):1798\u20131805. doi:10.1177\/0363546509333015"},{"issue":"1","key":"i1938-162X-59-8-785-b31","series-title":"Clin Sports Med","first-page":"1","article-title":"Epidemiology of sport-related concussion","volume":"40","author":"Pierpoint","year":"2021","unstructured":"Pierpoint\n              LA,\n            \n            \n              Collins\n              C.\n            \n          \n          Epidemiology of sport-related concussion. Clin Sports Med. 2021;40(1):1\u201318. doi:10.1016\/j.csm.2020.08.013"},{"issue":"3","key":"i1938-162X-59-8-785-b32","series-title":"J Athl Train","first-page":"228","article-title":"Knowledge of concussion and reporting behaviors in high school athletes with or without access to an athletic trainer","volume":"52","author":"Wallace","year":"2017","unstructured":"Wallace\n              J,\n            \n            \n              Covassin\n              T,\n            \n            \n              Nogle\n              S,\n            \n            \n              Gould\n              D,\n            \n            \n              Kovan\n              J.\n            \n          \n          Knowledge of concussion and reporting behaviors in high school athletes with or without access to an athletic trainer. J Athl Train. 2017;52(3):228\u2013235. doi:10.4085\/1062-6050-52.1.07"},{"issue":"7","key":"i1938-162X-59-8-785-b33","series-title":"J Athl Train","first-page":"682","article-title":"Sex differences in high school athletes\u2019 knowledge of sport-related concussion symptoms and reporting behaviors","volume":"52","author":"Wallace","year":"2017","unstructured":"Wallace\n              J,\n            \n            \n              Covassin\n              T,\n            \n            \n              Beidler\n              E.\n            \n          \n          Sex differences in high school athletes\u2019 knowledge of sport-related concussion symptoms and reporting behaviors. J Athl Train. 2017;52(7):682\u2013688. doi:10.4085\/1062-6050-52.3.06"},{"issue":"10","key":"i1938-162X-59-8-785-b34","series-title":"Arch Phys Med Rehabil","first-page":"1751","article-title":"Depression and neurocognitive performance after concussion among male and female high school and collegiate athletes","volume":"93","author":"Kontos","year":"2012","unstructured":"Kontos\n              AP,\n            \n            \n              Covassin\n              T,\n            \n            \n              Elbin\n              RJ,\n            \n            \n              Parker\n              T.\n            \n          \n          Depression and neurocognitive performance after concussion among male and female high school and collegiate athletes. Arch Phys Med Rehabil. 2012;93(10):1751\u20131756. doi:10.1016\/j.apmr.2012.03.032"},{"issue":"6","key":"i1938-162X-59-8-785-b35","series-title":"J Emer Med","first-page":"795","article-title":"Characteristics and outcomes for delayed diagnosis of concussion in pediatric patients presenting to the emergency department","volume":"59","author":"Corwin","year":"2020","unstructured":"Corwin\n              DJ,\n            \n            \n              Arbogast\n              KB,\n            \n            \n              Haber\n              RA,\n            \n            et al.\n          \n          Characteristics and outcomes for delayed diagnosis of concussion in pediatric patients presenting to the emergency department. J Emer Med. 2020;59(6):795\u2013804. doi:10.1016\/j.jemermed.2020.09.017"},{"issue":"17","key":"i1938-162X-59-8-785-b36","series-title":"Br J Sports Med","first-page":"981","article-title":"Under-representation of female athletes in research informing influential concussion consensus and position statements: an evidence review and synthesis","volume":"56","author":"D\u2019Lauro","year":"2022","unstructured":"D\u2019Lauro\n              C,\n            \n            \n              Jones\n              ER,\n            \n            \n              Swope\n              LM,\n            \n            \n              Anderson\n              MN,\n            \n            \n              Broglio\n              S,\n            \n            \n              Schmidt\n              JD.\n            \n          \n          Under-representation of female athletes in research informing influential concussion consensus and position statements: an evidence review and synthesis. 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