Youth intentions to provide social support to a peer with a concussion

Figures & data

Table 1. Number of questions per survey section.

Survey Section	Number of Survey Questions
Section 1: Anonymous identification code	8
Section 2: Participant demographics	8 + 3
Section 3: Concussion knowledge	13
Section 4: Attitudes	12
Section 5: Subjective norms	4
Section 6: Self-efficacy	10
Section 7: Intentions to provide social support to a peer	10
Total	65 + 3

Table 2. Participant demographic information (N = 200).

Demographic	Participants
Age, mean (SD)	15.30 (1.52)
Grade, N (%)
9	92 (46.00)
10	21 (10.50)
11	20 (10.00)
12	64 (32.00)
Other	3 (1.50)
Gender, N (%)
Male	99 (49.50)
Female	96 (48.00)
Prefer not to specify	2 (1.00)
Other	2 (1.00)
Did not respond	1 (0.50)
Age, N (%)
13	10 (5.00)
14	82 (41.00)
15	23 (11.50)
16	25 (12.50)
17	46 (23.00)
18	11 (5.50)
19	3 (1.50)
In the last 12 months, what organized sports (i.e. on a school team, or in a league or club) have you participated in(individually or on a team)? (check all that apply) N (%)
Ball Hockey	25 (12.50)
Baseball	25 (12.50)
Basketball*	54 (27.00)
Badminton	27 (13.50)
Boxing	4 (2.00)
Cheerleading	2 (1.00)
Cross Country Running	28 (14.00)
Cycling (Road)	8 (4.00)
Curling	4 (2.00)
Dance	18 (9.00)
Diving	3 (1.50)
Downhill Skiing	27 (13.50)
Equestrian	6 (3.00)
Field Hockey	7 (3.50)
Figure Skating	4 (2.00)
Football*	19 (9.50)
Golf	27 (13.50)
Gymnastics	3 (1.50)
Hockey*	53 (26.50)
Kickball	4 (2.00)
Lacrosse	7 (3.50)
Martial Arts (e.g. Karate, Tae Kwon Do, Judo etc.)	6 (3.00)
Mountain Biking	5 (2.50)
Nordic (Cross-Country) Skiing	0 (0.00)
Ringette	0 (0.00)
Roller Derby	0 (0.00)
Rowing	4 (2.00)
Rugby	18 (9.00)
Running	33 (16.50)
Snowboarding	15 (7.50)
Soccer*	41 (20.50)
Softball	19 (9.50)
Speed Skating	2 (1.00)
Spikeball	10 (5.00)
Swimming	43 (21.50)
Synchronized Swimming	4 (2.00)
Tennis	30 (15.00)
Track and Field	34 (17.00)
Ultimate Frisbee	18 (9.00)
Volleyball	27 (13.50)
Waterpolo	1 (0.50)
Weightlifting	11 (5.50)
Wrestling	2 (1.00)
I don’t play organized sports	23 (11.50)
I play sports recreationally	25 (12.50)
Other	11 (5.50)
Have you ever been diagnosed with a concussion? N (%)
Yes	58 (29.00)
No	127 (63.50)
Not sure	15 (7.50)
Prefer not to answer	0 (0.00)
If yes, how many? N (%)
1	26 (13.00)
2	18 (9.00)
3	8 (4.00)
4	0 (0.00)
5 or more	4 (2.00)
Did not respond	2 (1.00)
Has somebody close to you, like a friend, teammate or family member ever been diagnosed with a concussion? N (%)
Yes	167 (83.50)
No	22 (11.00)
Not sure	11 (5.50)
Do you think you know a lot about concussions? N (%)
Yes	90 (45.00)
No	110 (55.00)
If yes, how did you learn about concussions? (select all that apply) N (%)
Information from an adult	69 (34.50)
Information from a course	36 (18.00)
Looked up information on your own	33 (16.50)
Information from a friend or sibling	26 (13.00)
Other	8 (4.00)
During the past year, did you learn about concussions at school? N (%)
Yes	102 (51.00)
No	98 (49.00)

*Highest pediatric concussion risk sports, as reported by Zemek et al (4).

