A Reasoned Action Approach to Parent-Child Concussion Communication in Youth Sports

Abstract

This study applied the reasoned action approach to examine psychosocial predictors of parent-child communication intentions about sport-related concussions (SRCs). While parents are central to youth concussion safety, little research has identified which belief-based mechanisms shape their intent to initiate SRC conversations. Using a cross-sectional survey of U.S. parents of youth athletes aged 8–12 (N = 300), both main and interaction effects of experiential and instrumental attitudes, injunctive and descriptive norms, and perceived behavioral control (operationalized as capacity) were tested. Findings showed that experiential attitudes, injunctive norms, and capacity significantly predicted intention. Moderation analyses revealed that perceived behavioral control strengthened, and perceived norms attenuated, the attitude–intention relationship. These results suggest intention formation is not merely additive but shaped by the relationships between attitudinal, normative, and control-based beliefs. Theoretically, this study expands the reasoned approach by modeling moderation across all three intention pathways and addresses calls for more granular application of theory in sport communication. Practically, it identifies belief-based levers—emotional framing, normative messaging, and confidence-building—that can improve concussion education for parents during a critical developmental window. Findings contribute both to sport health messaging and to understanding how psychosocial beliefs shape behavior in emotionally sensitive, parent-driven safety contexts.

Keywords

Sport-related concussions (SRCs) remain a formidable health crisis for youth athletes, with approximately 10% expected to experience a concussion during their athletic participation (Bretzin et al., 2022). Among youth athletes with SRCs, roughly one in three will experience long-term psychological problems such as depression, anxiety, or anger issues (Burns et al., 2024) and worsened academic performances (Jo et al., 2024). Despite the health risks youth athletes face, there remains a significant lack of research in this context for children ages 8–12 (Zargari et al., 2024). This developmental window is formative for internalizing safety norms, as children are highly responsive to parental modeling and communication (Vega-Diaz et al., 2023). The research gap is especially concerning given that prompt reporting of concussion symptoms is critical to ensuring proper care. SRCs that go unreported or are reported pose risks of long-term neurological harm—as evidenced by D’Lauro and colleagues (2024), who found delayed care-seeking in a combined sample of athletes and military personnel, highlighting the broader challenges of symptom disclosure in high-pressure environments. This troubling trend is further explained by a systematic review of adolescent athletes which found that underreporting often stems from a desire to continue playing, normative pressures, and fear of letting down teammates (Ferdinand Pennock et al., 2023). As educational efforts have largely been ineffective at increasing athlete SRC reporting rates (for review, see Conaghan et al., 2021), often struggling to overcome social and normative barriers within athletic environments, a more novel approach is needed. Recent research underscores this challenge, demonstrating that subjective norms are the strongest predictor of athletes’ self-reporting intentions and the only predictor of their intentions to report signs of concussion in teammates (i.e., other-reporting), yet these norms are notably resistant to change via traditional educational materials (Cranmer et al., 2025). This highlights the limitations of focusing solely on athletes and supports shifting focus to utilize youth athletes’ referents (e.g., parents, coaches) to promote healthier sporting environments (Cranmer & LaBelle, 2018).

Given the limitations of athlete-focused education, research has increasingly recognized health referents—including athletic trainers, coaches, and parents—as crucial agents for improving youth SRC safety. This paradigm shift is well-supported by scholarship demonstrating these groups’ influence. Adame and colleagues (2022) documented how narratives from trainers, coaches, and teammates shape collegiate athletes’ concussion attitudes and reporting behaviors, while Cranmer and colleagues (2025) specifically highlighted teammates’ critical role in athlete reporting intentions. Recent work by Hartman and Cranmer (2025) has further emphasized the need for greater scholarly focus on coaches as key influencers. Within this landscape, parents represent a particularly vital referent group. As Cranmer and Rey (2024) outline in their chapter of family-sport dynamics, parent-child communication exists on a continuum from problematic (e.g., criticism, pressure) to open (e.g., empathy, encouragement), where open communication fosters athlete well-being and problematic communication heightens stress and dropout risk. Engaging parents is therefore a strategic priority (Bonavolontà et al., 2021) yet emphasizing athletic success over safety reduces children’s likelihood of discussing SRCs (Kroshus et al., 2018). This communication gap risks conveying parental disapproval of injury disclosure and undermines athlete safety. To counter this, actively engaging in open, supportive conversations about SRCs and safety measures is critical. Such dialogue not only addresses immediate health risks but also fosters children’s broader psychosocial development (Ho et al., 2022). Strengthening these conversations fosters a culture of safety and resilience in youth sports (Zhang, 2020). This communication should be initiated early, as parental influence peaks before adolescence and establishes foundational safety attitudes that persist even as direct oversight diminishes (Dorsch et al., 2021). Thus, a strategy for addressing the barriers to SRC reporting for youth athletes is through parent-child SRC communication.

