Number of prior concussions predict poorer concussion care seeking in military cadets
Julianne D. Schmidt, Melissa N. Anderson, Michelle Weber Rawlins, Craig A. Foster, Brian R. Johnson, Christopher D’Lauro
Abstract
Primary objective: To determine whether concussion history predicts concussion care seeking, self-management practices, or confidence to recognize/report.Research design:Cross-sectional.Methods & procedures: 706 United States Air Force Academy (USAFA) cadets completed survey items regarding concussion history (0,1,2,3+), likelihood of reporting a concussion, self-management, and confidence to recognize/report. We used multivariate ordinal and binary logistic regression models to predict responses using concussion history, sex, and race.Main outcomes & results: cadets with 1 (OR = 0.59, 95%CI:0.43–0.82), 2 (OR = 0.55, 95%CI:0.31–0.98), or 3+ (OR = 0.36, 95%CI:0.17–0.78) concussions while at USAFA had respective 41%, 45%, and 64% lower likelihood to report the concussion scenario (ref = no history, p < .001). USAFA cadets with more extensive concussion histories had higher prevalence of not seeking care for a concussion (p < .001); more strongly endorsed self-management (p = .001–0.010); and had greater confidence in their ability to recognize a concussion (p = .005), but not to report (p = .198–0.413).Conclusions: Prior concussion experiences may deter cadets from seeking medical care for future concussions. Interventions should address concussion history and clinicians should consider how the post-concussion management process might deter care seeking.