Table 3. Knowledge question responses (N = 200).

Knowledge Question	Frequency of Correct Response N (%)
These questions contain statements about concussions that may or may not be true. To the best of your knowledge, please select true or false for each statement.
In order to be diagnosed with a concussion, you have to be knocked out (false)	197 (98.50)
A concussion can only occur if there is a direct hit to the head (false)	166 (83.00)
Immediately returning to play after experiencing a suspected concussion can delay getting better (true)	184 (92.00)
Symptoms of a concussion can sometimes last for several weeks (true) (Missing: N = 1)	197 (98.50)
Concussions can sometimes lead to sadness and difficulty sleeping (true)	194 (97.00)
You can tell if someone has a concussion by looking at them (false)	187 (93.50)
A person may feel lonely when recovering from a concussion (true)	188 (94.00)
Sometimes students need to be away from school for a couple days after being diagnosed with a concussion (true)	194 (97.00)
A concussion can only occur during sports (false)	199 (99.50)
All youth experience sensitivity to light and nausea after being diagnosed with a concussion (false)	132 (66.00)
Section score (out of 10), mean (SD)	9.20 (0.98)
Think about someone who has had a concussion. Check off the following signs and symptoms that you believe are common to experience AFTER a concussion.
Hives (false)	195 (97.50)
Headache (true)	183 (91.50)
Skin Rash (false)	195 (97.50)
Drowsiness (true)	158 (79.00)
Sensitivity to Light (true)	182 (91.00)
Difficulty Remembering (true)	158 (79.00)
Black Eye (false)	182 (91.00)
Fever (false)	169 (84.50)
Balance Problems (true)	151 (75.50)
Nausea (true)	162 (81.00)
Feeling in a ‘Fog’ (true)	134 (67.00)
Sadness (true)	135 (67.50)
Feeling Slowed Down (true)	145 (72.50)
Reduced Breathing Rate (false)	162 (81.00)
Excessive Studying (false)	192 (96.00)
Difficulty Concentrating (true)	157 (78.50)
Dizziness (true)	173 (86.50)
Joint Stiffness (false)	184 (92.00)
Irritability (true)	94 (47.00)
Hair Loss (false)	196 (98.00)
Section score (out of 20), mean (SD)	16.54 (3.07)
Total knowledge score (out of 30), mean (SD)	25.73 (3.46)

Table 4. Social support question responses (N = 200).

