“It Might Also Be Good for Your Brain”: Cognitive and Social Benefits That Motivate Parents to Permit Youth Tackle Football

Abstract

Concussions in youth sports are a rising health concern. Between 1.7- and 3-million concussions occur each year in youth sport and recreation settings. This qualitative study investigated how parents assess the physical and social risks of allowing their children to participate in tackle football. Semi-structured interviews were conducted with 12 sets of parents (N = 24) who had permitted their middle school aged children to play on tackle football teams. Guided by the theory of planned behavior, findings illustrate the complex risk decisions parents must make regarding football participation. Although parents in our study acknowledged the risk of concussions, they identified cognitive and social benefits of football participation that shaped positive attitudes toward football outcomes. Participants also noted social factors that limited control over their children’s football participation, including community pressures. The findings indicate key factors that motivate football enrollment, as parents must consider competing goals for their child of protection and development. Future research directions, theoretical implications, and practical applications are discussed.

Keywords

youth football concussions sport socialization risk theory of planned behavior

Although many parents seek to socialize children through sport participation (Kremer-Sadlik & Kim, 2007), no sport has generated more concern for injuries than tackle football (Vos et al., 2018). Participation rates for youth football have decreased in recent years (National Federation of State High School Associations, 2018; Sports & Fitness Industry Association, 2019), with risk of head injury a reason for the decline (Findler, 2015; Murphy et al., 2017). Collisions are common in football, and repeated hits to the head can spur negative physical consequences (Binney & Bachynski, 2019). Each year, between 1.7- and 3-million concussions occur in youth sport and recreation settings (DePadilla et al., 2018; University of Pittsburgh Medical Center, 2019). The Centers for Disease Control and Prevention (CDC) estimates 283,000 emergency visits annually to treat brain injuries sustained in youth activities (Sarmiento et al., 2019). Injuries to the head during adolescence can be particularly problematic for cognition later in life (Carman et al., 2015). Despite these risks, the decision for parents regarding football enrollment is not a simple one, as there are also risks incurred by not allowing a child to play football. Tackle football participation has the potential to offer a variety of physical, social, and developmental benefits for children. Parents of children who want to play must assess the immediate benefits of youth tackle football participation against the potential long-term risks.

The purpose of this study was to understand the factors that motivate parents to permit children to play tackle football. Guided by the theory of planned behavior (TPB; Ajzen, 1991, 2015), we analyzed interviews conducted with 12 sets of parents who had allowed their middle school aged children to play on tackle football teams. This study advances understanding of how parents balance mutual goals for their children of development and protection, and identifies key considerations of benefit and risk that motivate permission for football participation. Cognitive benefits, social factors, and community dynamics emerged to influence parents’ assessment of football risks.

The findings indicate parents associate football participation with cognitive and social benefits for their child. Results highlight the influence of community influences and social norms on risk judgments, and describe how parents’ varying sense of perceived control over children’s behavior influenced football participation. The findings suggest complex tensions experienced in parents’ risk decisions, and lend insight to the dynamics of risk communication between parents and children with regard to contact sport participation. To guide analysis of the motivating factors that influenced football participation, we employed the framework of the TPB.

Theory of Planned Behavior

The TPB is a behavioral outcome theory that focuses on the influence of attitudes toward outcomes, social norms, and sense of perceived control on actions and decisions (Ajzen, 1991). Specifically, TPB highlights the importance of perceived benefits and risks associated with a behavior, draws attention to social expectations from important referent groups, and emphasizes the importance of perceived ability to implement desired behaviors. Although TPB describes behavioral intention as the primary outcome variable, Ajzen (2015) also notes the importance of elicitation stages within TPB research, where empirical efforts seek to identify important factors that inform decisions and affect behaviors. Prior TPB research spans a wide array of contexts, such as injury prevention (McGlashan & Finch, 2010), smoking cessation (Tseng et al., 2018), and alcohol consumption (French & Cooke, 2012). TPB analyses seek to identify important leveraging factors on which to build interventions and promotions, and to determine the core influences that shape risk judgments and behaviors (Ajzen, 2015).

Researchers have applied TPB to examine a host of issues in sports generally and football in particular. For example, previous work employed TPB to understand how the attitudes of athletes (Register-Mihalik et al., 2013), trainers (Rigby et al., 2013), and parents (Murphy et al., 2017) influenced intentions to report concussion symptoms. Attitudes toward concussion reporting, perceived social norms, and sense of control over the risk shaped 53% of the variance in athletes’ intention to report concussion symptoms (Register-Mihalik et al., 2013). Similarly, athletic trainers with positive attitudes toward concussion recommendations were more likely to implement the proper safety precautions (Rigby et al., 2013). However, the likelihood of athletic trainers following prescribed precautions decreased when trainers felt they lacked the power or ability to do so. The ability to implement safety behaviors emphasizes the importance of perceived control, or self-efficacy, in relation to risk attitudes.

