Racial and Ethnic Diversity of Athletic Trainers of the National Collegiate Athletic Association: A Retrospective Study

Abstract Context: Athletic trainers (ATs) are the most visible members of the sports medicine team and are responsible for the health and well-being of student-athletes (SAs). Objective: Quantifying the representation from Black, Indigenous, and People of Color (BIPOC) ATs in National Collegiate Athletic Association (NCAA) member institutions has not been previously studied. Design: Retrospective study Setting: National Collegiate Athletic Association's (NCAA) Demographic Database Participants: NCAA teams' athletic personnel at NCAA member institutions. Main Measures: Chi-square tests were employed to assess differences in racial and ethnic frequencies across division, calendar year and gender. Linear regressions models were used to examine change in racial and ethnic distributions of head and assistant ATs over time. Results: The majority of NCAA athletic trainers were categorized as white (88%), which was reflected in both head (90.8%) and assistant (87.2%) AT positions. Black ATs made up the largest proportion of a specific racial/ethnicity group within BIPOC ATs (3.4% of head ATs, 4.6% of assistant ATs), with the next most prevalent being Hispanic (2.8% of head ATs, 3.9% of assistant ATs). Historically Black College and Universities (HBCUs) showed higher proportions of BIPOC ATs in both head and assistant categories compared to non-HBCU institutions. Division I schools had the greatest AT racial/ethnicity diversity in comparison to Division II and Division III (p<0.0001). In our linear regression models, we found statistically significant increases in many of the racial/ethnic categories for both head and assistant ATs. Conclusions: Our study demonstrates that BIPOC ATs represent a small proportion of the ATs currently working at NCAA member institutions. Although there has been an increase in BIPOC athletic trainers over the past ten years, a large racial and ethnic discordance gap still exists between student athletes and the ATs caring for them. Future studies may identify barriers encountered by BIPOC ATs and the effectiveness of current diversity initiatives.

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Moderating Effects of Gender Among Collegiate Student-Athletes Receiving a Novel Peer Concussion Education Program

Health Education & Behavior ◽

10.1177/1090198120977128 ◽

2020 ◽

pp. 109019812097712

Author(s):

Meredith Kneavel ◽

William Ernst ◽

Kevin McCarthy

Keyword(s):

Education Program ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Female Athletes ◽

Athletic Trainers ◽

Male Student ◽

Well Being ◽

Return To Play ◽

Moderating Effects ◽

Concussion Education

Background More than 460,000 female and male student-athletes compete in college sports each year, with 5.5 concussions reported per 1,000 athlete exposures. The majority of these concussions occurred during competition and are somewhat more likely to be reported by female athletes. Aims To evaluate moderating effects of gender differences in response to a Peer Concussion Education Program (PCEP). Method A total of 1,100 male and 511 female student-athletes from 60 teams (30 experimental, 30 control) representing all National Collegiate Athletic Association divisions from high-concussive sports participated before, postintervention, and 1-month following the intervention. Participants completed assessments of symptom and return-to-play knowledge, reporting behavior, and reporting attitudes. Results The PCEP was more effective than control on all measures, females in the PCEP showed significantly greater changes than males in return to play knowledge, intention to report self and teammate, and indirect attitudes for self and teammate. PCEP females were more likely to discuss concussions with athletic trainers, peers, and teammates. In addition, females had a higher likelihood of reporting their own suspected concussion. Discussion Females had greater rates of change in understanding of some key components of the PCEP. Conclusion These findings suggest that females may learn differently in a peer environment and have different attitudes toward reporting and safety when consideration is given to the well-being of others.

