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329 Playing the game or gaming the system: are US private high school student-athletes reporting, hiding or faking concussions?

Background Sports- and recreation-related (SRR) activities are a major cause of concussions among adolescents. Most adolescent SRR concussion research has been conducted among public school students. As private schools are qualitatively different from public schools (e.g. location, socioeconomic status, sports played), this study explores the concussion experiences of a large group of private high school students. Objective The purpose of this study is to describe concussion reporting and return to learn (RTL) and return to play (RTP) post-concussion in a sample of private high school students who play a sport or engage in a recreational activity. These outcomes were also stratified by gender, contact level of their primary sport, and grade. Design We surveyed students who played sports or a recreational activity about the sports they played, and their self-reported concussion experiences between April - May, 2018. Descriptive, bivariate, and multivariate statistics are presented. Setting Ten New England private preparatory high schools. Patients (or Participants) Data was collected from 2,122 male and female students. Interventions (or assessment of risk factors) Sex, grade, contact level of primary sport played and age of first concussion. Main outcome measurements The main outcome of interest was percentage of students who reported/hid a concussion, and the time it the student to return to school and then to sport. Results One-third (33.0%) of students who reported engaging in sport-activities, self-reported experiencing a concussion in their lifetime. A higher percentage of males, students who played contact sports, and those who played multiple seasons of school sports, reported a concussion. Sex, contact level of primary sport played and age of first concussion were also significantly associated with reporting a sports-related concussion. 3% of students reported faking concussions. Conclusions A sizeable proportion of private preparatory high school students reported experiencing a concussion, with some students at higher risk.