TPB analyses have also provided insight into how social norms influence the reporting of concussions. Previous work identified factors that influenced concussion reporting, including athletes’ attitudes toward concussion risks, perceptions of whether teammates would report similar symptoms, and perceived ability to report concussion symptoms under the guise of contextual challenges, such as being in the middle of an important game (Kroshus et al., 2014). Despite these efforts, attempts to promote greater awareness of concussion risk through education efforts have produced tepid results (Kroshus et al., 2015). This prior work highlights the applicability of TPB to sport contexts and indicates the relevance of examining parent attitudes, social norms, and self-efficacy in the context of youth tackle football. One such influence on parents’ attitudes toward sports is the attribution of responsibility for negative outcomes associated with sport participation.

Risk Attributions

Attributions of risk have important consequences, as they can influence social motivations (Weiner, 2006) and support for policy changes (Niederdeppe et al., 2011). When facing potential risks, invested parties may benefit from attributing the risk to sources external to the organization (Nadesan, 2016). For example, youth baseball leagues have begun to rely on statistical measures to decide when to remove pitchers from games, measuring things like the torque on a player’s arm ligaments during a throw. This reliance on statistics to determine the likelihood of risk functions to shift the burden of responsibility for injuries away from league officials and onto coaches with real-time access to the data (Sanderson & Baerg, 2018).

In football, injury risk is often portrayed as an expected consequence of playing the game (Weinberg et al., 2013). If injury risk is embedded into the game itself, then players assume the responsibility for the inherent risk of injury upon deciding to play. The portrayal of injuries as intrinsic to sport participation allows organizers to distance themselves from injury responsibility, and alleviates the need for league officials to make substantive changes to reduce, minimize, or avoid injury risks (Sanderson & Baerg, 2018). Of all the risks associated with tackle football, concussions and potential cognitive damage from repeated hits to the head have received the greatest empirical attention.

Concussion Risks and Chronic Traumatic Encephalopathy (CTE)

Concussions are one of the most common injuries for football players (Moser, 2007). Sometimes referred to as minor traumatic brain injuries (mTBIs), concussions can have serious consequences on cognitive functioning, especially when experienced multiple times (Galgano et al., 2016). A specific negative outcome associated with concussions and mTBIs is the development of CTE (Pilon & Belson, 2013). Research on NFL (National Football League) players indicates that at least 10% of NFL athletes may develop CTE later in life (Binney & Bachynski, 2019). Complicating risk assessments for parents, the onset of CTE symptoms may not occur until long after the initial hit to the athlete’s head (Galgano et al., 2016).

Despite the prevalence of concussions in football, many parents show low awareness for connections between repeated hits to the head and negative long-term cognitive outcomes (Kroshus et al., 2017). Many players and parents are not able to accurately identify symptoms of concussions, which include neck pain, vomiting, personality change, or concentration problems (Cournoyer & Tripp, 2014). Furthermore, even when players do recognize they may have had a concussion, athletes often choose not to report symptoms for personal, contextual, and competitive reasons (McCrea et al., 2004). Both male and female athletes suffer concussions (Sanderson et al., 2017), but there are intrinsic differences between adult and youth concussions (McCrory et al., 2004). As mTBIs at young ages can have notable long-term negative effects (Colvin et al., 2009), youth tackle football provides an important context for understanding how parents assess and conceptualize sport risks. Parents must contemplate the possibility of football risks in relation to the gains received from socialization in youth sports.

Youth Sport Socialization

Parents play an active role in the socialization of children and sport (Fredericks & Eccles, 2005). Many parents seek out sports as a way to teach children important societal values and skills (Kremer-Sadlik & Kim, 2007). Understanding important cultural values intrinsic to sports remains a primary reason why parents encourage sport participation (Dunn et al., 2003). Discussions between parents and athletes shape children’s attitudes toward sports, with parents often using the time during the car ride home to discuss difficult topics (Tamminen et al., 2017). Understanding family and community dynamics helps to reveal key tensions in parents’ decision-making processes for sport participation (Kassing et al., 2004).

Attitudes toward sport risks and benefits are dynamic and may change over time. For example, parents’ goals for sport participation may adjust in accordance with new experiences and information (Dorsch et al., 2015). Personal and community dynamics also influence sport attitudes and participation (Tamminen et al., 2017). Prior work has discussed the influence of family characteristics on decisions to allow children to play tackle football (Boneau et al., 2020). Parents’ history, community factors, and relationships with teammates and coaches affect sport participation (Cranmer, 2018).

Current Study

Prior quantitative analyses employing TPB identified four factors that predict a parent’s intention to allow their child play football: attitudes toward football participation, social norms, behavioral control, and perceived risk of concussions (Murphy et al., 2017). In this study, we build on the identification of these factors by addressing noted limitations of previous efforts. Specifically, prior work relied on hypothetical scenarios of youth football participation, and only measured parents’ intentions to allow a child to participate in tackle football. This study adds to this knowledge by only interviewing parents who have actually chosen to permit their children to play tackle football. Furthermore, prior work in this area noted the difficulty in ascertaining potential differences between mothers and fathers’ attitudes toward football and risk, highlighting uncertainty of potential gender differences toward football attitudes. We work to advance this understanding by speaking to both mothers and fathers during interviews for this study.

