Date of Award

Spring 3-9-2020

Degree Type


Degree Name

PhD Health Sciences


Health and Medical Sciences


Deborah DeLuca, JD

Committee Member

Genevieve Pinto-Zipp, Ed.D.

Committee Member

Terrence Cahill, Ed.D.


concussion, coaches, high school, knowledge, attitudes


Background and Purpose of the Study: Sport-related concussions are a major public health issue, particularly so in the setting of sports. Sports dominate American culture and with millions of athletes of all ages participating in these sports these athletes predispose themselves to the risks of sport-related concussions. High-school athletes are of particular interest because of the heightened risks of long-term consequences and of particular note second impact syndrome, which is a catastrophic injury primarily reported in the adolescent aged athlete. Appropriate concussion assessment and management is necessary for reducing the possibility of these long- term effects of concussions. Properly trained and educated medical personnel such as Certified Athletic Trainers (ATC) can help reduce these risks, however, there is a lack of these qualified healthcare professionals throughout high-school sports. With this limited number of high schools employing Certified Athletic Trainers and medical professionals, coaches become the primary decision makers in their absence.

Methods: This study utilized a modified mixed methods methodology with a triangulation design to measure the knowledge and attitudes of high-school coaches. A sample of 183 high school coaches participated in this study.

Results: High-school coaches had adequate knowledge of sport-related concussions (Mean: 18.96) and good attitudes (Mean: 66.67) as measured by the RoCKAS-HSCH instrument. Statistically significant differences were found between high-school coaches’ knowledge and coaching experience (p=.008) and gender coached (p=.017). This indicated that those coaches who had higher levels of coaching experience and coached both male and female athlete’s had significantly higher mean knowledge scores. Significant differences also existed between high school coaches’ attitudes and experience (p=.010) as well as level of sport coached (.001) indicating those coaches with higher levels of coaching experience who coached a combination of freshman, junior varsity and varsity level sports had significantly higher mean attitude scores.

Conclusion: It is vital to understand the knowledge and attitudes that coaches have about concussion and to persist with educational efforts and the assessment of their efficacy in a systemic and organized manner. Through ensuring that coaches are educated about sport-related concussion, athletic trainers and coaches can work together to make sure that the best care is being provided to athletes and develop Initiatives to assist the coaches in helping them establish team cultures that are supportive of concussion safety. Together, coaches and athletic trainers can ensure that athletes and parents are educated about concussion recognition and can work collaboratively to develop and implement concussion safety policies at their schools.