Lost in translation: the association of international status and native language on concussion in collegiate athletes in the United States

ABSTRACT

Objective

The purpose of this study was to characterize the associations of international student status and native language on time (in days) with the date of injury to (i) diagnosis, (ii) symptom resolution, and (iii) return to sport.

Methods

Utilizing data from a cross-sectional cohort of 1,044 concussion cases from LIMBIC MATARS member institutions (n = 11) in the US, we conducted two, matched case–control designs. Cases were divided into two groups: (i) international (n = 32) or domestic students (n = 32) and (ii) English as an Additional Language (EAL) speakers (n = 18) or Native English language speakers (n = 18). Both groups were individually matched to their respective controls based on gender, age, sport, and preexisting health conditions.

Results

There were no significant differences in days from injury to diagnosis (p = 0.94), symptom resolution (p = 0.64), or return to sport (p = 0.15) between international and domestic athletes. EAL speakers experienced symptom resolution approximately 7.5 days sooner (Md = 4.50; IQR = 4.00, 8.00) than Native English language speakers (Md = 12.00; IQR = 7.00, 21.00, p = 0.01).

Conclusions

Our findings suggest that native language is associated with symptom resolution in collegiate athletes. Healthcare professionals should consider barriers related to native language that may impact symptom reporting and the overall injury experience of diverse collegiate athletes.

KEYWORDS:

• Culture
• traumatic brain injury
• sport
• head impact
• social determinants

Acknowledgments

The authorship would like to acknowledge the contributing LIMBIC MATARS site investigators: Michelle Kirk, M.D. and David Gable, ATC, (Texas Christian University), Brett Mortensen, Ph.D., Michael Larson, Ph.D., (Brigham Young University), James Day, Ph.D. (Augustana University), Michael McCrone, ATC and Allison Peplowski (University of South Dakota), Kristin Wilmoth, Ph.D., C. Munro Cullum, Ph.D., (The University of Texas Southwestern Medical Center), Tom Campbell, M.S. (Old Dominion University), Sean Ahonen, ATC (Virginia Union University), Thayne Munce, Ph.D. and Verle Valentine (Sanford Health), Kate Higgins, Ph.D. and Heather Bouchard (University of Nebraska), Jessica Wallace, Ph.D. (University of Alabama), Jessica Gill, Ph.D. (Johns Hopkins University), Catherine Donahue, M.Ed., Daniel Rosenblum, M.Ed., Donna Broshek, Ph.D. and Rachel Smetana, Ph.D. (University of Virginia), Tenesha Helm (Lynchburg University), and Jessie Oldham, Ph.D. (Virginia Commonwealth University), as well as the NCAA collegiate athletes who contributed to this dataset.

Disclosure statement

Authors PMK, EB, MD, TGB, RR, ND, and DXC do not have conflicts relative to this study to disclose. JER has received funding by the Medical Technology Enterprise Consortium. SRW reports receipt of honorarium and travel costs from the National Athletic Trainers’ Association (NATA; 2022); he presently works on research projects funded by the National Collegiate Athletic Association (NCAA), National Football League (NFL), U.S. Department of Defense (DoD), and U.S. Department of Veterans Affairs (VA), and these agencies do not provide oversight of his research activities. MP acknowledges support from grants from the National Institute on Aging [NIA grant number K01AG065492] and the National Institute on Minority Health and Health Disparities [NIMHD contract number L60MD009326L] and the National Institute on Disability, Independent Living, and Rehabilitation Research [NIDILRR grant number 90DPTB0025],”. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.