This study seeks to extend prior work on football risk judgments by understanding the attitudes and perceived benefits that motivate parents’ tackle football decisions. Although prior work has identified factors that predict intentions of hypothetical football participation, this analysis enhances this knowledge by speaking directly to parents who have already permitted their child to play tackle football. We further seek to extend existing knowledge by filling gaps with regard to the specific benefits and influences that galvanize parents’ decision-making. Guided by the core tenets of TPB, we propose the following research question:

Research Question: How do attitudes toward football outcomes, social norms, and perceived control influence parents’ decision to allow children to play youth tackle football?

Method

This study was approved by the university internal review board. This analysis is part of a larger investigation on parents’ football attitudes and decisions. All participants provided informed consent before participating. Pseudonyms were used to replace all potentially identifying information, including changing the names of participants, children, and schools.

Recruitment and Participants

To qualify for this study, participants needed to have at least one child playing tackle football in middle school. Researchers spoke to families who fit the criteria to participate and subsequently posted a call on Facebook (a social media website) to recruit additional families. Subsequently, snowball sampling was employed to recruit additional participants. Snowball sampling requires study participants to recommend other friends, family members, or acquaintances to engage in the research project (Tracy, 2013). Qualitative researchers choose purposeful sampling to recruit participants that can offer understanding of the context and an in-depth inquiry into the research question (Creswell, 2013).

Recruitment efforts produced 12 married couples, equating to 24 participants (N = 24). The sample included 12 females and 12 males. All participants lived in Texas at the time of data collection. Texas is regarded as a state with a strong dedication to football (Conine, 2016), and as a region that places a high value on youth participation in the sport (Fisher, 2018; Peter, 2017). Ages of participants ranged from 28 to 51 years (M = 42.9) for females and 40 to 56 years (M = 45.1) for males. The majority of interviewees (22 participants) identified as White/Caucasian; two participants identified as Black/African American. At the time of this study, all participants had at least one child playing middle school tackle football.

Procedure

Parents were interviewed together through a semi-structured, open-ended interview format. Using this format, an interview guide was followed, but follow-up questions were permitted. Semi-structured formats allow participants the freedom to speak openly and to process experiences in real time (Tracy, 2013). All interviews were audio recorded. Seven interviews were conducted in person and five via telephone. Interviews lasted between 45 and 90 min (M = 50 min). The interviews were then transcribed by a professional transcription company. Transcripts produced 149 pages of single-spaced data for analysis.

Data Analysis

We analyzed the data using a constant comparative method (Saldaña, 2015). Specifically, we performed an iterative analysis (Tracy, 2013), which combines analyzing emergent data with an existing theoretical framework, in this case, the TPB. We did not identify TPB as the guiding framework for this analysis prior to conducting the interviews. Rather, the utility of TPB emerged during the reading of the transcripts. This approach allowed us to give preference to the meaning of the data as it emerged (Lindlof & Taylor, 2002). Interviews continued until data produced fewer and fewer unique results, indicating we were approaching theoretical saturation (Glaser & Strauss, 1967).

Data analysis included a three-step process which involved open coding, axial coding, and dimensionalization. First, we read through the entire transcription once to get a feel for interviews and begin making theoretical memos for the data (Lindlof & Taylor, 2002). Our unit of analysis for the data included each thought expression articulated by the participants (Charmaz, 2006). During the second reading of the transcripts, we began the process of open coding of the statements. Categories for incidents were created. We then compared subsequent incidents and either (a) placed them into conceptually similar categories or (b) created a new category when appropriate (Charmaz, 2006).

Next, we performed axial coding which is a process of integrating categories/codes (Lindlof & Taylor, 2002). Axial coding involved systematically grouping similar categories into themes that synthesized the individual categories (Tracy, 2013). In the second stage of axial coding, we looked at the remaining codes independently to identify a theoretical theme to categorize the code. While processing the individual codes, we considered the utility of developing a new theme or adding the code to an existing theme. Axial coding allowed us to develop integrated sets of topics from the original set of codes (Banks et al., 2000). At the conclusion of this process, themes were identified that captured common meanings in the emergent codes. These themes became the basis for identifying theoretical constructs specific to this study.

Finally, we examined the themes and found commonality between them, in a process called dimensionalization (Lindlof & Taylor, 2002). Dimensionalization, or “selective coding,” allows researchers to identify core categories and verify interpretations of the data (Banks et al., 2000). As a step of verification (Creswell, 2009), we presented our findings to two of the sets of parents who had participated in this study. Both sets of parents agreed the findings accurately captured their attitudes and experiences surrounding the decision to permit their middle school aged children to play youth tackle football.