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Sports Medicine Staffing Across National Collegiate Athletic Association Division I, II, and III Schools: Evidence for the Medical Model

Journal of Athletic Training ◽

10.4085/1062-6050-0463-19 ◽

2020 ◽

Vol 55 (6) ◽

pp. 573-579 ◽

Cited By ~ 5

Author(s):

Christine M. Baugh ◽

Emily Kroshus ◽

Bailey L. Lanser ◽

Tory R. Lindley ◽

William P. Meehan

Keyword(s):

Health Care ◽

Health Outcomes ◽

Health Care Providers ◽

Sports Medicine ◽

National Collegiate Athletic Association ◽

Athletic Trainers ◽

Full Time ◽

Care Providers ◽

Collegiate Sports ◽

Financial Oversight

Context The ratio of clinicians to patients has been associated with health outcomes in many medical contexts but has not been explored in collegiate sports medicine. The relationship between administrative and financial oversight models and staffing is also unknown. Objective To (1) evaluate staffing patterns in National Collegiate Athletic Association sports medicine programs and (2) investigate whether staffing was associated with the division of competition, Power 5 conference status, administrative reporting structure (medical or athletic department), or financial structure (medical or athletic department). Design Cross-sectional study. Setting Collegiate sports medicine programs. Patients or Other Participants Representatives of 325 universities. Main Outcome Measure(s) A telephone survey was conducted during June and July 2015. Participants were asked questions regarding the presence and full-time equivalence of the health care providers on their sports medicine staff. The number of athletes per athletic trainer was determined. Results Responding sports medicine programs had 0.5 to 20 full-time equivalent staff athletic trainers (median = 4). Staff athletic trainers at participating schools cared for 21 to 525 athletes per clinician (median = 100). Both administrative and financial oversight from a medical department versus the athletics department was associated with improved staffing across multiple metrics. Staffing levels were associated with the division of competition; athletic trainers at Division I schools cared for fewer athletes than athletic trainers at Division II or III schools, on average. The support of graduate assistant and certified intern athletic trainers varied across the sample as did the contributions of nonphysician, nonathletic trainer health care providers. Conclusions In many health care settings, clinician : patient ratios are associated with patient health outcomes. We found systematic variations in clinician : patient ratios across National Collegiate Athletic Association divisions of competition and across medical versus athletics organizational models, raising the possibility that athletes' health outcomes vary across these contexts. Future researchers should evaluate the relationships between clinician : patient ratios and athletes' access to care, care provision, health care costs, health outcomes, and clinician job satisfaction.

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National Collegiate Athletic Association Division I Athletic Trainers' Concussion-Management Practice Patterns

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.25 ◽

2014 ◽

Vol 49 (5) ◽

pp. 665-673 ◽

Cited By ~ 53

Author(s):

Kassandra C. Kelly ◽

Erin M. Jordan ◽

A. Barry Joyner ◽

G. Trey Burdette ◽

Thomas A. Buckley

Keyword(s):

Clinical Examination ◽

Ncaa Division I ◽

Sports Medicine ◽

National Collegiate Athletic Association ◽

Practice Patterns ◽

Management Practice ◽

Athletic Trainers ◽

Division I ◽

Concussion Management ◽

Consensus Statements

Context: A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together. Objective: To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%. Main Outcome Measure(s): The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined. Results: We identified high rates of multifaceted assessments (ie, assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations. Conclusions: Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.

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Developing Student-Athlete School Satisfaction and Psychological Well-Being: The Effects of Academic Psychological Capital and Engagement

Journal of Sport Management ◽

10.1123/jsm.2020-0091 ◽

2020 ◽

Vol 34 (4) ◽

pp. 378-390 ◽

Cited By ~ 2

Author(s):

Minjung Kim ◽

Brent D. Oja ◽

Han Soo Kim ◽

Ji-Hyoung Chin

Keyword(s):

