# Knowledge and Attitudes of Youth Ice Hockey Players and Their Parents Toward Concussion in the United Kingdom

## TL;DR

This study examines the knowledge and attitudes of UK youth ice hockey players and their parents about concussions, finding that parents know more and have safer attitudes than players.

## Contribution

The study provides novel insights into concussion awareness among UK youth ice hockey players and their parents, a topic previously underexplored in this region.

## Key findings

- Parents scored significantly higher on concussion knowledge than players.
- Players showed a strong positive correlation between knowledge and safer attitudes, unlike parents.
- Many players endorsed unsafe return-to-play decisions, indicating critical misconceptions.

## Abstract

Introduction and aim

There is a lack of research investigating the knowledge and attitudes of youth ice hockey players and their parents toward concussion in the United Kingdom. This is a topic of increasing concern given the well-known risks associated with contact sports. Previous research in this area has primarily come from North America. The primary objective of our research was to evaluate the knowledge and attitudes regarding concussion among youth ice hockey players and their parents in the United Kingdom. The secondary objective was to examine whether increased knowledge was associated with improved attitudes toward concussion.

Methods

Using the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST), the research assessed both concussion knowledge (Concussion Knowledge Index {CKI}) and attitudes toward concussion management (Concussion Attitudes Index {CAI}) among youth players and their parents. The survey was distributed online to club secretaries to disseminate to their members. In addition, researchers attended local ice hockey matches and directly invited parents and players to participate in the survey. The collection period lasted for six weeks between October 12, 2025, and November 23, 2025. A total of 29 youth players and 55 parents met the inclusion criteria.

Results

Results revealed that both groups demonstrated relatively good levels of concussion knowledge, with parents scoring significantly higher than players (mean CKI: 19.69 vs. 17.86, p=0.0011). Similarly, parents exhibited safer attitudes toward concussion management (mean CAI: 62.62 vs. 57.41, p=0.0015). Notably, a strong positive correlation between knowledge and attitudes was observed among players (Pearson correlation coefficient 0.6213; 95% confidence interval 0.3299 to 0.8046), but not among parents (Pearson correlation coefficient 0.1852; 95% confidence interval -0.0842 to 0.4294). Notably, many players endorsed unsafe return-to-play decisions.

Conclusion

Despite overall positive findings, substantial variability and important misconceptions were identified, particularly among youth players, with a significant proportion providing unsafe responses regarding return-to-play decisions. The study highlights the need for enhanced concussion education, especially for young athletes, and calls for ongoing research and targeted interventions to improve safety in youth ice hockey.