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To examine whether a "letter to my future self" analyzed using structural topic modeling (STM) represents a useful technique in revealing how participants integrate educational content into planned future behaviors. 453 club-sports athletes in a concussion-education randomized control study wrote two-paragraph letters describing what they hoped to remember after viewing one of three randomly assigned educational interventions. A six-topic solution revealed three topics related to the content of the education and three topics related to the participant behavioral takeaways. The content-related topics reflected the educational content viewed. The behavioral takeaway topics indicated that the Consequence-based education was more likely to generate the Concussion Seriousness[CS:23%] topic while Traditional(24%) and Consequence-based(20%) interventions were more likely to generate the Responsibility for Brain Health[BH] topic. Traditional(21%) and Revised-symptom(17%) interventions were more likely to generate the Awareness and Action topics. Unstructured user-generated data in the form of a "letter to my future self" analyzed using structural topic modeling provides a novel evaluation of the present and likely future impact of educational interventions. Patient educators can enhance the effectiveness of education through the application of these methods to the evaluation of and innovation in programs. • A "letter to their future self" reveals content and behavioral intentions produced by the education. • Structured topic modeling (STM) offers insights into the effectiveness of patient education. • STM offers qualitative insights with quantitative ease. • This method has the potential to inspire innovation in health education. • A template for the application of the method is offered. [ABSTRACT FROM AUTHOR]

Background: Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course. Method: Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted. Results: The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test. Conclusion: SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs. [ABSTRACT FROM AUTHOR]