A - 05 The Relationship between Child Opportunity and Self-Efficacy Following Pediatric Concussion

Purpose An individual’s confidence in their ability to facilitate their concussion recovery (i.e., self-efficacy [SE]) is important for outcomes. Self-efficacy may be influenced by early childhood experiences and access to environmental resources. This study explores the relationship between neighborhood opportunity and self-efficacy following pediatric concussion. Method Participants completed a 17-item self-efficacy measure (PACE-SE) during an initial clinic visit. The Child Opportunity Index (COI) was obtained based on each child’s home address. A stepwise linear regression was employed to examine the relationship between COI and PACE-SE accounting for symptom burden, days since injury, and sex. Results 431 participants aged 13–18 (M = 15.1+/−1.6; 58% female) were seen within three months of concussion (M days since injury = 19.2+/−16.2) at a specialty clinic. The majority were injured playing sports (67%). Lower PACE-SE score was associated with female sex (r = 0.180; p < 0.001), higher symptom burden (r = −0.493, p < 0.001), and more days from injury (r = −0.132; p = 0.003). There was a small but significant relationship between COI and PACE-SE, after accounting for covariates (R2 = 0.008, p = 0.033). Stepwise regressions showed associations between COI and the PACE-SE subdomains Managing my Stress (MMS; R2 = 0.008, p = 0.031), Seeking Adult Assistance (SAA; R2 = 0.015, p = 0.008), and Maintaining a Positive Outlook (MPO; R2 = 0.009, p = 0.022), but not Managing my Activity (MMA). SAA and COI were significantly associated in males (p < 0.05), while MPO and COI were significant in females (p = 0.001, <0.05). Conclusions The results suggest that lower neighborhood opportunity is associated with lower overall self-efficacy in facilitating one’s recovery after concussion. Specific aspects of self-efficacy may be uniquely impacted, such as seeking adult assistance.