Concussion Risk and the Need for Prevention: An Exploration Into the Complexity of Community Perspectives in Rugby Union

Abstract

Background Community perceptions of injury risk can impact participation rates and may influence attitudes and behaviours around prevention efforts. Understanding how end-users think about concussion-related risk and the need for prevention is critical for the design and implementation of interventions. This study aimed to explore community rugby union stakeholders’ perceptions of concussion risk and the need for prevention.

Methods This pragmatic, qualitative descriptive study utilised semi-structured interviews and focus groups with 62 school- and club-level community rugby stakeholders (provincial union representatives, players, coaches, school/club sport administrators, team leads (managers), physiotherapists, nurses and doctors) from across New Zealand during the 2022 rugby season. Reflexive thematic analysis was used to analyse the data.

Results Three themes were developed from the data. The theme ‘concussion risk: a spectrum of concern’ included a spectrum of beliefs ranging from ‘concussions are a problem’ to the belief that concussions are only a problem if not managed well or that it has always been part of the game, and the risks are being exaggerated. A second theme, ‘focus on technique and conditioning, or is injury just the nature of the game?’, described beliefs in the importance of technique and conditioning or contrary beliefs such as ‘as long as there is contact, there will be concussion’. A third theme, ‘conflicting concussion narratives’, described the tendency of some participants to move back and forth across the spectrum of risk and prevention perceptions, depending on the context.

Conclusions Findings reveal a diversity of perspectives on how concussions should be managed or prevented. Balancing these perspectives is critical. This involves addressing unfavourable beliefs, prioritizing both prevention and effective management and community-wide education