Student Athletes ◽

National Collegiate Athletic Association ◽

Psychological Capital ◽

Well Being ◽

School Satisfaction ◽

Student Athlete ◽

Collegiate Sports ◽

Psychological Well Being ◽

Study Results ◽

Educational Engagement

The quality of a student-athlete’s experience can be a product of the services provided by their sponsoring sport organization. In an attempt to improve the student-athlete experience, this study was positioned to examine how collegiate sport services could use academic psychological capital (PsyCap) and student-athlete engagement to promote school satisfaction and psychological well-being. A total of 248 National Collegiate Athletic Association Division I student-athletes participated in this study. Results indicated that academic classification moderated academic PsyCap’s influence on engagement. In addition, the academic PsyCap of the student-athletes positively influenced school satisfaction and psychological well-being, but student-athlete engagement fully mediated the relationship between academic PsyCap and psychological well-being. This empirical evidence provides new knowledge on the relationships among student-athletes’ motivational cognitive constructs, educational engagement, school satisfaction, and psychological well-being in the context of highly competitive collegiate sports. Theoretical and practical implications are discussed, including incorporating the results with services provided to student-athletes.

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Athletic Trainers' Attitudes Toward Lesbian, Gay, and Bisexual National Collegiate Athletic Association Student-Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-46.1.69 ◽

2011 ◽

Vol 46 (1) ◽

pp. 69-75 ◽

Cited By ~ 13

Author(s):

Kristine A. Ensign ◽

Athena Yiamouyiannis ◽

Kristi M. White ◽

B. David Ridpath

Keyword(s):

Family Member ◽

Athletic Training ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Athletic Trainers ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Cross Sectional ◽

Positive Attitudes ◽

And Bisexual

Abstract Context: Researchers have investigated heterosexuals' attitudes toward homosexuals, focusing on factors such as sex, race, religion, education, and contact experiences. However, in the context of sport, this research is deficient. We found no published literature investigating athletic trainers (ATs') attitudes toward lesbian, gay, and bisexual student-athletes (LGB). Objective: To determine heterosexual ATs' attitudes toward LGB student-athletes in the National Collegiate Athletic Association. Design: Cross-sectional study Setting: E-mailed survey. Patients or Other Participants: A total of 964 ATs employed at member institutions. Main Outcome Measure(s): We measured attitudes using the Attitudes Toward Lesbian, Gay Men, and Bisexuals (ATLGB) Scale. To determine the extent to which sex, religion, and whether having an LGB friend or family member had an effect on ATs' attitudes, we performed analysis of variance. To establish the effect of age on ATs' attitudes, we calculated a Pearson correlation. We used an independent t test to identify differences between ATs who reported working with LGB student-athletes and ATs who did not. Results: With ATLGB score as the dependent factor, a main effect was noted for sex, religion, and having an LGB friend or family member (P < .01 for all comparisons). Age and total score were related (P < .01). A difference was seen in the ATLGB scores between ATs who were aware of LGB student-athletes on their teams and ATs who were not (P < .001). Conclusions: Many ATs hold positive attitudes toward LGB student-athletes, especially females, those who have an LGB friend or family member, and those who are aware of LGB student-athletes. Still, it is important to provide an open environment in the athletic training room for all student-athletes.

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Mental Toughness, Sport-Related Well-Being, and Mental Health Stigma Among National Collegiate Athletic Association Division I Student-Athletes

Journal of Clinical Sport Psychology ◽

10.1123/jcsp.2020-0043 ◽

2020 ◽

pp. 1-17

Author(s):

Matthew D. Bird ◽

Eadie E. Simons ◽

Patricia C. Jackman

Keyword(s):

Mental Health ◽

Help Seeking ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Well Being ◽

Division I ◽

Mental Toughness ◽

Public Stigma ◽

Personal Stigma ◽

The Relationship

Mental toughness has been associated with factors related to psychological well-being, but little is known about its relationship with stigma toward mental health and mental health help-seeking. This study investigated the relationship between mental toughness, sport-related well-being, and personal stigma toward mental health in a sample of 154 National Collegiate Athletic Association Division I student-athletes. The moderating effect of mental toughness on the relationship between public stigma and self-stigma toward mental health help-seeking was also explored. Mental toughness was significantly and positively associated with sport-related well-being, but not significantly related to personal stigma toward mental health. Moderation analysis indicated that mental toughness was not a significant moderator of the relationship between public stigma and self-stigma, but higher levels of mental toughness were significantly associated with lower levels of stigma toward mental health help-seeking. Building mental toughness may be a way to increase well-being and to reduce stigma toward help-seeking in student-athletes.

