PURPOSE: To evaluation adolescent concussion knowledge and behaviors regarding concussion using a modified Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) questionnaire.
METHODS: RoCKAS questionnaire was taken by female and male 9^th and 10th-grade high school students (n=190) with a mean age of 15.1 ± 0.8 years (64.7% female; 35.3% male). 59.4% reported belonging to a competitive sports team. A sampling of questions from the RoCKAS questionnaire was used to assess groups for (1) general concussion knowledge and (2) the demonstration of safe attitudes and behaviors in situational decision making (“safe” or “unsafe”).
RESULTS: Validity scale scores were appropriate, meaning participants were actually reading and answering the questions thoughtfully. General concussion knowledge was correctly answered by 83.8% (p=0.007). Those not participating in athletics were less knowledgeable than those participating in sports (20.1%). Males not participating in sports answered incorrectly 23.4% of the time. There was no statistical significance comparing females in relation to sports participation. Responses to the four situational questions analyzed identified answers to be unsafe on the behavior questions 87.1 % of the time (p=0.0001). In fact, the actual age of the participants negatively correlated with the behavior answers (r=-0.4, p=0.0001).
CONCLUSIONS: High school 9^th and 10^th-graders are knowledgeable about concussion. Those participating in sporting teams are more knowledgeable, especially males. There is no knowledge differences between females who participate or do not participate in sports. Situation based questions indicate an unacceptable level of safety, suggesting poor behaviors in return-to-play (RTP) and concussion reporting decisions, which was worse in older individuals. The RoCKAS information may be helpful to identify behavior deficits that can inform cohort-specific concussion educational programs designed to enhance the safety of youth athletics.