Even with parents’ known influence on SRC outcomes (Fuller et al., 2022), the specific belief-based determinants shaping their direct communication with children remain less explored. Research has established parental concern about SRCs (Beidler et al., 2024), heightened awareness following a child’s concussion (Schatz et al., 2020) and identified broader psychological processing of concussion risks influencing children’s sport involvement and parental orientations towards safety, social, and familial importance (e.g., Boneau et al., 2020; McGlynn et al., 2022). However, despite this foundational work on parental cognitions and attitudes towards SRC risks and sport participation, many lack confidence in initiating effective conversations (Grimm et al., 2017). Critically, while scholars agree effective parent-child discussions should prioritize symptom recognition and reporting urgency (Fontana et al., 2022; Hartman & Quick, 2024), parents often defer to coaches—who may address SRCs minimally (Kroshus & Chrisman, 2019). This study therefore addresses a vital gap by applying the reasoned action approach to specifically examine the attitudinal, normative, and efficacy-based beliefs that predict parents’ intentions to communicate with their children about SRCs. Hartman and Quick (2024) recommend parents of youth athletes discuss (1) what concussion symptoms are and how to identify them and (2) the importance of the child immediately reporting symptoms to a coach if they were to experience them. To identify the specific psychological factors that shape these recommended communication behaviors, a theoretical framework that accounts for the cognitive, emotional, and social influences guiding parental communication behavior is needed.

Reasoned Action Approach

Although widely used in health behavior research, the reasoned action approach (Fishbein & Ajzen, 2010) remains largely absent from SRC literature. The reasoned action approach refines the theory of planned behavior (Ajzen, 1991), which itself expanded the theory of reasoned action (Fishbein & Ajzen, 1975). While theory of planned behavior has been widely used in SRC research to predict a range of behaviors (for review, see Goodwin and colleagues, 2024), it often relies on broad, composite measures that obscure the psychological mechanisms driving intention and behavior. Fontana and colleagues (2022) found attitudes and social norms predicted parental intentions to communicate with their child about SRCs. However, their use of the theory of planned behavior did not differentiate instrumental and experiential attitudes and collapsed injunctive and descriptive norms into one subjective-norm score, making it impossible to determine whether intentions were driven more by cognitive (i.e., instrumental) versus affective (i.e., experiential) attitudes or by moral obligation (i.e., injunctive) versus perceived prevalence (i.e., descriptive). Thus, the reasoned action approach improves upon theory of planned behavior by decomposing its core constructs into more precise subcomponents. Reasoned action approach’s refinement of these constructs enables more precise identification of the beliefs driving behavior. Its capacity to isolate emotional, normative, and efficacy-based influences makes it especially relevant for addressing social barriers to parent-child SRC communication. To contextualize the rationale for using reasoned action approach in this study, a brief overview of its theoretical development is provided.

The reasoned action approach (Fishbein & Ajzen, 2010) builds on its predecessors—the theory of reasoned action (Fishbein & Ajzen, 1975) and the theory of planned behavior (Ajzen, 1991)—by offering more precise conceptual distinctions among the beliefs that drive behavior. While the theory of reasoned action emphasized attitudes and subjective norms as key predictors of behavioral intention, it struggled to account for behaviors constrained by external factors. The theory of planned behavior addressed this by introducing perceived behavioral control, improving predictive accuracy across health behaviors (McEachan et al., 2011). However, its broad constructs often masked meaningful psychological differences—for example, conflating emotional and cognitive evaluations within attitudes or failing to distinguish between social approval and behavioral prevalence in norms (McEachan et al., 2016). Reasoned action approach resolves these issues by disaggregating its core constructs: attitudes into instrumental (cognitive) and experiential (affective) dimensions; norms into descriptive (perceived prevalence) and injunctive (perceived expectations); and control into capacity (self-efficacy) and autonomy (freedom from constraints). These refinements enable researchers to test more granular hypotheses and tailor interventions to specific belief types. This is especially important in emotionally and socially sensitive contexts like parent-child concussion communication, where affective responses and social pressures may differentially shape behavioral intentions (Fishbein & Ajzen, 2010; McEachan et al., 2016).

Despite offering greater conceptual precision, reasoned action approach remains underutilized in SRC research compared to the more widely adopted theory of planned behavior. The latter has been widely applied to examine various concussion-related behaviors, including athlete symptom reporting (Carpenter et al., 2020; Kroshus et al., 2014), parent-child communication (Fontana et al., 2022), athletic trainers’ adherence to management protocols (Rigby et al., 2013), and the effectiveness of concussion education for collegiate athletes (Cranmer et al., 2025). A recent systematic review (Goodwin et al., 2024) confirmed the theory of planned behavior remains the most used framework for explaining concussion reporting behaviors. However, this dominance comes at the expense of theoretical precision. The reasoned action approach, though underutilized, offers greater conceptual granularity and holds considerable promise for identifying more specific predictors of parent-child SRC communication.

