Decision-Making Capacity

Warmath, Dee, and Andrew Winterstein. The Impact of a Social Marketing Intervention on Concussion Reporting Beliefs. Journal of Athletic Training. Accepted November 2019.

This study applies Expectancy Value Theory (EVT) to identify how marketing the possible consequences of concealing concussion symptoms influences a young adult’s concussion reporting beliefs in support of a greater likelihood of reporting. Club sports athletes exposed to the consequence-based social marketing showed higher levels of positive reporting beliefs, and lower levels of negative beliefs than athletes exposed to traditional or revised symptom education. Social marketing offers Athletic Trainers another strategic tool for motivating concussion symptom reporting by translating scientific findings into marketable statements and then communicating the benefits of reporting or the negative consequences of concealing concussion symptoms.

Warmath, Dee, and David Zimmerman. 2019. Financial Literacy as More than Knowledge: The Development of a Formative Scale through the Lens of Bloom’s Taxonomy of Knowledge. Journal of Consumer Affairs 53(4): 1602-1629.

For well over a decade, financial literacy has been a primary lens through which researchers approach financial education. Unfortunately, in most cases, this potentially rich construct is reduced to mere financial knowledge. This myopic conceptualization hampers the development of the concept and programs to build financial literacy. Despite research that reveals these limits, the field has either persisted with this narrow definition of financial literacy or abandoned the model altogether in favor of capability or similar constructs. Using Bloom’s domains of knowledge, we redefine financial literacy as the combination of three different indicators reflecting three domains of knowledge: financial skill, self-efficacy, and explicit knowledge. Using data from a national survey, we apply the methods of formative scale development to construct and validate a more robust conceptualization and measurement of financial literacy. We explore how this financial literacy index might inform development of innovative financial education programs.

Warmath, Dee, and Andrew P. Winterstein. 2019. Reporting Skill: The Missing Ingredient in Concussion Reporting Intention Assessment. Sports Health 11(5): 416-424.

Extant literature suggests that a substantial portion of athletes may not report a possible concussion and
that concussion knowledge is insufficient to predict concussion reporting behavior. One area that has not been explored is reporting skill; that is, mastery of the actions required to report a concussion. This study evaluated the relationship between reporting skill and reporting intention, introducing a measure of the reporting skill construct. Knowing the actions to take in reporting was more important than having knowledge of concussions or concussion symptoms. Reporting skill, not concussion or concussion symptom knowledge, was associated with higher intentions to report symptoms. Among those with higher levels of reporting skill, concussion symptom knowledge (but not general concussion knowledge) was associated with higher intentions to report symptoms. Incorporating reporting skill development in concussion education and team activities to teach athletes how to report is likely to improve actual reporting intentions. While further study is needed with particular sports and additional age groups, reporting skill holds promise as a new avenue for increased concussion reporting.

Emily Kroshus, Kenneth L Cameron, J Douglas Coatsworth, Christopher D'Lauro, Eungjae Kim, Katherine Lee, Johna K Register-Mihalik, Jeffery J Milroy, E Paul Roetert, Julianne D Schmidt, Ross D Silverman, Dee Warmath, Heidi A Wayment, Brian Hainline. 2020. Actionable Approaches to Improving Concussion Disclosure: Consensus from the NCAA-Department of Defense Mind Matters Research & Education Grand Challenge, British Journal of Sports Medicine, 54:1314-1320.

Early disclosure of possible concussive symptoms has the potential to improve concussion-related clinical outcomes. The objective of the present consensus process was to provide useful and feasible recommendations for collegiate athletic departments and military service academy leaders about how to increase concussion symptom disclosure in their setting. Consensus was obtained using a modified Delphi process. Participants in the consensus process were grant awardees from the National Collegiate Athletic Association and Department of Defense Mind Matters Research & Education Grand Challenge and a multidisciplinary group of stakeholders from collegiate athletics and military service academies. The process included a combination of in-person meetings and anonymous online voting on iteratively modified recommendations for approaches to improve concussion symptom disclosure. Recommendations were rated in terms of their utility and feasibility in collegiate athletic and military service academy settings with a priori thresholds for retaining, discarding and revising statements. A total of 17 recommendations met thresholds for utility and feasibility and are grouped for discussion in five domains: (1) content of concussion education for athletes and military service academy cadets, (2) dissemination and implementation of concussion education for athletes and military service academy cadets, (3) other stakeholder concussion education, (4) team and unit-level processes and (5) organisational processes. Collectively, these recommendations provide a path forward for athletics departments and military service academies in terms of the behavioural health supports and institutional processes that are needed to increase early and honest disclosure of concussion symptoms and ultimately to improve clinical care outcomes.

