Document Type

Thesis - Open Access

Award Date


Degree Name

Master of Science (MS)


Health and Nutritional Sciences

First Advisor

Bernadette Olson


adolescent, athletic trainer, attitudes, concussion safety, injury reporting, knowledge


Context: Evidence supports education initiatives to improve knowledge of sport-related concussion (SRC) in active children and adolescents, as well as improve attitudes towards reporting concussion events to a supervising adult with the ultimate goal of early diagnosis and management. Most evidence focuses on urban and suburban children’s SRC knowledge and attitudes; however, little is known regarding knowledge and attitudes of children participating in sport in rural environments. Understanding current knowledge and attitudes of rural children can inform future education and health behavior strategies that encourage early reporting. Objective: Two objectives guided this study. First, obtain and analyze pilot data regarding current sport-concussion knowledge and attitudes from a rural youth cohort using a validated survey tool for adolescents. Secondly, make recommendations regarding the use of the tool and process to apply this method to a larger sample. Design: Survey Design. Setting: Middle and high school education setting. Participants: Twenty of 81 students who participated in interscholastic sport at a rural high school completed the survey for a response rate of 24.7%. More females (70%) than males (30%) completed the survey (Mage=15.0yrs, SD=1.89; range 13-18 years). Data Collection and Analysis: Rosenbaum Concussion Knowledge and Attitudes Survey – Student Version (RoCKAS-ST). Main Outcome Measure(s): Self-reported “likelihood to report”, concussion knowledge index (CKI), and concussion attitude index (CAI). Results: Concussion knowledge (CKI) was high amongst all respondents (19.7/25) and related positively to concussion attitude towards safe environments (CAI = 60.5/75). Students also self-reported a strong likelihood to report a concussion (7.3/10). Age, sex nor participation in contact verses noncontact sports did not vary from this trend with one exception; football respondents reported the lowest likelihood to report regardless of having knowledge and a safe attitudes. Conclusions: Although no formal education strategy has been delivered to this small cohort, respondents demonstrated a high or acceptable level of SRC knowledge, attitude and likelihood to report. The RoCKASST as well at the process for delivering the survey was generally sound, however, delivering the survey during baseline testing may improve response rate. Future research should investigate the knowledge and attitudes of a larger cohort of rural student-athletes and should include more details on where students are receiving their education.

Library of Congress Subject Headings

Brain -- Concussion.
Sports injuries in children.
Rural youth -- Attitudes.


Includes bibliographical references (pages 48-52)



Number of Pages



South Dakota State University


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