Ncaa sickle cell trait screening: Challenges facing health education and promotion

Background: National Collegiate Athletic Association (NCAA) sickle cell trait (SCT) screening policy mandates SCT testing for athletes in Divisions I-III. There is some ambiguity in scientific evidence regarding the health risks related to SCT and extreme exertion leading some to question the necessity of the NCAA's universal screening policy. Experts have expressed concerns about the possibility of discrimination towards athletes who are SCT carriers. Despite the concerns about the social and behavioral consequences, most literature examines the NCAA's SCT screening policy from a clinical perspective-discounting the potential health inequities that may result. Objectives: 1) To explore college athlete and coaches perceptions about SCT and NCAA policies on SCT testing, and 2) To determine potential health inequities that could result from the NCAA's SCT screening policy. Methods: A mixed methods study was conducted utilizing the PRECEDE-PROCEED planning model and the Health Belief Model and Critical Race Theories. Phase I included a survey of 259 student athletes. Phase II involved three focus groups and several in-depth interviews conducted with 18 athletes and four coaches at the same University. Results: When surveyed, most athletes (72.2%; n=187) believed that NCAA mandated SCT testing was “Very Good/Good”. However, qualitative analysis revealed that the NCAA policy has potential to produce health inequities for SCT carriers. Conclusion: The context of organized sport creates unique challenges for health education and promotion including ensuring informed decision making regarding SCT screening among athletes and making key stakeholders aware of unintended health disparities that may result from this policy.