Research has begun to illustrate the unique value of the reasoned action approach in SRC contexts. Baer and colleagues (2024) found attitudes, descriptive and injunctive norms, and capacity predicted collegiate athletes’ intentions to report SRC symptoms. Based on Baer and colleagues’ (2024) study, using the reasoned action approach instead of the theory of planned behavior revealed more distinct predictors of SRC reporting due to the reasoned action’s differentiation of descriptive and injunctive norms as exerting positive and unique influences on intentions. Fontana and colleagues (2022) applied the theory of planned behavior to SRC communication by collapsing descriptive and injunctive norms into a single subjective-norm construct, which may mask how different social pressures (e.g., moral obligation vs. perceived prevalence) distinctly impact parents’ intentions. Additionally, the significance of capacity allows targeted intervention strategies that would have been obscured under the theory of planned behavior’s broader constructs. More specifically, the reasoned action approach clarified that autonomy was irrelevant to reporting intention, highlighting that interventions should focus on building athletes’ confidence (i.e., capacity) and correcting normative misperceptions rather than emphasizing personal control. This study exemplifies reasoned action approach’s ability to reveal more specific behavioral determinants where theory of planned behavior’s broader constructs falls short, highlighting its potential for application to novel SRC contexts like parent-child communication.

The reasoned action approach’s disaggregation of attitudes into instrumental and experiential components is especially relevant to SRC communication, which engages both cognitive and emotional judgments. Instrumental attitudes, for instance, reflect parents’ beliefs about the outcomes of the conversation, such as helping their child recognize concussion symptoms and understanding the importance of reporting them to a coach. Conversely, experiential attitudes reflect how parents anticipate the conversation will feel emotionally; for example, whether talking about SRCs will make their child feel more secure and confident or instead cause stress or discomfort. Fontana and colleagues (2022), using the theory of planned behavior framework, found that parents’ general attitudes toward SRC communication positively predicted behavioral intentions. However, because the theory of planned behavior does not differentiate between instrumental and experiential attitudes, it is unclear which type of evaluation drives intention. In contrast, reasoned action’s separation of these attitudinal dimensions enables researchers to identify the unique contribution of each to behavioral intention, offering clearer guidance on which message strategies (i.e., cognitive-based or affective-based) are most effective in promoting parent-child SRC conversations. Aligning with reasoned action approach’s demonstration that both attitude subtypes independently predict intentions across health behaviors:

Favorable instrumental (H1a) and experiential attitudes (H1b) will be positively associated with parents’ intentions to communicate with their child about SRCs.

The second core attitudinal construct in the reasoned action approach is perceived norms. According to Fishbein and Ajzen (2010), normative influence is best understood by distinguishing between descriptive and injunctive norms. Descriptive norms refer to an individual’s perception of what others typically do (Cialdini et al., 1990; e.g., “Do other parents of youth athletes discuss concussions with their child?”). Injunctive norms pertain to perceived social expectations—what important others think one should or should not do (Rimal & Yilma, 2022). In the context of parent-child SRC communication, injunctive norms would reflect parental perceptions on whether they believe others think they should communicate with their child about SRCs. Research consistently demonstrates that descriptive and injunctive norms can exert distinct influences on behavior, underscoring the importance of differentiating between these constructs. Heiman and colleagues (2023) examined mask-wearing behavior during the COVID-19 pandemic and found that descriptive norms had a stronger effect on future mask-wearing than injunctive norms. Similarly, a study on gambling behavior found that injunctive norms predicted gambling frequency, whereas descriptive norms did not (Meisel & Goodie, 2014). These studies demonstrate that descriptive and injunctive norms function as conceptually distinct constructs and can also differ in their predictive power depending on the behavioral context. Understanding whether parents are more influenced by what they perceive others are doing (i.e., descriptive norms) or by what they believe others expect them to do (i.e., injunctive norms) can inform the design of more tailored and effective interventions. Given the theoretical rationale and empirical support for treating these constructs separately, the following hypothesis is proposed:

Perceived descriptive (H2a) and injunctive norms (H2b) will be positively associated with parents’ intentions to communicate with their child about SRCs.

Perceived behavioral control is a core construct in reasoned action approach, reflecting the degree to which individuals feel capable of performing a given behavior. Reasoned action approach divides this into two distinct subcomponents: capacity, which captures an individual’s confidence or self-efficacy to perform the behavior, and autonomy, which reflects the perceived freedom from external constraints (Fishbein & Ajzen, 2010). While both are theoretically relevant, the present study focuses exclusively on capacity, considering its centrality to communication behaviors (Lar et al., 2023) such as educating (Poulou et al., 2019) and learning (Talsma et al., 2018) and its consistent predictive utility in health contexts (Sheeran & Webb, 2016).

Although Fontana and colleagues (2022) reported nonsignificant effects for perceived behavioral control in parent-child SRC communication, their measurement conflated capacity (e.g., “If I wanted to I could talk to my child about reporting concussion symptoms.”) with autonomy (e.g., “I have complete control over talking with my child about reporting concussion symptoms.”). This conflation likely obscured capacity’s unique role, as demonstrated by Baer and colleagues (2024), where isolated capacity significantly predicted intention while autonomy did not—a finding consistent with meta-analytic evidence that autonomy lacks predictive utility for health intentions (McEachan et al., 2016). In the current study, only capacity was measured, given that parent-child SRC communication is a largely volitional behavior unlikely to be constrained by external barriers. By isolating capacity, this study offers a cleaner test of its influence on communication intentions and aligns with theoretical recommendations for modeling intention formation in controllable behaviors. Accordingly, the following hypothesis is proposed:

Capacity will be positively associated with parents’ intentions to communicate with their child about SRCs.