Results

Through coding and constant comparison of data, factors emerged that revealed pertinent influences on parents’ risk assessment and decision-making for football participation. These factors included cognitive and social benefits. Cognitive benefits described by parents incorporated both mental and emotional rewards of participation, including persistence, discipline, respect for authority, self-esteem, and increased attention paid to their grades. Parents also noted social benefits of football participation, including camaraderie and learning to contribute to a larger collective. Parents also indicated perceptions of control over their child’s participation, acknowledging the tensions of community influence, the child’s wishes, and the parents’ desires to shield children from harm’s way.

For parents who permit their children to play tackle football, the perceived benefits outweigh the risks. The current results highlight specific benefits that motivate parents’ positive attitudes toward football participation. The three most prevalent benefits stated included persistence, camaraderie, and being part of a team collective. Parents’ positive attitudes toward football outcomes, and subsequent acceptance of inherent risks, were influenced by perceptions of cognitive and social developments associated with playing football.

Cognitive Benefits of Football Participation

Persistence

Although football presents risks to proper brain function, parents in our study described perceived cognitive benefits of football participation, such as increased persistence, confidence, and self-esteem. For example, Jacob pointed to persistence as a value built by football participation. He said,

I can specifically remember days, when I played in high school, where I just thought I was done. I had nothing more left in the tank, and I remember coaches saying, “Look, you don’t know your limits yet.” And I believe you do find more limits, and more limits, than . . . when it’s fourth quarter, it’s two minutes to go. You’re tired, you’re beaten down, and you suck it up, and you plow through.

Talking of the life skills instilled by football participation, Brandon said,

I guess I’ve always been a competitor and try to teach kids, you know, life situations with football. Just not giving up, being tough, holding your ground, just different little everyday things that . . . I try to tell them you got to practice, whatever job you going to get, you’re gonna have to study it, practice it, so you can become great at it.

Brandon’s response illustrates the perceived importance of football participation toward building mental capacity. The ability to practice and study are benefits that lend themselves to achievements later in life.

Discipline

Referencing how football has provided their child with benefits of discipline and ability to follow authority, Kristin said,

I think it [football] had a positive impact, not just from the exercise standpoint, but from teaching them to follow direction. I really believe, an uncoachable kid is an unemployable adult. If you cannot be part of a team and be coached, in whatever sport, not just football, then I don’t know how you succeed as an adult.

In this quote, Kristin indicates her attitude toward the sustained benefits produced by football participation. Despite potential long-term cognitive risks of hits to the head, cognitive gains of discipline, focus, and being coachable are presented. For example, Anna described the compliments she received as a parent regarding her children’s disciplined behavior, which she attributed to football, saying, “It’s taught our kids how to . . . I believe they’re real respectful of like authority. We get compliments.”

Self-esteem

In addition to helping children develop discipline and respect, some parents indicated playing football increased their sons’ confidence and self-esteem. Kurtis said, “Even though it’s a physical and dangerous sport, it does do a lot for kids’ confidence. Their confidence level is at an all-time high when they’re on the team, especially if the team’s having success.” Maddie echoed these remarks, describing the self-esteem boost that can come with football accomplishments. She said,

It gives them self-esteem I think as well, ‘cause they know that they can accomplish stuff. It’s made them feel more secure in themselves, I believe. They’ll go out there and you know, they’ll pretty much try anything once. We went skiing for the first time . . . and they were right at it, you know what I mean, they just tried. They’ve got really good self-esteem.

In this example, Maddie describes how the confidence gained from football can encourage children to be more willing to engage in new activities, such as skiing. Furthermore, she attributes her child’s self-esteem to football participation rather than her parenting skills or other influences.

Academic benefits

Speaking directly to cognitive benefits for her child in the form of academic grades, Brittney said,

They have to keep their grades at a certain level in order to be able to play on team sports. So I know that’s one thing that motivates some parents to allow them to play, is that it’s “No pass, no play.”

Another participant similarly described academic benefits, saying,

You can’t play unless you pass. And so they always kept their grades up, that was never an issue. It kept them out of trouble as well. Like the oldest one, he’s 19, almost 20, he hasn’t been arrested, you know what I mean? He’s taking classes, he’s working full-time.

Remarking on how the long hours required by football keeps their son away from potential trouble, Amanda noted, “We do joke that he’s too tired to do drugs, because he works so hard. We dropped him off at 5:55 this morning at the school, and he’s tired.” Again, we note parents attributing their children’s positive characteristics to football participation over other sources.

Social Benefits of Football Participation

Camaraderie

Multiple participants mentioned camaraderie specifically when describing the benefits of playing tackle football. For example, Tyler said,

I like the camaraderie that the boys have. The bus rides and making friends and teamwork and stuff. Not too many shenanigans in the locker room as far as I know. I think the boys had a good sense of responsibility, or ‘bustedness’—they knew they were gonna get in trouble.

Kurtis described the potential to build closer relationships by overcoming frustration and fatigue as a group. He said,

It’s a great team sport. And you’re kind of in the trenches. When football season starts, it’s in the hottest part of Texas summer. So you’re out there suffering with your buddy, so peer-to-peer. Awesome relationship building. And so you’re right there with your guys in the trenches, working out, getting better. And it gets frustrating sometimes, but the reward of winning, with a team. It builds such a . . . a good camaraderie between the players and just building team effort and staying together.

