Daneshvar Daniel H, Baugh Christine M, Lama Roberto D, Yutsis Maya, Pea Roy D, Goldman Shelley, Grant Gerald A, Cantu Robert C, Sanders Lee M, Zafonte Ross D, Hainline Brian, Sorcar Piya
Department of Physical Medicine and Rehabilitation, Harvard Medical School; Boston, Massachusetts, USA; Massachusetts General Hospital; Boston, Massachusetts, USA; Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.
Chronic Traumatic Encephalopathy Center, Boston University School of Medicine, Boston, Massachusetts, USA.
Neurotrauma Rep. 2021 Dec 8;2(1):581-591. doi: 10.1089/neur.2021.0033. eCollection 2021.
Undiagnosed concussions increase the risk of additional concussion and persistent symptoms from concussion. Because there are no reliable objective markers of concussion, self-reporting of subjective and non-visible symptoms are critical to ensuring proper concussion management. For this reason, educational interventions target concussion reporting, but the majority of studies have examined the efficacy of single educational interventions or compared interventions to one another. This randomized crossover study sought to identify whether there was benefit to administering multiple concussion education programs in tandem, back to back. The study randomized 313 male high school football players to first receive CrashCourse concussion education (CC) or Centers for Disease Control and Prevention video concussion education (CDC) followed by crossover with the other education. Athlete concussion-reporting intention, attitudes, subjective norms, perceived behavioral control, and enjoyment of education were assessed at baseline and after each intervention. There were statistically significant improvements across all measures, both after single intervention and crossover (all < 0.001). Secondary analyses examining differences between education found that athletes reported higher enjoyment of concussion education immediately after participating in CC, as compared to CDC ( < 0.001). These findings demonstrate an additive benefit to implementing CC and CDC education in tandem, without decrement in enjoyment of concussion education after experiencing dual educations; in fact, enjoyment of concussion education improved after receiving education programs back to back. These educational programs appear to complement one another, and the results support the use of multi-modal concussion education to differentially target and maximize concussion reporting.
未确诊的脑震荡会增加再次发生脑震荡以及脑震荡后持续出现症状的风险。由于目前尚无可靠的脑震荡客观标志物，主观且不可见症状的自我报告对于确保脑震荡的妥善管理至关重要。因此，教育干预的重点是脑震荡报告，但大多数研究都考察了单一教育干预的效果，或者对不同干预措施进行了相互比较。这项随机交叉研究旨在确定连续、相继实施多个脑震荡教育项目是否有益。该研究将313名男性高中橄榄球运动员随机分组，先让他们接受“碰撞课程”脑震荡教育（CC）或疾病控制与预防中心的脑震荡视频教育（CDC），之后再交叉接受另一种教育。在基线时以及每次干预后，对运动员的脑震荡报告意愿、态度、主观规范、感知行为控制以及对教育的喜爱程度进行了评估。在单次干预和交叉干预后，所有指标均有统计学意义上的显著改善（所有P值均<0.001）。对不同教育方式之间差异的二次分析发现，与接受CDC教育相比，运动员在参加CC教育后立即报告对脑震荡教育的喜爱程度更高（P<0.001）。这些研究结果表明，同时实施CC和CDC教育具有累加益处，在接受双重教育后对脑震荡教育的喜爱程度并未降低；事实上，相继接受教育项目后脑震荡教育的喜爱程度有所提高。这些教育项目似乎相互补充，研究结果支持使用多模式脑震荡教育来有针对性地提高并最大化脑震荡报告率。