While reasoned action approach traditionally conceptualizes attitudes, perceived norms, and perceived behavioral control as independent predictors of intention, emerging evidence suggests that these constructs do not always operate in isolation. Rather, their influence on behavioral intentions may shift depending on how they interact with one another—a phenomenon particularly salient in socially sensitive behaviors like parent-child SRC communication. For example, the effectiveness of a parent’s positive attitude toward concussion conversations may depend on whether they perceive support or indifference from other parents and coaches in their child’s sport environment. Likewise, even when parents recognize the value of SRC communication, a lack of confidence in their ability to have the conversation may suppress their intention to act. These interactive effects, often referred to as “boundary conditions,” help identify when and for whom each reasoned action approach construct is most influential (Ho et al., 2022; Martinez & Lewis, 2016). In this context, research has shown that parental involvement can moderate the influence of concussion knowledge on communication intentions (Hartman & Quick, 2024), reinforcing the need to move beyond main effects and examine how key psychosocial variables shape one another’s impact.

A primary example of this dynamic interplay involves the relationship between attitudes and behavioral intentions, which is not always direct. Normative pressures can fundamentally reshape this connection, serving as powerful moderators that amplify or constrain attitudinal influence depending on context (Rimal, 2008). For instance, a parent who believes SRC communication is important (i.e., positive attitude) might hesitate if they observe other parents dismissing their child’s symptoms (i.e., negative descriptive norms). This dynamic is supported by research indicating that perceived norms can significantly influence parental behaviors related to youth sports safety (Hartman & Quick, 2024). Thus, norms act as a boundary condition for attitudinal effects (Fishbein & Ajzen, 2010). For instance, research on university drinking behaviors found that campus-level descriptive norms moderated the relationship between students’ attitudes and their intentions to limit alcohol use—such that perceived group norms could either bolster or weaken the impact of personal attitudes (Park et al., 2009). These findings suggest that the strength of the attitude-intention relationship is contingent upon the perceived normative environment. Applying this to the current study, it is hypothesized that:

Perceived norms will moderate the attitudes to behavioral intentions relationship, such that this relationship will become stronger as perceived norms increase.

Even robust attitudes may falter without the perceived capability to act. Parents may value SRC discussions yet feel unequipped to initiate conversations, thereby weakening intention formation. In contrast, when parents possess strong perceived behavioral control, their positive attitudes become potent drivers of behavioral intentions, transforming conviction into concrete plans for concussion communication. Critically, the attitude-intention link strengthens significantly when parents possess higher self-efficacy (operationalized as capacity in this study). Thus, norms act as a boundary condition for attitudinal effects (Fishbein & Ajzen, 2010). When individuals perceive higher control over a behavior, the link between their attitudes and intentions to act is stronger such as in the context of quitting smoking (Yzer & Van Den Putte, 2014), recycling (Liu et al., 2022), as well as exercising and preserving energy (La Barbera & Ajzen, 2021). Therefore:

Perceived behavioral control will moderate the relationship between attitudes and behavioral intentions, such that this relationship will become stronger as perceived behavioral control increases.

Within the reasoned action approach, perceived norms are a key predictor of behavioral intentions. However, their influence is theorized to be moderated by perceived behavioral control, which shapes how individuals interpret and respond to normative pressures (Ajzen, 1991). When perceived behavioral control is low, social norms may carry more weight, as individuals feel less confident in relying on their own attitudes and instead turn to external guidance (Lapinski & Rimal, 2005). Conversely, high perceived behavioral control enables individuals to base intentions more firmly on personal beliefs, reducing dependence on normative expectations. Empirical evidence supports this boundary condition across various contexts. For example, Castanier and colleagues (2013) found that normative influence on driving intentions was stronger in low-control situations (e.g., impaired driving) but weaker in high-control contexts (e.g., sober driving). Similarly, Jain and Humienny (2020) reported that individuals with lower self-efficacy were more influenced by descriptive norms in their intentions to misuse prescription drugs. Borg and colleagues (2020) also found that higher self-efficacy reduced the association between descriptive norms and plastic avoidance behaviors. Although Martinez and Lewis (2016) observed stronger norm-intention associations under high perceived behavioral control in certain health behaviors (e.g., screenings), the broader literature suggests that normative influence tends to weaken as perceived control increases. Accordingly, the following hypothesis is proposed:

Perceived behavioral control will negatively moderate the relationship between perceived norms and behavioral intentions, such that this relationship weakens as perceived behavioral control increases.

This study aims to identify the psychological factors that predict parents’ intentions to communicate with their child about SRCs, using the reasoned action approach (Fishbein & Ajzen, 2010). Although prior research has established that parents are influential in shaping youth athletes’ safety behaviors, few studies have unpacked the specific attitudinal, normative, and efficacy-based beliefs that guide SRC communication—particularly through the granular lens that reasoned action approach provides. Addressing this gap, the current study tests both the independent and interactive effects of reasoned action’s key constructs to clarify which beliefs most strongly motivate parental intention. This work responds to calls for more theory-driven approaches in sport communication research (Cummins & Hahn, 2024) and extends concussion communication scholarship by modeling not just what parents believe, but how those beliefs interact to form intentions. The following section outlines the study’s methodology.

