Padded Headgear in Junior and Youth Australian Football: Player Insights From a National Survey

Objectives: To investigate beliefs and factors associated with padded headgear (HG) use in junior (<13 years) and youth (≥13 years) Australian football. Design: Online survey. Setting: Junior and youth athletes in Australia. Participants: Australian football players aged U8 to U18. Assessment of Variables: Survey questions regarding demographics, HG use, concussion history, beliefs about HG, and risk-taking propensity. Main Outcome Measures: Rates of padded HG use, and beliefs associated with HG use. Results: A total of 735 players (including 190, 25.9% female) representing 206 clubs participated. Headgear was worn by 315 players (42.9%; 95% CI: 39.3-46.4). Most (59.5%) HG users wore it for games only and wore it voluntarily (59.7%), as opposed to being mandated to do so. Junior players were more likely than youth players to agree to feeling safer (P < 0.001) and being able to play harder while wearing HG (P < 0.001). Median responses were “disagree” on preferring to risk an injury than wear HG, and on experienced players not needing to wear HG. Beliefs did not differ between males and females. Headgear use was associated with players belonging to a club where HG was mandated for other age groups (OR 16.10; 95% CI: 7.71-33.62, P < 0.001), youth players (OR 2.79; 95% CI: 1.93-3.93, P < 0.001), and female players (OR 1.57; 95% CI: 1.07-2.30, P = 0.019). Conclusions: Club HG culture, older age and being female were prominent variables associated with voluntary HG use. Players reported believing that HG offers protection. The rate of voluntary and mandated HG use identified is at odds with current scientific evidence that does not support HG as effective concussion prevention.