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Collegiate Athletic Trainers' Experiences With External Pressures Faced During Decision Making

Journal of Athletic Training ◽

10.4085/1062-6050-165-19 ◽

2020 ◽

Vol 55 (4) ◽

pp. 409-415

Author(s):

Alicia M. Pike Lacy ◽

Stephanie Mazerolle Singe ◽

Thomas G. Bowman

Keyword(s):

Ncaa Division I ◽

Sports Medicine ◽

National Collegiate Athletic Association ◽

Athletic Trainers ◽

External Pressure ◽

Division I ◽

Return To Play ◽

Major Theme ◽

Patient Centered ◽

Medical Decisions

Context Conflict is prevalent between sports medicine professionals and coaching staffs regarding return-to-play decisions for athletes after injury in the National Collegiate Athletic Association (NCAA) Division I setting. The firsthand experiences of athletic trainers (ATs) regarding such conflict have not been fully investigated. Objective To better understand the outside pressures ATs face when making medical decisions regarding patient care and return to play after injury in the NCAA Division I Football Bowl Subdivision (FBS) setting. Design Qualitative study. Setting Semistructured one-on-one telephone interviews. Patients or Other Participants Nine ATs (4 men, 5 women; age = 31 ± 8 years [range = 24–48 years]; years certified = 9 ± 8). Data Collection and Analysis Interviews were audio recorded and later transcribed. Thematic analysis was completed phenomenologically. Researcher triangulation, peer review, and member checks were used to establish trustworthiness. Results Two major themes emerged from the qualitative analysis: (1) pressure is an expected component of the Division I FBS AT role, and (2) strategies can be implemented to mitigate the negative effects of pressure. Three subthemes supported the second major theme: (1) ensuring ongoing and frequent communication with stakeholders about an injured athlete's status and anticipated timeline for return to play, (2) providing a rationale to coaches or administrations to foster an understanding of why specific medical decisions are being made, and (3) establishing positive relationships with coaches, athletes, and administrations. Conclusions External pressure regarding medical decisions was an anticipated occurrence for our sample. Such pressure was described as a natural part of the position, not negative but rather a product of the culture and environment of the Division I FBS setting. Athletic trainers who frequently face pressure from coaches and administration should use the aforementioned strategies to improve the workplace dynamic and foster an environment that focuses on patient-centered care.

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Exploring the Athletic Trainer's Role in Assisting Student-Athletes Presenting With Alcohol-Related Unintentional Injuries

Journal of Athletic Training ◽

10.4085/1062-6050-50.5.09 ◽

2015 ◽

Vol 50 (9) ◽

pp. 977-980 ◽

Cited By ~ 3

Author(s):

Steven M. Howell ◽

Adam E. Barry ◽

William A. Pitney

Keyword(s):

Student Athletes ◽

Athletic Trainers ◽

Unintentional Injury ◽

Collegiate Athletes ◽

Well Being ◽

Heavy Episodic Drinking ◽

Lifestyle Behaviors ◽

Protective Behaviors ◽

Face To Face ◽

Health And Well Being

Compared with their nonathlete peers, collegiate athletes consume higher quantities of alcohol, drink with greater frequency, and exhibit an increased propensity to engage in heavy episodic drinking (ie, binge drinking), which often may result in alcohol-related consequences. Moreover, collegiate athletes are also more likely to engage in other maladaptive lifestyle behaviors, such as participating in physical fights and riding with an intoxicated driver, and less likely to engage in protective behaviors, such as wearing a helmet while operating a motorcycle, moped, or bicycle. Taken together, these behaviors clearly pose a health risk for student-athletes and increase the likelihood that they will experience an alcohol-related unintentional injury (ARUI). An ARUI represents a risk not only to the health and well-being of collegiate athletes but also to their athletic performances, collegiate careers, and potential professional opportunities. Therefore, athletic trainers need to be equipped with the knowledge and skills to provide face-to-face brief interventions to student-athletes presenting with ARUIs and to evaluate the effect of their involvement. We address potential action items for implementation by athletic trainers.