Method

Participants and Procedures

The questionnaire was conducted via Amazon Mechanical Turk (M-Turk). The study advertised as an “investigation of parents’ of youth athletes (aged 8–12) attitudes towards player health and safety.” To be eligible for the study, participants must have lived in the United States, indicated they were a parent in their M-Turk account, had a child in the desired age range who had played at least one organized sport within the past year, and passed all data quality checks (described below). Participants were paid $3.00 for their participation in a 15–20-min study.

The data for this study are a subset derived from a larger survey of 418 parents. From this initial pool, eighteen participants were removed for not meeting the eligibility criterion of having a child between the ages of 8 and 12. This analysis focuses exclusively on psychosocial predictors of concussion communication intentions, isolating variables specifically relevant to the reasoned action approach framework while the broader survey included additional constructs not relevant to the present analysis. Subsequent quality control exclusions applied specifically for this analysis were based on failure of: two attention checks (n = 32), and an authenticity check comparing the child’s reported birth month at the start and end of the survey (n = 6). The attention checks involved selecting ‘proud’ for a mood question and ‘strongly disagree’ for a specific later item. After applying all eligibility and quality control criteria relevant to this study, 300 responses remained for analysis.

Participants were 300 parents who were mostly White (97.6%) and male (52.3%) with an average age of 34.50 (SD = 4.23). Children in the sample were predominantly male (53.7%) with an average age of 9.50 (SD = 1.05). Nearly all parents (95.3%) reported earning at least a 4-year college degree. Approximately half (48%) of parents believed their child had sustained a concussion. The most common sports parents reported their child had played within the last year were basketball (47.7%), baseball (38.3%), American football (35.3%), swimming (28.3%), and dance (24.3%).

Measures

All items were evaluated using a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) and adapted from Fishbein and Ajzen’s (2010). Reliability was assessed using Cronbach’s Alpha. Each measure consisted of items addressing two domains: (1) recognizing concussion symptoms and (2) the importance of the child reporting those symptoms to a coach. Attitudes (M = 4.30, SD = 0.44, α = .88) were measured with 12 items—six assessing instrumental attitudes (e.g., “My communicating with my child about the importance of reporting their concussion symptoms to a coach would be useful for them”; M = 4.33, SD = 0.44, α = .78) and six assessing experiential attitudes (e.g., “My communicating with my child about recognizing concussion symptoms would make them feel good about themselves”; M = 4.26, SD = 0.47, α = .78). Perceived norms (M = 4.09, SD = 0.47, α = .86) were also assessed with 12 items, split evenly between descriptive norms (e.g., “Most parents of youth athletes my child competes against talk to their child about reporting concussion symptoms to a coach”; M = 4.08, SD = 0.49, α = .72) and injunctive norms (e.g., “Most parents of my child’s teammates would want me to communicate with my child about recognizing concussion symptoms”; M = 4.11, SD = 0.50, α = .75). Perceived behavioral control was operationalized as capacity and measured with six items (e.g., “I know how to communicate with my child about identifying concussion symptoms”; M = 4.14, SD = 0.45, α = .72). Behavioral intentions were assessed with four items (e.g., “I plan to talk to my child about noticing concussion symptoms in the next month”; M = 4.14, SD = 0.51, α = .67), and past behavior was measured with two items (e.g., “I have communicated with my child about the importance of reporting concussion symptoms to a coach”; M = 4.16, SD = 0.60). Table 1 shows correlations between all measured variables.

Table 1.

Correlations Among Measured Variables

	1	2	3	4	5	6
1. Instrumental attitudes
2. Experiential attitudes	.83^**
3. Descriptive norms	.62^**	.69^**
4. Injunctive norms	.63^**	.69^**	.82^**
5. Capacity	.75^**	.77^**	.75^**	.74^**
6. Past behavior	.67^**	.60^**	.61^**	.60^**	.68^**
7. Intentions	.66^**	.71^**	.66^**	.73^**	.73^**	.59^**

Note. **p < .01.

Results

Main Effects (H1–H3)

To test H1–H3, a two-block hierarchical linear regression was used with the first block consisting of past behavior while the second block contained the reasoned action constructs.

Past behavior (β = .59, p < .001) alone significantly predicted intentions, F(1, 298) = 156.90, p < .001, accounting for 34.5% of the variance. When added in the second block, the reasoned action approach variables were significant predictors of parent-child SRC communication intentions F(6, 293) = 87.27, p < .001, R² = .64, ΔR² = .30.

H1 proposed that both instrumental (H1a) and experiential attitudes (H1b) would positively predict parents’ intentions to communicate with their child about SRCs. Regression results indicated that experiential attitudes were significantly associated with intentions (β = .23, p < .01), supporting H1b. However, instrumental attitudes did not significantly predict intentions (β = .05, p = .43), providing no support for H1a.

H2 predicted that both descriptive (H2a) and injunctive norms (H2b) would positively relate to parental SRC communication intentions. Injunctive norms showed a strong positive association (β = .35, p < .001), supporting H2b. In contrast, descriptive norms were not significantly related to intentions (β = −.04, p = .54), and thus H2a was not supported.

H3 hypothesized that capacity, reflecting parents’ self-efficacy to initiate SRC conversations, would positively predict intentions. Results confirmed this hypothesis, as capacity emerged as a significant positive predictor (β = .23, p < .001), supporting H3.