Or as Jake stated, “I think what [name of son] gets out of it the absolute most is his buddies, his camaraderie.”

Being part of a collective

Referencing the social benefits their child gains from football participation, Steven remarked, “It’s about the overall team . . . being part of a group. You doing your piece to make sure the overall thing is successful and when needed, be a leader.” Talking about how it is not just about self-achievement by getting the ball and scoring, Melanie said, “It’s helping somebody else doing it, too.”

Describing the impact on his sons from being on the football team, Jim noted, “It’s even helped them with social interactions, and being a part of a team. Being part of something bigger than you are.” Morris echoed and expanded on these sentiments, talking about benefits of football and about the importance of being a part of a larger community. He said,

I think it helps you be a part of something and in . . . in the community we’re in, that is bigger than in other communities, you know? Filling the void, and belonging, and having a duty. A job. Somebody else giving you discipline. It’s just, it’s a whole lot to me, it’s a whole lot, from discipline to listening. To learn how to listen and to face personal adversity.

Through this statement, Morris conveys wide-ranging benefits of football that stem from being a part of larger collective. He indicates football helps to give players a sense of purpose, and the ability to be part of something bigger than themselves. Part of this benefit stems from the need to band together and to work as a unit. Benefits of discipline and learning to listen emanate from the sense of having “a duty” within the larger community, and enhance players’ abilities to overcome adversity and challenges.

Social Norms

Social factors and expectations also influenced parents’ football decisions. For instance, Tammy discusses how she and her husband initially declined to allow their children to play football over concerns of CTE. However, they eventually acquiesced, citing the importance of having coaches they felt they could trust in charge of the team. She said,

It really flipped him [husband] out because it said little bitty hits leave these little bitty bruises on the brain, but they don’t show up forever. They could have lasting effects. So he was like, “Don’t even ask me.” And the kids constantly, “Can we play football?” He was like, “No.” They just quit asking. So, in seventh grade [name of son] was like, “Can I play football now?” and Scott was like, “Sure.” It’s the first time it’s with coaches that know what they’re doing and not just a dad that wants you to get out there and play for him.

This quote speaks specifically to the importance of trust in coaches, and positive social expectations of behavior and instruction from coaches in contact sports. Findings also illustrate outside influences that can affect football participation judgments.

Social norms of football participation illustrate themselves at an early age for some children. As Richard said,

Henry was invited . . . when he was seven, he was invited by one of my co-workers who had a flag football team, and said, “Hey, how old is Henry?” I told him [he was seven]. “Why doesn’t he join our team?” David was the same way. When he was four or five, he joined that same team. Friends of ours were on that team, and asked if he wanted to play.

In this quote, Richard illustrates how community norms can affect sport enrollment. Social expectations and relationships, such as being friends with a local football coach, spurred football enrollment for certain parents in our study.

Jenna spoke of the influence of her sons’ friends as the catalyst for participation. She said, “They got invited by friends. They wanted to play with their friends.” Gary similarly referenced the influence of social peers, saying, “The second day of the seventh-grade year . . . he was playing football. And I think it’s because all his friends were playing football.” Overall, these quotes illustrate the importance of social influence on football participation.

Perceived Behavioral Control

Our analyses indicated an intertwined relationship between social norms and perceived behavioral control. As community members and social norms both indicated positive attitudes toward football, parents’ perceived ability to control their son’s participation was reduced. Some parents spoke of the difficulty of controlling their child’s sport participation. Tom articulated both his hesitation toward his son’s participation and the complexity of the factors that influenced the decision. As he said,

So now, I still fully support high school football, but for me, if my kid didn’t want to play it, there ain’t no way he’d be playing it. If he was even on the fence, kind of wishy-washy, I would encourage him not to play. But since he loves it and I do know the benefits and values of . . . the teamwork, the camaraderie, and all those things I mentioned early on, there’s a ton of value in team sports. But you do have to accept that risk that every day he goes out there, not just in games, but in practice, because when I told you I broke two bones my senior year, that was in practice . . . I didn’t break anything in the game. Yeah. So you have to accept that risk.

It was obvious Tom had concerns about his son playing football, but these did not outweigh his desire for his son to play a sport he valued.

Stephanie remembered her firsthand encounter with the dangers of her son being involved in football participation, but noted that she still allowed her son to play. Talking of the concern of her child being promoted to compete with the varsity squad as only a freshman student, she remarked,

His freshman year, they moved him out of freshman class and put him in varsity class . . . He came home and I was terrified. He looked like he had been in a car wreck. And I was like, “What is wrong with you? What happened?” I didn’t know what happened to him and he was like, “Mom, they’re putting all of us freshman against all the varsity.” They were their “tackling dummies” for the varsity team.

