Abstract
Purpose: Many athletes do not seek care for a suspected concussion for a number of reasons. Failing to do so can lead to persisting symptoms, longer recovery, or secondary injury. The Theory of Planned Behavior (TPB), along with knowledge of concussion, has been used to examine concussion care seeking. It is theorized that TPB components including attitudes, subjective norms, and self-efficacy are associated with one’s intention to perform a health-related behavior, and their actual behavior. Many studies have used the TPB in an attempt to predict concussion disclosure, with mixed results. The purpose of this systematic review was to determine if knowledge, attitudes, subjective norms, and self-efficacy predict concussion care seeking intentions and self-reported behavior. Methods: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychInfo, SportDiscus, Cochrane Central Register of Controlled Trials, and reference lists were searched. Studies were selected to be reviewed if they were published in English within the last 20 years, included athletes as participants, and the TPB constructs, along with knowledge were independent variables, while intentions and behavior were dependent variables. Article quality was assessed with the National Institute of Health Quality Assessment Tool and the Critical Appraisal Skills Programme. Results: Twenty-eight studies were included in our systematic review. Higher self-efficacy scores were most frequently associated with greater intentions, followed by attitudes and subjective norms. Self-efficacy was also associated with self-reported behavior. Mostly, intentions either were not predictive of reported behavior or results were inconclusive. Conclusions: Numerous articles examined that one’s perceived ability to disclose a concussion (i.e.., recognize a concussion, capacity to seek care even when others may not want them to, etc.) is beneficial to influencing one’s intentions to disclose a suspected concussion. However, we were unable to determine the relationship strength between variables due to heterogeneity of outcome variables and study designs. Understanding concussion care seeking is complicated and should include a multitude of personal, social, and contextual factors collectively for deeper insight. Future research should aim to consistently apply measures which would enable meta-analyses to be conducted in order to determine which TBP constructs predict concussion disclosure intentions and behavior.
Acknowledgements
None.
Recommended Citation
Weber Rawlins ML, Bay RC, Valovich McLeod T. Application of the Theory of Planned Behavior in Concussion Disclosure: A Systematic Review. The Internet Journal of Allied Health Sciences and Practice. 2025 Jan 17;23(1), Article 14.
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