1. Cassie Glodowski Candidate for Master’s of Science in Athletic Training Weber State University Mentor: Dr. Jordan Utley Identifying predictors of non-reporting in NCAA (DI,DII,DIII) Women’s collegiate soccer athletes

2. Introduction In the US alone 1.7 million will suffer a TBI (McCrea, 2004) 75% of these are concussions or mild TBI (CDC, 2003) 1.35 Million will report to an ER (McCrea, 2004) 275,000 will be hospitalized (McCrea, 2004) Soccer had highest incidence among women’s sports and second overall (Lincoln et al, 2011)

3. Introduction to PROBLEM Diagnosing a sport related concussion is considered the most elusive challenge that sports medicine clinicians face today The problem is increased by athletes underreporting and masking symptoms Only 47.3% who later admit to concussion/symptoms reported it (McCrea,2004) Implications for Second-impact Syndrome Chronic Post-concussion syndrome; early degenerative disease

4. Introduction to the Problem Studies show clear incidence in football due to full body contact (McCrea,2004) Women’s sports and soccer are not often studied, however, contact exists This study looks to determine if there is an underreporting of concussions and reasons for underreporting in NCAA DI,II,III women’s soccer

5. Research Questions Are concussions underreported in NCAA DI,DII,DIII Women’s soccer athletes? Why are concussions underreported in NCAA DI,II,III women’s soccer athletes?

6. Implications for Athletic Training ATCs are most commonly called on to evaluate and manage concussions (McCrea, 2004) 76.7% reported to ATC If we as clinicians know the reasons concussions are not reported we can more effectively combat the problem

7. Methods: Design & Subjects Design Survey study Subjects Participants will be a convenient sample of volunteers from the student investigators contact schools (Divisions I, II, III) Age 18+ Procedure Each athlete will complete the survey during pre- season meetings with other forms

8. Methods: Tools Survey created by Broglio et al. (2010) Valid & Reliable Instrument Assesses Concussion incidence and reasons for not reporting Demographic Form age, position on field, year in school, division of school

9. Methods: Variables Independent Variables of Interest Position on field Year in school Division of school Dependent Variables Self reported concussion rate Self Reported incidence of unreported concussion rate Reasons for underreporting

10. Limitations/Delimitations Limitations Not random sample; limits generalizability Survey completion and return Assume all athlete’s answer honestly Athlete’s knowledge of what is considered a concussion or concussion symptom Delimitations Only Women’s Soccer Teams Only athletes that student-investigator has contact with

11. Hypothesis H 0 : Concussions and concussion like symptoms are reported when they occur in NCAA (DI,DII,DIII) Women’s soccer H 1 : Concussions are underreported in NCAA DI,II,III Women’s Soccer Rationale Athletes are afraid of losing playing time Athletes are afraid of letting the team down The athlete’s coach influenced them to not report The Athlete didn’t believe the symptoms were severe enough The athlete didn’t believe that the sports medicine staff had the proper tools to evaluate and treat the concussion.

12. Timeline Spring 2013 IRB approval Survey and Demographic Forms created in packet Summer 2013: Begin data collection August Convenient sampling of 60-80 athletes Athletes complete survey and return to contact person at each school Fall 2013 September-November: Statistical Analysis Nov 1st: Submit to NATA Student exchange track March 2013: Manuscript written/Poster created

13. References McCrea M, Hammeke T, Olsen G, et al. Unreported Concussion in High School Football Players. Clinical Journal of Sports Medicine. 2004: 4(1) 13-17. Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention; 2003. Lincoln AE, Caswell SV, Almquist JL, et al. Trends in Concussion Incidence in High School Sports. The American Journal of Sports Medicine. 2011 (XX)X 1-6. Broglio SP, Vagnozzi R, Sabin M, et al. Concussion occurrence and knowledge in Italian football. Journal of Sports Science and Medicine. 2010: 9, 418-430.