Stephanie continued,

His chin had about a two-inch cut. Both shoulders from the elbow up were black and blue, completely bruised. I said, ‘How are you getting that if you’re wearing pads?’ He said, “Because I play defense. They just put us against them.” He was black and blue. One time I think his cheek was cut or forehead, and I was in tears. I was like, “I don’t want you doing that. You’re taking hits on your head every time.” He was like, “Mom, I’m fine. It looks a lot worse than it is.” I was literally in tears. It was terrible.

These quotes exemplify the perspective of Stephanie and her husband, the only parents in our sample who actively campaigned against their children participating in football. In their case, the influence of peer and community members increased their sons’ desire to stay on the football team, despite their lobbying against his involvement.

Although some parents expressed hesitation and lengthy decision processes, not all parents responded with caution when their child indicated they wanted to play. Nelson indicated, “I don’t think there was a decision. It was just, no discussion at all. Sign him up.” Similarly, Cindy described a lack of equivocation,

It was just like, “Okay. Is that something you want to do?” And you know, I try not to put fear into the kids. You know what I mean? So I was okay with it. It wasn’t a discussion for us. We just kind of said “Okay.”

In this response, Cindy noted that she did not want to instill fear into her children by showing hesitation in allowing them to play. Further describing the balancing act parents must make between risk and development, Johnny said,

I just had to put my dad hat on and let them. Life isn’t easy, it’s going to be physical, you can’t dance through life, and so they need to tough it out and see if it was for them. Give it a try.

Next, we discuss the theoretical and practical implications of our findings.

Discussion

The purpose of this study was to examine the attitudes, social norms, and perceptions of behavioral control that influence parents’ youth tackle football decisions. Despite the negative media coverage regarding brain injury risks, parents in this study cited both cognitive and social benefits related to football. Football participation was associated with cognitive and emotional benefits of persistence, respect, discipline, confidence, and self-esteem. Certain parents also linked academic benefits with football participation. In addition, football was described as producing social benefits, including camaraderie and being part of a collective. Finally, parents’ football judgments were influenced by the perceived level of control over their child’s behavior. Family and community dynamics emerged that limited some parents’ sense of efficacy to heed caution and withhold their child from playing tackle football.

Theoretical Implications

Our results provide additional support to the applicability of TPB for understanding parents’ decisions to allow participation in potentially risky sports. Although most research utilizing TPB examines attitudes of the individual who will perform the action (Cooke et al., 2016; Harmitage & Conner, 2001), this study looked at third-party attitudes about a behavior (tackle football) performed by another individual, in this case, their child. The inclusion of perceived behavioral control is a defining element of TPB, as perceived control influences intention and action (Ajzen, 1991). Some parents indicated they felt able to decide whether their child joined the team, whereas other parents expressed a lack of control over their child’s football participation due to social and family factors.

Perceived behavioral control

In prior quantitative analyses of football participation intentions, behavioral control was noted difficult to measure accurately (Murphy et al., 2017). The current interview analysis indicates that parents’ behavioral control for sport participation is a complex issue. Friends and community members play a key role in shaping children’s desire to play tackle football. Results indicated some parents may have hesitations about signing up their children, but feel the decision is out of their control. The complexity of behavioral control for parental consent of sport participation is likely why measuring this variable specifically has been difficult for researchers. Current results indicate additional components of behavioral control that should be incorporated in future measures to add external validity. Specifically, factors of family history, community norms, and the influence of relevant peers should be incorporated into future measures of parents’ behavioral control of sport participation.

These results highlight a mixed sense of control parents had over their children’s participation. Some parents indicated they had hesitations about allowing their child to play football. However, due to community dynamics and children’s desires, some parents noted an inability to restrict their children’s participation without risking reactance from their child. Parents also indicated that certain benefits that would be forsaken if football participation was foregone, such as camaraderie and the thrill of belonging in team settings and school environments, and being a cog in a larger collective. These benefits were specifically described as building blocks that would help enable the child’s success later in life.

In some cases, it seemed as if parents’ risk assessment was overruled by the child’s desire to play football. For example, Stephanie and her husband spoke passionately about actively trying to dissuade their son from playing tackle football, but in the end left the decision up to the child because they had explained the risks and believed “it was his life.” Congruent with previous work (Andrews et al., 2010), parents in this study reported influence of salient groups (e.g., child’s friends, adult friends, coaches) who approved of their child playing football. Subjective norms are not created individually, but rather occur through the process of interacting with other people or groups (Richardson et al., 2012).

The results speak to the tensions parents experience in their decisions to allow children to play tackle football. Some parents indicated emotional costs such as crying and being in tears over the repeated hits to the head that their son was taking, saying, “He looked like he had been in a car wreck.” Despite these concerns, the parent did not have the control to overrule her son’s desire to play due to the influence of social pressures.