Question	Score Mean (SD)	Frequency of Favorable Response N (%)
Social Support Attitudes
If my friend has a concussion …
I would let them know where they can get more information about concussions (Missing: N = 1)	3.37 (0.66)	183 (91.50)
I would tell them why it is important to be seen by a doctor	3.57 (0.62)	188 (94.00)
I would tell them to sit in a dark room and rest*	2.06 (0.84)	61 (30.50)
I wouldn’t ask them about their experience*	2.79 (0.90)	130 (65.00)
I’d check to see how they’re feeling	3.58 (0.57)	194 (97.00)
I’d make sure they know that I’m thinking about them (Missing: N = 1)	3.24 (0.77)	170 (85.00)
I’d make sure to leave them alone while they’re recovering* (Missing: N = 1)	2.44 (0.81)	97 (48.50)
I would text them to make sure they still feel part of the team while they’re recovering (Missing: N = 1)	2.93 (0.90)	141 (70.50)
I would make fun of them for talking about their concussion symptoms*	3.60 (0.76)	178 (89.00)
I would help them study for an upcoming test after they missed days of school	3.26 (0.78)	176 (88.00)
I’d ask them how I can help them make up for missed school work	3.36 (0.66)	185 (92.50)
I’d offer to take notes for them	3.32 (0.74).	178 (89.00)
Section score (out of 48), mean (SD)	37.45 (4.43)
Social Support Subjective Norms
Scenario A: A student runs into another student during a sport competition and complains of a headache, dizziness and difficulty concentrating. The student is diagnosed with a concussion and misses the next day of school
My close friends would provide the student with notes and handouts from classes they missed	3.37 (0.60)	187 (93.50)
Most students at my school would provide the student with notes and handouts from the classes they missed	2.93 (0.72)	154 (77.00)
Scenario B: A student slips in the stairwell at school, hitting their head against the wall. The student does not black out, but cannot remember exactly what happened. They do not have dizziness or nausea but complain of difficulty concentrating in class
My close friends would explain why it is important that the student sees a doctor as they have signs of a concussion (Missing: N = 1)	3.42 (0.62)	187 (93.50)
Most students at my school would explain why it is important that the student sees a doctor as they have signs of a concussion	3.06 (0.70)	163 (81.50)
Section score (out of 16), mean (SD)	12.75 (2.10)
Social Support Self-Efficacy
If my friend has a concussion, I am confident in my ability to …
Direct them where to go at school for concussion support, even if I have never had a concussion	3.34 (0.68)	187 (93.50)
Explain why they may need to switch seats in the classroom, even if it was in front of our classmates	3.16 (0.79)	162 (81.00)
Explain common concussion symptoms to them, even if I have never had a concussion	3.24 (0.71)	174 (87.00)
Treat them the same as before their concussion, even if they cannot participate in practice (Missing: N = 1)	3.45 (0.65)	188 (94.00)
Reassure them of not playing in our final game, even if our teammates feel that they are letting the team down	3.42 (0.61)	189 (94.50)
Make sure they still feel part of the group, even if they missed a couple days of school	3.46 (0.62)	191 (95.50)
Bring them homework from school, even though I will have to walk or be driven to their house	3.25 (0.77)	170 (85.00)
Walk with them to class, even though it might take away from time with other friends	3.35 (0.62)	184 (92.00)
Eat lunch with them in a quiet place, even if all my other friends are eating somewhere loud	3.37 (0.67)	183 (91.50)
Help them study for a test, even if I had my own studying to do	3.26 (0.71)	177 (88.50)
Section score (out of 40), mean (SD)	33.27 (5.25)
Intentions to Provide Social Support
If my friend has a concussion, I would …
Tell them to talk to their parent/guardian if they were feeling in a fog after falling off a bike	3.49 (0.56)	194 (97.00)
Encourage them to play in a sports competition if they were still experiencing symptoms* (Missing: N = 1)	3.05 (1.04)	138 (69.00)
Encourage them to talk to their teacher if they were having trouble concentrating at school	3.47 (0.56)	196 (98.00)
Listen to them describe how they are feeling	3.44 (0.61)	187 (93.50)
Text them to check on them if they weren’t at school	3.28 (0.73)	177 (88.50)
Tell them that I thought they were faking their symptoms to get out of school*	3.12 (1.07)	138 (69.00)
Take their shift at work if they needed time off (Missing: N = 1)	3.25 (0.65)	179 (89.50)
Be unlikely to give them notes from the classes they missed*	2.97 (1.06)	135 (67.50)
Bring them updates from the school club they are involved with	3.31 (0.68)	179 (89.50)
Take their role in a group presentation if they were unable to come to class (Missing: N = 2)	3.23 (0.74)	170 (85.00)
Section score (out of 40), mean (SD)	32.52 (4.73)
Total social support score (out of 144), mean (SD)	115.98 (13.84)

*The most favorable response was strongly disagree and therefore, questions were reversed scored.

Table 5. Bivariate associations between demographic variables and survey sections (N = 200).