Interaction Effects (H4–H6)

Prior to testing interaction hypotheses (H4–H6), experiential and instrumental attitudes were combined into a unitary attitudinal construct, as well as injunctive and descriptive norms into perceived norms, while capacity was retained as the sole indicator of perceived behavioral control. This operational decision was guided by three considerations. First, the reasoned action approach conceptualizes attitudes, norms, and perceived behavioral control as distinct antecedent pathways to intention (Fishbein & Ajzen, 2010). Testing interactions between these higher-order constructs (e.g., attitudes × norms) align with reasoned action approach’s structural logic, whereas subcomponent-level interactions (e.g., experiential attitudes × descriptive norms) lack theoretical grounding. Secondly, including all possible two-way interactions between five subconstructs would generate eight interaction terms. This risks multicollinearity (VIF > 5) due to shared variance between subconstructs, potentially inflating Type I errors (Hayes, 2022). Lastly, H4–H6 explicitly examine cross-construct dynamics (e.g., “Do norms amplify attitude effects?”). Subcomponent interactions would fragment these hypotheses into mechanistically distinct questions (e.g., “Do descriptive norms moderate experiential attitudes?”), deviating from our theoretical focus. This approach follows established reasoned action approach/theory of planned behavior interaction analyses (La Barbera & Ajzen, 2021).

The second block of this hierarchical linear regression introduced the composite reasoned action approach constructs—attitudes, perceived norms, and perceived behavioral control—after once again controlling for past behavior in the first block. This model significantly improved prediction of intentions, F(4, 295) = 123.13, p < .001, R² = .63, ΔR² = .28. Each composite construct significantly predicted intention: attitudes (β = .24, p < .001), perceived norms (β = .35, p < .001), and perceived behavioral control (β = .22, p < .01).

To test H4–H6, a third block was added to the hierarchical regression model to examine interaction effects between attitudes, perceived norms, and perceived behavioral control. Interaction terms were created by mean-centering each construct and calculating their multiplicative products (i.e., attitudes × norms, attitudes × perceived behavioral control, norms × perceived behavioral control). This block was entered after controlling for past behavior and main effects. The inclusion of interaction terms led to a marginally significant improvement in model fit, F(7, 292) = 72.60, p < .001 R² = .64 ΔR² = .010.

H4 predicted that perceived norms would moderate the relationship between attitudes and intentions, such that the relationship would be stronger at higher levels of perceived norms. The interaction between attitudes and norms (β = −.18, p < .05) was statistically significant, however, the interaction indicated an attenuating rather than amplifying effect. Figure 1 shows how the attitudinal influence on intention weakened as perceived norms increased—contrary to the hypothesized direction. Thus, H4 was statistically supported, but in the opposite direction than predicted.

Figure 1.

Attitudes by Perceived Norms on SRC Communication Intentions

H5 proposed perceived behavioral control would moderate the effect of attitudes on intentions, strengthening this relationship at higher levels of perceived control. As seen in Figure 2, interaction between attitudes and perceived behavioral control was significant (β = .15, p < .05), supporting H5. This finding indicates that parents’ confidence in their ability to have SRC conversations enhances the predictive power of their attitudes on intentions.

Figure 2.

Attitudes by Perceived Behavioral Control on SRC Communication Intentions

H6 posited a negative moderation effect of perceived behavioral control on the norms-intention relationship, such that normative influence would weaken as perceived behavioral control increased. The norms × perceived behavioral control interaction failed to reach significance (β = .08, p = .19), providing no support for H6.

Discussion

This study examined the psychosocial predictors of parent-child communication intentions about SRCs using the reasoned action approach. Despite the critical role parents play in promoting health sport-related attitudes in their children (Ho et al., 2022; Zhang, 2020), few studies have isolated which attitudinal, normative, and efficacy-based beliefs drive parental communication about concussion recognition and reporting. By applying reasoned action approach, an underutilized framework, this research clarifies how distinct belief components predict and interact to shape communication intentions among parents of children aged 8–12 participating in organized sports.

Finding partially supported the hypotheses regarding the main effects of attitudes. Experiential attitudes significantly predicted parents’ intentions to discuss SRCs with their children, but instrumental attitudes did not. This suggests that parents are more motivated by anticipated emotional outcomes—such as feeling connected to their child or providing reassurance—than by cognitive evaluations of the conversation’s utility. In other words, how the conversation is expected to feel matters more than what it is expected to do. Parents may be reluctant to communicate about SRCs if they fear it will come across as uncomfortable or ‘nagging’ (Sarmiento et al., 2019). Future research should find ways parents can initiate such conversations, with attention paid to nonverbals such as tone (e.g., serious or casual), and timing (e.g., before or during sport season).

