All ETDs from UAB

Advisory Committee Chair

Laura E Dreer

Advisory Committee Members

Olivio J Clay

James M Johnston

David C Schwebel

Erin Swanson-Kimani

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


Objective: To examine 1) adolescent communication comfort levels, 2) barriers to com-munication with systems of care (e.g., family, medical, school, athletic, friends), and 3) associations between communication comfort and demographic, injury characteristics, medical history, emotional well-being, and recovery outcomes following a concussion.Methods: Participants were 73 adolescents (mean age = 14 years old, 61.6% male, 67.1% White) recruited from sports medicine clinics. Communication comfort level ratings with individuals in each system of care were assessed with possible responses including: not at all, a little, somewhat, and very. To evaluate barriers to communication, participants provided reasons for comfort ratings less than very. The reasons were coded into key themes through qualitative content analysis. Demographic, injury characteristics, medical history, emotional well-being, and recovery outcomes were collected to evaluate the association between communication comfort levels and those factors. Results: The majority of participants reported feeling very comfortable communicating about their concussions with family and medical systems of care while approximately two thirds were very comfortable with the athletic system. Less than half were very comfortable with the school system of care. Seventy-eight percent were somewhat or very comfortable communicating with their friends. Common themes that emerged as communication barriers across systems of care included poor relationship quality/unfamiliarity, perception that others would not understand or take their injury seriously, a desire to maintain privacy, and concern of being viewed or treated negatively. Only school level was significantly related to communication comfort for multiple systems of care as middle school students reported less comfort communicating with physicians and athletic trainers. When considering effect sizes, history of pre-injury academic accommodations was related to communication comfort with medical, friends, and athletic systems of care. Conclusions: Adolescents were very comfortable talking about issues related to their concussion with medical and family systems of care followed by the athletic system of care. However, hesitancy in communicating with friends and school personnel was apparent. There is a need to improve communication between adolescents with concussions, school personnel, and their friends as failure to disclose concussion symptoms may hinder recovery. Additionally, feeling heard and supported can positively impact psychological functioning during concussion recovery.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.