Demographic Variable	Concussion Knowledge	Attitudes	Subjective Norms	Self-Efficacy	Intentions to Provide Social Support
Wilcoxon Rank Sum Test (W)
Gender	4571	2567***	3690*	3298***	2411***
Participation in High-Risk Sports	5199	6677***	5264	5797	6721***
Self-Reported Concussion History	3397	3892	3822	3674	3893
Knowing Someone with a Concussion History	1556	1668	1666	1604	1659
Perceived Concussion Knowledge	3269***	4039*	4299	3757**	3959*
Spearman Rank-Order Correlation Coefficient (rho)
Age	− 0.115	0.321***	0.051	0.187*	0.411***

*p ≤ 0.05, ** p < 0.01 and *** p < 0.001

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A	B	C	D	E	F	G	H	I	J
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□ Ball Hockey □ Baseball □ Basketball □ Badminton □ Boxing □ Cheerleading □ Cross Country Running □ Cycling (Road) □ Curling □ Dance □ Diving □ Downhill Skiing □ Equestrian □ Field Hockey □ Figure Skating □ Football □ Golf □ Gymnastics □ Hockey □ Kickball □ Lacrosse □ Martial Arts (e.g. Karate, Tae Kwon Do, Judo, etc.) □ Mountain Biking

□ Nordic (Cross-Country) Skiing □ Ringette □ Roller Derby □ Rowing □ Rugby □ Running □ Snowboarding □ Soccer □ Softball □ Speed Skating □ Spikeball □ Swimming □ Synchronized Swimming □ Tennis □ Track and Field □ Ultimate Frisbee □ Volleyball □ Waterpolo □ Weightlifting □ Wrestling □ I do not play organized sports □ I play sports recreationally □ Other please specify: __________

Table

(1) In order to be diagnosed with a concussion, you have to be knocked out.	True	False
(2) A concussion can only occur if there is a direct hit to the head.	True	False
(3) You cannot get an injury while playing sports.	True	False
(4) Immediately returning to play after experiencing a suspected concussion can delay getting better.	True	False
(5) Symptoms of a concussion can sometimes last for several weeks.	True	False
(6) Concussions can sometimes lead to sadness and difficulty sleeping.	True	False
(7) Students in grade 3 and grade 12 are always the same age.	True	False
(8) You can tell if someone has a concussion by looking at them.	True	False
(9) A person may feel lonely when recovering from a concussion.	True	False
(10) Sometimes students need to be away from school for a couple days after being diagnosed with a concussion.	True	False
(11) A concussion can only occur during sports.	True	False
(12) All youth experience sensitivity to light and nausea after being diagnosed with a concussion.	True	False

Table

□ Hives	□ Feeling in a “Fog”
□ Headache	□ Sadness
□ Skin Rash	□ Feeling Slowed Down
□ Drowsiness	□ Reduced Breathing Rate
□ Sensitivity to Light	□ Excessive Studying
□ Difficulty Remembering	□ Difficulty Concentrating
□ Black Eye	□ Dizziness
□ Fever	□ Joint Stiffness
□ Balance Problems	□ Irritability
□ Nausea	□ Hair Loss

Table

(13) I would let them know where they can get more information about concussions.	Strongly Disagree	Disagree	Agree	Strongly Agree
(14) I would tell them why it is important to be seen by a doctor.	Strongly Disagree	Disagree	Agree	Strongly Agree
(15) I would tell them to sit in a dark room and rest.	Strongly Disagree	Disagree	Agree	Strongly Agree
(16) I would not ask them about their experience.	Strongly Disagree	Disagree	Agree	Strongly Agree
(17) I would check to see how they are feeling.	Strongly Disagree	Disagree	Agree	Strongly Agree
(18) I would make sure they know that I am thinking about them.	Strongly Disagree	Disagree	Agree	Strongly Agree
(19) I would make sure to leave them alone while they are recovering.	Strongly Disagree	Disagree	Agree	Strongly Agree
(20) I would text them to make sure they still feel part of the team while they are recovering.	Strongly Disagree	Disagree	Agree	Strongly Agree
(24) I would make fun of them for talking about their concussion symptoms.	Strongly Disagree	Disagree	Agree	Strongly Agree
(22) I would help them study for an upcoming test after they missed days of school.	Strongly Disagree	Disagree	Agree	Strongly Agree
(23) I would ask them how I can help them make up for missed school work.	Strongly Disagree	Disagree	Agree	Strongly Agree
(24) I would offer to take notes for them.	Strongly Disagree	Disagree	Agree	Strongly Agree