Planned simultaneous publication in the Journal of Special Operations Medicine 20(3), 88 - 95.

Warmath, Dee, Casey Newmeyer, Genevieve O’Connor, and Nancy Wong. 2021. Have I Saved Enough to Social Distance? Journal of Consumer Affairs 2021, 1-20.

Behavioral responses such as social distancing are important in the fight to contain COVID-19 transmission, yet motivating such responses is an overwhelming, resource-intensive task. Using multi-wave data from 23,735 US adults collected in May/September 2020, and January 2021, this study examines how financial preparedness in the form of savings influences the relationship predicted by the Health Belief Model between the degree of concern for COVID-19 and engagement in social distancing. Findings indicate that general concern for COVID-19 is related to the decision to engage in social distancing for individuals who have less saved. Curiously, higher levels of financial preparedness are associated with a lower likelihood of social distancing at least among people who had been laid off during the pandemic. The findings suggest a tradeoff between protecting one's standard of living and their health. Government and public health agencies should consider financial preparedness in the design of public health communications.

Warmath, Dee, Andrew Winterstein, and David Bell. 2022. The Role of High School Athlete’s Competitiveness in Sport Specialization: A National Study. Orthopaedic Journal of Sports Medicine 10(3), 23259671221079670.

Background: Sport specialization has been associated with increased injury and negative psychosocial effects on young athletes. With the continuing trend toward specialization, studies have begun to examine what motivates this decision (eg, building a skill, getting a scholarship). No study has directly assessed the personal characteristics underlying these stated reasons. Purpose/Hypothesis: This study examined the role of athlete competitiveness (enjoyment of competition and competitive contentiousness) as a characteristic associated with propensity to specialize in the United States. We hypothesized that, at the high school level, athletes would be more likely to engage in sport specialization owing to enjoyment of competition versus competitive contentiousness. Study Design: Cross-sectional study; Level of evidence, 3.
Methods: We conducted an online survey of 975 high school athletes in the United States who were  recruited via the Dynata research panel. Measures included a previously published sport specialization categorization (low, medium, high) and the 2 dimensions of the Revised Competitiveness Index (enjoyment of competition and competitive contentiousness). Also collected were athlete characteristics, sports played by the athletes, level of competition, and whether they planned to play sports in college. Analytical methods employed included cross-tabulations, multinomial logit, and ordinary least squares regression.
Results: Overall, 22.4% of the athletes reported a high, 34.8% reported a medium, and 42.9% reported a small level of specialization. No differences in the distribution of sport specialization by sex or age were observed; however, athletes who definitely planned to play in college were significantly more likely to have a high level of specialization (P < .001). Enjoyment of competition was associated with greater  specialization (beta ¼ .196; P < .001), whereas competitive contentiousness was associated with lower levels of specialization (beta ¼ .299; P < .001). These findings were robust to all 3 different analytical methods we employed. Conclusion: Study findings indicated that, while athlete competitiveness is associated with sport specialization, the nature of that competitiveness determined the association. Being an argumentative contrarian may predispose athletes to lower levels of sport specialization, whereas enjoying competition may encourage higher levels of specialization.

Warmath, Dee. 2022. Measuring and Applying Financial Literacy. In John Grable and Swarn Chatterjee (eds.), De Gruyter Handbook of Personal Finance. Boston: De Gruyter.

While financial literacy is hailed as the promised antidote or remedy to poor financial decision making, there is mixed evidence for the ability of financial literacy to deliver on this promise and a lack of consensus as to what financial literacy is. The dominant view equates financial literacy with knowledge of financial concepts and calculations. Numerous studies suggest that financial knowledge alone is insufficient to improve financial outcomes. Despite attempts to conceptualize financial literacy as more than mere knowledge, there remains a misalignment between the concept and its measures. There is an opportunity to clarify and potentially expand what is needed to make effective financial decisions (i.e., what financial literacy is) as well as produce stronger evidence of the role of (or lack of a role for) financial literacy in financial outcomes.