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Bilateral Pulmonary Emboli in a Collegiate Gymnast: A Case Report

Journal of Athletic Training ◽

10.4085/1062-6050-44.6.666 ◽

2009 ◽

Vol 44 (6) ◽

pp. 666-671 ◽

Cited By ~ 5

Author(s):

Leamor Kahanov ◽

Tarah Daly

Keyword(s):

Pulmonary Embolism ◽

Emergency Room ◽

Health Care Providers ◽

Sports Medicine ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Renal Calculi ◽

Student Athlete ◽

Pulmonary Emboli ◽

Care Providers

Abstract Objective: To characterize the diagnosis of pulmonary embolism in collegiate student-athletes and to raise awareness among sports medicine providers of the possibility of this potentially fatal disease in the student-athlete population. Background: An 18-year-old, previously healthy National Collegiate Athletic Association Division I female gymnast complained of intense pain, bilaterally, deep in her chest. The athlete was referred to her team physician, who identified normal vital signs but referred her to the emergency room because of significant pain. The student-athlete was diagnosed with bilateral pulmonary emboli in the emergency room. Differential Diagnosis: Pneumonia, renal calculi, upper urinary tract infection, intercostal muscle strain or rib fracture, pancreatitis, gall bladder disease, gastritis, ulceration, esophagitis, infection, tumor, pulmonary embolism. Treatment: The student-athlete was immediately placed on anticoagulants for 6 months. During that time, she was unable to participate in gymnastics and was limited to light conditioning. Uniqueness: Documented cases of female student-athletes developing a pulmonary embolism are lacking in the literature. Two cases of pulmonary embolism in male high school student-athletes have been documented, in addition to many cases in elderly and sedentary populations. Conclusions: All health care providers, including sports medicine professionals, should be aware that this condition may be present among student-athletes. During the initial evaluation, prescreening should include questions about any previous or family history of pulmonary embolism or other blood clots. Athletes who answer positively to these questions may have a higher likelihood of pulmonary embolism and should be referred for testing.

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Mental Health in Times of the COVID-19 Pandemic: Exploring the Impact on Well-Being Across the Athlete-Collegiate Career

Journal of Clinical Sport Psychology ◽

10.1123/jcsp.2021-0041 ◽

2021 ◽

pp. 1-19

Author(s):

David P. Schary ◽

Carolina Lundqvist

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Student Athletes ◽

National Collegiate Athletic Association ◽

Psychosocial Support ◽

Well Being ◽

Division I ◽

Anxiety Depression ◽

The Impact

In reaction to the COVID-19 pandemic, restrictive policies altered student-athletes’ academic and athletic life. Sparse research has investigated the pandemic’s effect on student-athlete mental health in terms of both negative (e.g., depression, anxiety) and positive (e.g., well-being, quality of life) dimensions. This study explored the effect of the COVID-19 pandemic on well-being and quality of life among National Collegiate Athletic Association Division I student-athletes at different stages of their collegiate career. Ninety-nine student-athletes (Mage = 19.7 years, SD = 1.5) completed assessments on their mental health. Regression analysis revealed experiences directly related to COVID-19 did not affect general well-being or quality of life, but anxiety, depression, and significant insomnia did. Social well-being was lower for student-athletes closer to graduation (e.g., juniors, seniors), independent of reported anxiety and depression levels. These findings highlight the importance of psychosocial support, particularly in times of crisis, and indicate that tailored support might be beneficial at later stages of the collegiate years.

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