Table

(25) My close friends would provide the student with notes and handouts from classes they missed.	Strongly Disagree	Disagree	Agree	Strongly Agree
(26) Most students at my school would provide the student with notes and handouts from the classes they missed.	Strongly Disagree	Disagree	Agree	Strongly Agree

Table

(27) My close friends would explain why it is important that the student sees a doctor as they have signs of a concussion.	Strongly Disagree	Disagree	Agree	Strongly Agree
(28) Most students at my school would explain why it is important that the student sees a doctor as they have signs of a concussion.	Strongly Disagree	Disagree	Agree	Strongly Agree

Table

(29) Direct them where to go to school for concussion support, even if I have never had a concussion.	Strongly Disagree	Disagree	Agree	Strongly Agree
(30) Explain why they may need to switch seats in the classroom, even if it was in front of our classmates.	Strongly Disagree	Disagree	Agree	Strongly Agree
(31) Explain common concussion symptoms to them, even if I have never had a concussion.	Strongly Disagree	Disagree	Agree	Strongly Agree
(32) Treat them the same as before their concussion, even if they cannot participate in practice.	Strongly Disagree	Disagree	Agree	Strongly Agree
(33) Reassure them of not playing in our final game, even if our teammates feel that they are letting the team down.	Strongly Disagree	Disagree	Agree	Strongly Agree
(34) Make sure they still feel part of the group, even if they missed a couple of days of school.	Strongly Disagree	Disagree	Agree	Strongly Agree
(35) Bring them homework from school, even though I will have to walk or be driven to their house.	Strongly Disagree	Disagree	Agree	Strongly Agree
(36) Walk with them to class, even though it might take away from time with other friends.	Strongly Disagree	Disagree	Agree	Strongly Agree
(37) Eat lunch with them in a quiet place, even if all my other friends are eating somewhere loud.	Strongly Disagree	Disagree	Agree	Strongly Agree
(38) Help them study for a test, even if I had my own studying to do.	Strongly Disagree	Disagree	Agree	Strongly Agree

Table

(39) Tell them to talk to their parent/guardian if they were feeling in a fog after falling off a bike.	Strongly Disagree	Disagree	Agree	Strongly Agree
(40) Encourage them to play in a sports competition if they were still experiencing symptoms.	Strongly Disagree	Disagree	Agree	Strongly Agree
(41) Encourage them to talk to their teacher if they were having trouble concentrating at school.	Strongly Disagree	Disagree	Agree	Strongly Agree
(42) Listen to them describe how they are feeling.	Strongly Disagree	Disagree	Agree	Strongly Agree
(42) Text them to check on them if they were not at school.	Strongly Disagree	Disagree	Agree	Strongly Agree
(42) Tell them that I thought they were faking their symptoms to get out of school.	Strongly Disagree	Disagree	Agree	Strongly Agree
(45) Take their shift at work if they needed time off.	Strongly Disagree	Disagree	Agree	Strongly Agree
(46) Be unlikely to give them notes from the classes they missed.	Strongly Disagree	Disagree	Agree	Strongly Agree
(47) Bring them updates from the school club they are involved with.	Strongly Disagree	Disagree	Agree	Strongly Agree
(48) Take their role in a group presentation if they were unable to come to class.	Strongly Disagree	Disagree	Agree	Strongly Agree

Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahern C, Aglipay M, Sangha G, Boutis K, Beer D, et al. Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED. JAMA. 2016;315(10):1014–25. doi:10.1001/jama.2016.1203.

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