TY - JOUR
T1 - Intersection of Race and Socioeconomic Status on Concussion Recovery among NCAA Student-Athletes
T2 - A CARE Consortium Study
AU - Boltz, Adrian J.
AU - Memmini, Allyssa K.
AU - Brett, Benjamin L.
AU - Snedden, Traci R.
AU - Yengo-Kahn, Aaron M.
AU - Chandran, Avinash
AU - Conway, Darryl P.
AU - Shah, Rushil
AU - Pasquina, Paul F.
AU - McAllister, Thomas W.
AU - McCrea, Michael A.
AU - Master, Christina L.
AU - Broglio, Steven P.
N1 - Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Purpose The objectives of this study are to 1) describe collegiate student-athlete (SA) race and household income and 2) evaluate time to normal academic performance (i.e., return to learn (RTL)), initiation of the return to play (iRTP) protocol, RTP protocol duration, and time to unrestricted RTP (URTP) after sustaining sport-related concussion (SRC). Methods Data were collected between 2014 and 2020 by the Concussion Assessment, Research, and Education Consortium. Baseline data were used to characterize participant demographics (N = 22,819) and post-SRC outcomes (n = 5485 SRC) in time to RTL (n = 1724) and RTP outcomes (n = 2646) by race. Descriptive statistics and nonparametric tests examined differences across race by demographic and injury characteristics. Kaplan-Meier curves estimated median days to RTL, iRTP protocol, RTP protocol completion, and URTP by race and covariate measures. Multivariable Cox proportional hazards regression assessed the effect of race on risk of RTL and RTP recovery time points. Results SA largely identified as White (75%) followed by Black (14%), multiracial (7%), and Asian (3%). More than half (53%) of all SA reported a household income of >$120,000, whereas 41% of Black SA reported a household income <$60,000. Race was not associated with relative risk of RTL or iRTP but was associated with RTP protocol completion and URTP. Non-Black/non-White SA were 17% less likely (adjusted hazard ratio = 0.83; 95% confidence interval = 0.71, 0.97) to complete the RTP protocol, and Black SA were 17% more likely (adjusted hazard ratio = 1.17; 95% confidence interval = 1.05, 1.31) to reach the URTP time point compared with White SA. Conclusions The present findings suggest collegiate SA enrolled in the Concussion Assessment, Research, and Education Consortium are primarily White and come from household incomes well above the US median. Race was not associated with RTL or iRTP but was associated with RTP protocol duration and total time to URTP. Clinicians should be conscientious of how their implicit or preconceived biases may influence SRC management among National Collegiate Athletic Association SA.
AB - Purpose The objectives of this study are to 1) describe collegiate student-athlete (SA) race and household income and 2) evaluate time to normal academic performance (i.e., return to learn (RTL)), initiation of the return to play (iRTP) protocol, RTP protocol duration, and time to unrestricted RTP (URTP) after sustaining sport-related concussion (SRC). Methods Data were collected between 2014 and 2020 by the Concussion Assessment, Research, and Education Consortium. Baseline data were used to characterize participant demographics (N = 22,819) and post-SRC outcomes (n = 5485 SRC) in time to RTL (n = 1724) and RTP outcomes (n = 2646) by race. Descriptive statistics and nonparametric tests examined differences across race by demographic and injury characteristics. Kaplan-Meier curves estimated median days to RTL, iRTP protocol, RTP protocol completion, and URTP by race and covariate measures. Multivariable Cox proportional hazards regression assessed the effect of race on risk of RTL and RTP recovery time points. Results SA largely identified as White (75%) followed by Black (14%), multiracial (7%), and Asian (3%). More than half (53%) of all SA reported a household income of >$120,000, whereas 41% of Black SA reported a household income <$60,000. Race was not associated with relative risk of RTL or iRTP but was associated with RTP protocol completion and URTP. Non-Black/non-White SA were 17% less likely (adjusted hazard ratio = 0.83; 95% confidence interval = 0.71, 0.97) to complete the RTP protocol, and Black SA were 17% more likely (adjusted hazard ratio = 1.17; 95% confidence interval = 1.05, 1.31) to reach the URTP time point compared with White SA. Conclusions The present findings suggest collegiate SA enrolled in the Concussion Assessment, Research, and Education Consortium are primarily White and come from household incomes well above the US median. Race was not associated with RTL or iRTP but was associated with RTP protocol duration and total time to URTP. Clinicians should be conscientious of how their implicit or preconceived biases may influence SRC management among National Collegiate Athletic Association SA.
KW - BIOPSYCHOSOCIAL
KW - CLINICAL MANAGEMENT
KW - MILD TRAUMATIC BRAIN INJURY
KW - RETURN TO LEARN
KW - RETURN TO PLAY
KW - SOCIAL CONSTRUCT
UR - http://www.scopus.com/inward/record.url?scp=85177779380&partnerID=8YFLogxK
U2 - 10.1249/MSS.0000000000003258
DO - 10.1249/MSS.0000000000003258
M3 - Article
C2 - 37486776
AN - SCOPUS:85177779380
SN - 0195-9131
VL - 55
SP - 2180
EP - 2193
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 12
ER -