Social influences

Social pressures may also mitigate parents’ ability to control their child’s participation in football. Current results indicate that subjective norms can apply at the community level. Social influences and community culture emerged as elements considered in decision-making, pointing to participation in tackle football as a normative behavior for the communities in which the participants resided. Parents expressed lack of control through statements such as “It’s the one thing he wants to do, we don’t want to tell him ‘no’,” and “It is his only social outlet, we can’t pull him out.” Strong community dynamics, trust in local coaches, and other factors come together to reduce self-efficacy of parents in our study, even those who acknowledged hesitation in permitting their child to tackle football. Cultural norms reward playing through pain in the name of character development (Sabo, 2004), placing these norms even above individual health concerns (Messner & Sabo, 1994).

Camaraderie was spontaneously mentioned by participants in a majority of the interviews as a benefit of playing football. This finding highlights the importance of supportive communication among teammates, coaches, and supporters. Although the current work suggests the importance of camaraderie as a benefit of football participation, further work should investigate the moments, encounters, and specific interactions that build and develop camaraderie among teams. Notably, camaraderie also can be problematic. Locker room camaraderie can have inadvertent negative effects, such as when teammates do not speak out against hazing or wrongdoing by fellow players. Group loyalty reduces the likelihood of speaking out against wrongdoing (Dungan et al., 2015). Group camaraderie could also have negative effects on concussion reporting. Teammate expectations and external pressures can affect players’ reporting of concussion symptoms (Kroshus et al., 2014, 2015). With camaraderie described as a key benefit of football participation, researchers should focus on identifying the social patterns among teammates that promote healthy camaraderie.

Of value to mention is that the identified benefits of camaraderie, persistence, and contributing to a larger group are not tied directly to the physicality of the sport. Proponents of safer rules for football may benefit from shifting the frame of the conversation away from increases in safety and toward the promotion of the emotional benefits maintained, or even highlighted, by the rule changes. Advocates for reduced contact may benefit from emphasizing the emotional benefits unaffected by the proposed changes in their efforts to gain policy support, such as the development of persistence and self-esteem.

However, some parents did indicate that the toughness and physicality unique to tackle football provided the foundation for the benefits received. As one parent noted, “I think football is unique in the aspect of, with heart, and effort, and toughness, you become a better player.” Understanding the attitudes of this audience is key for any proponent of rule changes. Safety rule changes are frequently met with resistance (Cranmer & Sanderson, 2018), as they threaten norms of hypermasculinity in sport contexts (Richardson & McGlynn, 2011). Compromise on rule changes may be difficult for groups with divergent opinions on football physicality. Understanding the benefits of football that transcend physicality remains vital for meeting the dual needs of safety promotion and sustained sport participation.

Practical Implications

This study provides insight for practitioners of sport to understand how and why certain benefits and risks motivate or dissuade football participation. Advocates for increased football participation can apply these results to emphasize the gains that drive parents’ positive attitudes toward football outcomes. Risks and benefits have an inverse relationship; as perceived benefits rise, risk perceptions decrease (Fischhoff et al., 1978). Current findings indicate that identifying the potential cognitive benefits of football may reduce perceptions of risks associated with head injuries. To motivate football enrollment, organizations should emphasize benefits of persistence, camaraderie, and in-group membership as key benefits of football participation.

Similarly, advocates for increased player safety may strengthen their appeals by emphasizing the benefits parents articulated that were not associated with physicality. Understanding the dynamic of benefits is imperative for promoting positive outcomes of youth sport participation (Tamminen et al., 2017). Advocates may increase support by emphasizing how safer styles of football can still generate cognitive and social benefits for the players involved. For example, rewards of camaraderie, discipline, and respect for authority are not connected directly to physical contact. Our analyses indicated these factors as motivating influences on parents’ decision to enroll their child in tackle football. However, rule changes can be a sensitive issue for stakeholders (Cranmer & Sanderson, 2018). People avoid sensitive issues for many reasons, including topic fatigue (Donovan-Kicken et al., 2012). Proponents for safer rule changes should focus their messages on the benefits emphasized by the proposed rule changes, while also considering the frequency of appeals in relation to increased support.

Media messages can increase awareness for concussion risks (Hull & Schmittel, 2015), portraying concussions in the context of larger social issues of safety and risk (Cassilo & Sanderson, 2018). As media influence perceptions of the safety and long-term health of football players (Rugg, 2019), how the media choose to frame messages about injuries can affect cultural norms for prioritizing long-term health of athletes over immediate benefits (Sanderson et al., 2016). Parents in this study also noted the effect of social influences, which can encourage athletes to not report concussions so they do not let coaches or teammates down (Register-Mihalik et al., 2013). As strategic media messages shape perceptions of sport credibility (Benson, 2017), understanding the messages that remain memorable for athletes (Cranmer & Myers, 2017) with regard to concussions and football is an area of interest of future research.

In football, portrayals of risk as inherent to the game itself may function to externalize perceptions of responsibility away from involved parties in the event of a negative occurrence (Nadesan, 2016). When parents and players view football benefits as worth the potential risks, the need for organizations to make rule changes diminishes, until the point that parents stop enrolling their children in the sport. Future research would benefit from examining parents’ risk attributions for tackle football injuries, with a focus on how attributions of responsibility for injuries influence youth football decisions.

