Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Center for Bioethics and Humanities, University of Colorado Denver Anschutz Medical Campus, Aurora.
JAMA Netw Open. 2020 Dec 1;3(12):e2031509. doi: 10.1001/jamanetworkopen.2020.31509.
Despite increased concern about the health consequences of contact sports, little is known about athletes' understanding of their own risk of sports-related injury.
To assess whether college football players accurately estimate their risk of concussion and nonconcussion injury and to identify characteristics of athletes who misestimate their injury risk.
DESIGN, SETTING, AND PARTICIPANTS: In this survey study, questionnaires were given to 296 current college football players on 4 teams from the 3 of the 5 most competitive conferences of the US National Collegiate Athletic Association. Surveys were conducted between February and May 2017. Data were analyzed from June 2017 through July 2020.
Multiple approaches were taken to compare athlete perceptions of their risks of concussion and nonconcussion injury with individual probabilities of these risks, which were modeled using logistic regression.
Of 296 male college-aged athletes from 4 football teams who participated in the survey, 265 (89%) answered all questions relevant for this study. Participating teams were similar to nonparticipating teams across nearly all measured characteristics. One hundred athletes (34%) had sustained 1 or more concussions, and 197 (68% of the 289 who responded to the question) had sustained 1 or more injuries in the previous football season. Logistic regression models of single-season injury and concussion had reasonably good fit (area under the curve, 0.75 and 0.73, respectively). Of the 265 participants for whom all relevant data were available, 111 (42%) underestimated their risk of concussion (χ2 = 98.6; P = .003). A similar proportion of athletes (113 [43%]) underestimated their risk of injury, although this was not statistically significant (χ2 = 34.0; P = .09). An alternative analytic strategy suggested that 241 athletes (91%) underestimated their risk of injury (Wilcoxon statistic, 7865; P < .001) and 167 (63%) underestimated their risk of concussion (Wilcoxon statistic, 26 768; P < .001).
The findings of this survey study suggest that college football players may underestimate their risk of injury and concussion. The implications for informed participation in sport are unclear given that people generally underestimate health risks. It is necessary to consider whether athletes are sufficiently informed and how much risk is acceptable for an athlete to participate in a sport.
尽管人们越来越关注接触性运动对健康的影响，但对于运动员对自身运动相关伤害风险的认知却知之甚少。
评估大学橄榄球运动员是否能准确估计自己患脑震荡和非脑震荡损伤的风险，并确定哪些运动员可能会错误估计自己的受伤风险。
设计、地点和参与者：在这项调查研究中，对来自美国全国大学体育协会（National Collegiate Athletic Association）5 个最具竞争力联盟中 3 个联盟的 4 支球队的 296 名现役大学橄榄球运动员进行了问卷调查。调查于 2017 年 2 月至 5 月进行，数据分析于 2017 年 6 月至 2020 年 7 月进行。
采用多种方法比较运动员对脑震荡和非脑震荡损伤风险的感知与个体风险概率，使用逻辑回归模型对风险概率进行建模。
在参与调查的来自 4 支橄榄球队的 296 名男性大学生运动员中，有 265 名（89%）回答了所有与本研究相关的问题。参与调查的球队在几乎所有可衡量的特征上与未参与的球队相似。100 名运动员（34%）曾遭受过 1 次或多次脑震荡，197 名运动员（289 名回答了这个问题的运动员中有 68%）在之前的橄榄球赛季中遭受过 1 次或多次伤害。单赛季脑震荡和受伤的逻辑回归模型拟合度较好（曲线下面积分别为 0.75 和 0.73）。在所有相关数据均可用的 265 名参与者中，有 111 名（42%）低估了自己患脑震荡的风险（χ2=98.6；P=0.003）。尽管没有统计学意义（χ2=34.0；P=0.09），但同样比例的运动员（113 名[43%]）低估了自己受伤的风险。另一种分析策略表明，有 241 名运动员（91%）低估了自己受伤的风险（Wilcoxon 统计量，7865；P<0.001），167 名运动员（63%）低估了自己患脑震荡的风险（Wilcoxon 统计量，26768；P<0.001）。
这项调查研究的结果表明，大学橄榄球运动员可能会低估自己受伤和脑震荡的风险。鉴于人们普遍低估健康风险，这对知情参与运动的影响尚不清楚。有必要考虑运动员是否获得了足够的信息，以及运动员对某项运动的风险承受能力有多大。
