Concussion Knowledge and Attitude of English Youth Rugby Players: The RUCKAS-YOUTH Survey

Objective This cross-sectional study describes the concussion knowledge and attitudes of male and female 14-18-year-old school rugby union players in England. Methods Data from 515 (Male 421, Female 94) players from 19 schools were collected via the specifically designed Rugby Union Concussion Knowledge and Attitude Survey (RUCKAS-YOUTH) between 2019 and 2022. Knowledge and attitude questions were grouped into themes and analysed against primary cohorts of sex, school status and age group, and secondary cohorts of stated RFU education conduction, concussion history and rugby experience. Associations between knowledge and attitudes were then explored. Results No association between total concussion knowledge and attitude was found. Mean concussion knowledge was 79.3% (26.2/33 ± 2.9). Mean concussion attitude safety score was 76% (129.3/170 ± 14.8). RFU ‘Don’t Be a HEADCASE’ module completion was low (16.9%) and was not associated with concussion knowledge. Private school participants reported significantly safer attitudes towards concussion (77.8%, 132.2 ± 14.0) than state school pupils (74.5%, 126.6 ± 15.1), but not greater concussion knowledge. Male and female participants held similar knowledge and attitudes towards concussion, as did participants across the age spectrum. Concussion attitude safety was significantly greater in players with 7-15 years playing experience than the younger cohort (U=27563.0 p=.005). Conclusion The RUCKAS-YOUTH survey provides a detailed description of UK youth rugby concussion knowledge and attitudes. The survey results indicate that attitudes towards concussion, particularly those that influence symptom disclosure, should be a primary focus of concussion risk reduction interventions once key gaps in knowledge are addressed.