Talking with their children about the benefits and risks of football poses a challenge for parents. Parents who feel unable to control their child’s football participation may benefit from using narratives or stories to describe the long-term risks. The use of stories can increase engagement with health topics (Busselle & Bilandzic, 2009). Recent work has illustrated the potential of using narratives (Robbins & Niederdeppe, 2019), message frames (McGlynn & McGlone, 2019), and infographics (Reynolds et al., 2018) to communicate risk in health contexts. However, current research does not offer prescriptive strategies for how parents can effectively discuss long-term risks of sport participation with their children. Future research should examine the effectiveness of strategic message frames on perceptions of concussion risk for parents and youth athletes.

Limitations and Future Directions

Future work may consider how the benefits and risks identified here translate to other sports that feature physical contact, such as lacrosse or field hockey. Comparing and contrasting sports would help to identify the influence of cultural norms and risk tolerance on contact sport participation. Our sample size of participants was limited to only one geographic location and was not constructed of a nationally representative sample. Data should be collected from larger and more representative sample groups before extending these results to the general population.

Participants in this study all resided in the state of Texas, which traditionally ascribes a high value to football (Conine, 2016; Fisher, 2018; Peter, 2017). Taking geography and location further into account will add context and additional understanding to the findings described here. Specifically, the results would benefit from being contrasted with participants from other geographic regions to better understand community and regional influences on football attitudes. For example, a study that compared data from parents in different regions, such as the northeast and the northwest United States, would provide valuable context to the current results. Perceived tradeoffs between risk and benefit may be markedly different in different geographical areas. This notion could be particularly relevant for parents and children who relocate from one region to another, as they may face cultural shifts in attitudes, social norms, and community benefits associated with tackle football participation. Socio-economic variables may also affect concussion risk perceptions (Kroshus et al., 2019) and should be analyzed in future studies in this context.

The current analysis employed TPB to analyze and frame our results. Future studies should consider the use of other theories to guide analyses of football decisions. For example, social cognitive theory (Bandura, 1998, 2004) could be applied to emphasize the influence of environmental influences and parent–child interactions on football decisions. Examining the issue of youth football participation through additional theoretical lenses will offer increased understanding of the benefits that motivate parents’ youth football decisions.

The results of this study described cognitive benefits of football participation that can relate to both mental and social-emotional processes, such as persistence, respect, and discipline. We use the term cognitive benefits in a broad sense to differentiate from physical benefits of participation, such as gains in strength and conditioning. Distinctions between cognition and emotion can be difficult to ascertain, as cognitive processing and affective states are linked (Schwarz, 2000). Benefits of physical activity for youth include enhanced coping skills and improve attention in school (Diamond, 2015). Similarly, strategies that promote cognitive elaboration in adolescents are associated with increased self-discipline and goal persistence (Duckworth et al., 2011). Future work can build on the current findings by highlighting distinctions between cognitive and emotional benefits of participation, such as examining the relationships between cognitive complexity, confidence, and self-esteem.

This study focused only on football and only on male athletes. Future research would benefit from focusing on perspectives toward concussion risks for female athletes. Male and female athletes both experience concussions (Sanderson et al., 2017), and perceptions and social norms may differ based on the biological sex of youth athletes. This analysis also examined only parents of middle school aged children. Future research would benefit from including a more diverse age range, including elementary and high school athletes. Parents’ judgments and goals for participation may change over time (Dorsch et al., 2015). The desire to remain consistent with prior decisions is a prominent cognitive bias (Guadagno & Cialdini, 2010), as people often look for reasons to confirm previous selections (Nickerson, 1998). Future work should examine the cognitive biases that may influence football decisions and risk judgments.

Conclusion

This study examined the attitudes, social norms, and perceptions of behavioral control that shaped parents’ risk judgments of youth tackle football participation. Despite increased attention to the risks associated with playing tackle football, parents in this study noted various cognitive and social advantages experienced by their child as a result of football participation. The results indicate the cognitive and social benefits that affect parents’ football enrollment judgments. Findings suggest that although parents who permit tackle football do acknowledge physical and mental risks of participation, possible negative outcomes were not the only type of risk parents felt compelled to consider.

Footnotes

Declaration of Conflicting Interests

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

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Joseph McGlynn

Author Biographies

Joseph McGlynn (Ph.D., The University of Texas at Austin) is assistant professor in the Department of Communication Studies at the University of North Texas. His research focuses on health communication and risk perception in sport contexts. His work seeks to improve health communication efforts by identifying influential factors that affect attitudes toward risks and risk judgments.

Rebecca D. Boneau received her Master’s degree in Communication Studies from the University of North Texas. Her research interests focus on relational aspects of sports, including communication between parents, referees, parents and children, coaches and parents, and coaches and athletes.

Brian K. Richardson (Ph.D., The University of Texas at Austin) is a professor in the Department of Communication Studies at the University of North Texas. His research interests include organizational whistleblowing, disaster recovery, and decision-making within sport contexts.

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