Injunctive norms emerged as a strong positive predictor of parental intentions, whereas descriptive norms showed no significant association. This pattern differs from Fontana and colleagues (2022), who reported only a unified subjective norm effect; this disaggregated approach reveals that perceived approval (i.e., injunctive) drives intention far more than perceived prevalence (i.e., descriptive), a distinction critical for targeted messaging. It also contrasts with Cranmer and colleagues’ (2025) finding that subjective norms were highly predictive but resistant to change in athletes. Injunctive norms may be a more viable leverage point for influencing parental behavior than descriptive norms or the composite norms found resistant in athlete contexts. That is, parents are more influenced by perceived social expectations (i.e., what they believe other parents think they should do) than by perceptions of others’ actual behavior. One possible explanation is parents may lack information about how often others engage in concussion conversations, making descriptive norms less salient. In such cases, they may default to assumed social expectations (i.e., “I’m not sure if other parents talk to their kids about concussions, but I believe they would expect me to.”), consistent with research on injunctive norms (Lapinski et al., 2013). This supports Cialdini and colleagues (1990) focus theory of normative conduct, which argues that injunctive norms are especially potent in guiding behavior when individuals are motivated to fulfill perceived obligations.

Findings fully supported the hypothesis that capacity would positively predict parents’ intentions to discuss SRCs with their children. Parents who felt confident in their ability to have these conversations were significantly more likely to intend to do so. This aligns with prior research highlighting self-efficacy as a consistent and robust predictor of health-related communication behaviors (McEachan et al., 2016; Sheeran & Webb, 2016). This granularity may explain why Fontana and colleagues (2022) composite perceived behavioral control (i.e., merging capacity/autonomy) showed null effects, whereas this isolated capacity measure emerged significant. These findings contrast Cranmer and colleagues (2025) finding that self-efficacy was unassociated with reporting intentions among athletes. Evaluating other forms of efficacy, such as response efficacy (Witte, 1992; e.g., “Is communicating with my child about concussions an effective way of getting them to report them to a coach?”), would be essential for understanding whether parents not only feel capable of having the conversation but also believe it will make a meaningful difference.

While the attitude by perceived norms interaction was statistically significant, the direction contradicted expectations. As perceived norms increased, the strength of the relationship between attitudes and intentions decreased. This attenuation effect suggests that when parents perceive strong normative support for SRC communication, their own attitudes become less influential—possibly because social expectations reduce the need for personal deliberation. Such findings are particularly striking given parents’ uniformly high baseline attitudes (M = 4.30), suggesting normative pressures may override strongly held personal convictions in contexts where safety behaviors are perceived as collective duties. This dynamic supports prior work showing that the relative weight of attitudinal and normative influences can shift depending on the perceived social climate (Lapinski et al., 2007) and underscores the need to tailor health communication strategies based on the salience and strength of perceived norms. This unexpected pattern suggests that social approval may override deliberative reasoning in high-norm environments—an insight that may help refine how the reasoned action approach is applied to protective parenting behaviors.

As expected, perceived behavioral control significantly moderated the relationship between attitudes and intentions: the positive effect of attitudes on intentions was stronger at higher levels of self-efficacy (i.e., capacity). This finding reinforces prior research suggesting that even favorable attitudes may fail to translate into intentions if individuals lack confidence in their ability to act (La Barbera & Ajzen, 2021; Yzer & Van Den Putte, 2014). The moderating role of capacity represents a critical barrier for well-intentioned parents and suggests efficacy-building could unlock the motivational potential of existing positive attitudes. In the context of SRC communication, this suggests that parents who believe such conversations are important may still hesitate to engage unless they feel personally equipped to handle the topic. Practically, this underscores the value of interventions that not only promote positive attitudes but also build concrete communication skills and efficacy to ensure attitudinal support translates into action.

The interaction between perceived norms and perceived behavioral control failed to reach significance. This finding contrasts with prior research in other health domains where normative influence is typically stronger when perceived control is low (Castanier et al., 2013; Lapinski & Rimal, 2005). The persistent influence of norms regardless of capacity underscores their unique potency as motivational levers in parental safety communication, functioning independently of self-doubt barriers. Rather, it suggests that normative expectations may exert a consistent influence on parental intentions to communicate about SRCs, regardless of how confident parents feel in their ability to have those conversations. In other words, perceived social pressure to engage in SRC communication may be compelling enough to shape intentions independently.

By using reasoned action approach instead of the theory of planned behavior, this study offers greater conceptual precision and addresses Cummins and Hahn’s (2024) critique that sport communication research often applies frameworks in a surface-level or composite manner. Disaggregating attitudes, norms, and control into their respective subcomponents allowed for the identification of specific, belief-based predictors with distinct influences on intention. The finding that experiential attitudes, injunctive norms, and capacity were significant predictors—but their counterparts (instrumental attitudes and descriptive norms) were not—illustrates how theoretically similar constructs can have unequal psychological relevance in applied contexts. Additionally, by demonstrating that perceived norms attenuate rather than amplify attitudinal influence, this study challenges conventional moderation assumptions and suggests the need to revise expectations of reasoned action approach interactions in parent-child communication domains. These findings may also inform applications of the reasoned action approach in other parent-led health behaviors. This study also makes a theoretical contribution by simultaneously testing moderators across all three primary predictors of behavioral intention, an approach that remains relatively rare in reasoned action approach research. This comprehensive modeling approach answers recent calls to move reasoned action approach beyond additive predictions and explore its boundary conditions (Ho et al., 2022; Martinez & Lewis, 2016). It highlights that intention formation is not merely a summation of beliefs but shaped by their interplay in context-dependent ways for health communication behavior.

