Perspectives and Practices of Athletic Trainers and Team Physicians Implementing the 2010 NCAA Sickle Cell Trait Screening Policy


Sickle cell trait (SCT) is usually benign. However, there are some conditions that may lead to SCT-related problems and put athletes with the trait at particular risk. In 2010 the National Collegiate Athletic Association (NCAA) issued a policy that required all Division I (DI) student-athletes to confirm their SCT status or sign a liability waiver to opt out of testing. Athletic trainers and team physicians play key roles in the policy implementation and we examined their perceptions and practices. Between December 2013 and March 2014 we interviewed 13 head athletic trainers and team physicians at NCAA Division I colleges and universities in North Carolina. We used an interview guide with open-ended questions covering knowledge of SCT, historical screening and education practices, current implementation, and policy benefits and challenges. Participants were knowledgeable about SCT and thought the policy was beneficial in providing SCT health information to and for student-athletes. Schools varied in provision of genetic counseling, offering the waiver, SCT tests administered, and other aspects. Challenges included: insufficient guidance from the NCAA; financial considerations; and misunderstanding of the relationships of race and ancestry to SCT risk. Athletic staff found the policy valuable, but felt it needs clarity and standardization.

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The authors are grateful to the athletic trainers and team physicians who took the time to participate in the study. We also appreciate the intellectual contributions of Doriane Coleman at Duke Law School, and Althea Grant at the Centers for Disease Control and Prevention, in the early phase of the project. This research was supported, in part, by a grant from the National Collegiate Athletic Association (NCAA), Indianapolis, Indiana. The NCAA is only a funding partner; not a driver of our research project or outcomes.

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Correspondence to Charmaine DM Royal.

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Author McDonald, Author Creary, Author Powell, Author Daley, Author Baker, and Author Royal declare that they have no conflicts of interest.

Human Studies and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained orally from all participants in the study.

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No animal studies were carried out by the authors for this article.

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McDonald, M.A., Creary, M.S., Powell, J. et al. Perspectives and Practices of Athletic Trainers and Team Physicians Implementing the 2010 NCAA Sickle Cell Trait Screening Policy. J Genet Counsel 26, 1292–1300 (2017).

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  • Sickle cell trait
  • Genetic screening
  • Race
  • Policy implementation
  • Genetic counseling
  • Sports medicine