Understanding these predictors has implications not only for message design but for shifting safety culture in youth sports. First, interventions should focus on increasing parents’ confidence (i.e., capacity) to hold SRC conversations by providing practical guidance, suggested talking points, and modeled dialogues. Such can be achieved through use of visual or video narratives of a parent confidently and successfully communicating with their child about concussions. Because capacity predicted intentions independently and moderated the effect of attitudes, even well-meaning parents may not act without sufficient self-efficacy. Second, educational efforts that frame SRC conversations as beneficial to children’s emotional security, well-being, or parent-child trust may be more effective than fact-based appeals emphasizing knowledge transmission. This is especially true when a lack of concussion knowledge is not identified as a primary barrier to SRC reporting (Ferdinand Pennock et al., 2023). For instance, digital infographics pairing parent quotes (e.g., “Talking about concussions brought my daughter and me closer”) with guided scripts, and in-person workshops including role-play exercises of supportive opening lines (e.g., “I’ve been thinking of ways to keep you safe”), can strengthen positive experiential attitudes by making the emotional benefits of these dialogues salient. Third, messages encouraging parent-child SRC communication should emphasize injunctive norms over descriptive ones, aligning with Tallapragada and Cranmer’s (2022) evidence that morally framed narratives increased parents’ perceived importance of informing their children about SRCs. Although their study did not assess injunctive norms, the findings suggest narratives can shape parents’ motivation by enhancing identification with characters and activating affective engagement. Crucially, cultural barriers require segmented approaches. For “sports-first” parents (Cranmer and colleagues., 2021), reframe SRC discussions as protecting long-term athletic potential (e.g., “Reporting prevents career-ending injuries”); for disengaged families, emphasize ease and relevance through bite-sized content (e.g., “3-min talks keep your athlete safer”). When parents feel confident, emotionally prepared, and socially supported, they are more likely to initiate conversations that may ultimately prevent long-term harm to their child.

There are several limitations to this study. First, while the study isolated capacity as the most relevant form of perceived behavioral control, it did not include autonomy—a construct that may matter more in contexts involving shared decision-making or child resistance. Although capacity was justified as the primary focus here, future studies should explore autonomy’s predictive value, particularly for parental communication with adolescents. Second, reliance on cross-sectional data limits causal inferences. Longitudinal or experimental research is needed to confirm directional relationships and test interventions that manipulate belief subcomponents. Third, the sample was overwhelmingly White (97.6%), which limits the generalizability of these findings. Montalvo and colleagues (2024) illustrated that concussion knowledge and exposure to educational resources can differ between Black and White parents, likely due to differences in access, cultural context, and information dissemination factors. Community-based recruitment through partnering with urban or rural sports leagues can ensure equitable socioeconomic and cultural representation. Lastly, while the study focused on behavioral intentions, it did not assess actual parent-child communication behavior. Given the well-documented intention-behavior gap in health contexts (Sheeran & Webb, 2016), and evidence that narrative and educational appeals alone produce only modest follow-through (Fontana et al., 2022; Tallapragada & Cranmer, 2022), future research must test whether these psychosocial predictors (i.e., experiential attitudes, injunctive norms and capacity) can be shifted in practice to produce real conversations. Such work could employ orientation-tailored interventions (Cranmer et al., 2021) for example, pairing emotionally engaging narratives with concrete planning prompts for “football-first” or “nonchalant” parents to determine which approaches most effectively turn intention into action.

Conclusion

This study examined the psychosocial predictors of parent-child communication intentions SRCs through the lens of reasoned action approach. By disaggregating the reasoned action approach’s core constructs, the study identified experiential attitudes, injunctive norms, and capacity as the primary drivers of parents’ intentions to have these conversations. The findings revealed that these constructs interact in meaningful ways—attitudes were more predictive when parents had high self-efficacy, and surprisingly, less predictive when perceived norms were high. These interaction effects highlight the context-sensitive nature of behavioral intention formation, pushing reasoned action approach beyond its traditional additive structure. Theoretically, this work applies reasoned action approach in a new context and provides a rare test of moderation across all three pathways to intention. Practically, it offers clear message design recommendations: emphasize social expectations (i.e., injunctive norms), reinforce affective and relational benefits (i.e., experiential attitudes), and build parental confidence (i.e., capacity). As SRC underreporting continues to pose serious risks for youth athletes, equipping parents with the belief-based tools to initiate effective, emotionally grounded concussion conversations is a critical public health priority. Now is the time to treat concussion conversations not as optional, but as essential acts of care. Youth athletes’ health and future well-being depend on timely and intentional communication from parents. Doing so not only protects children physically but also empowers them to become self-advocates for health in youth sport environments.

Footnotes

Author Note

Daniel E. Hartman, Department of Communication, Pamplin College of Arts, Humanities, and Social Sciences, Augusta University.

ORCID iD

Daniel E. Hartman

Ethical Considerations

This study was approved by the Institutional Review Board at the University of Illinois Urbana-Champaign (Protocol #IRB24-0183). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

Consent to Participate

All participants provided informed consent prior to participation.

Funding

The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a 2024 Summer Dissertation Completion Fellowship from the University of Illinois Urbana-Champaign.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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