Individuals with Sickle Cell Trait have died suddenly after extreme exertion during military training, athletic practice or games (Kerle & Nishimura, 1996; Harrelson, Fincher & Robinson, 1995; Howe & Bowden, 2007). One of those deaths, Dale Lloyd, a football player at Rice University, prompted a change in the National Collegiate Athletic Association's (NCAA) Sports Medicine Handbook Guideline 3c: The Student Athlete with Sickle Cell Trait. Effective August 2010, the NCAA Division I Proposal No. 2009-75-B mandated sickle cell trait testing in all Division I athletes unless documented results of a prior test are provided to the institution or the student-athlete declines the test and signs a written release. It is well-documented that in the United States, Sickle Cell Disease/Sickle Cell Trait primarily affects African Americans more than any other race or ethnicity (NIH, 2008). Sickle cell screening programs have been scrutinized since the 1970s (Pemberton & Wailoo, 2006) because of insensitivity to race. The recent change in NCAA Guideline 3c has been scrutinized partially for the same reason. The purpose of this mixed methods study was threefold. It was necessary to 1) determine perceptions of SCT and NCAA mandated SCT testing from college coaches and athletes' points of view; 2) determine the necessary components of the Sickle Cell Orientation and Education (S.C.OR.E) intervention that will be developed to educate intercollegiate athletes, as well as their coaches, about sickle cell trait from pre-participation screening to sickle cell trait diagnosis, and 3) to highlight the potential implications of an NCAA policy that mandates SCT testing. The PRECEDE-PROCEED (PRE-PRO) model of program planning was utilized to determine the necessary components of the intervention (Green & Kreuter, 1999). Constructs of the Health Belief Model (HBM) and Critical Race Theory (CRT) were utilized as the theoretical framework for this study. It was found that knowledge, perceived importance of an athlete knowing his/her SCT status, perception of NCAA 3c resulting in unfair treatment of athletes, perception of receiving less playing time, and perception of risk of having SCT were all associated with athletes' outlooks on SCT and NCAA SCT testing. Overall, athletes and coaches did not perceive that athletes with SCT would be discriminated against. Individual, organizational, and policy recommendations were made to address this issue.
","abstract_html":"<p>Individuals with Sickle Cell Trait have died suddenly after extreme exertion during military training, athletic practice or games (Kerle & Nishimura, 1996; Harrelson, Fincher & Robinson, 1995; Howe & Bowden, 2007). One of those deaths, Dale Lloyd, a football player at Rice University, prompted a change in the National Collegiate Athletic Association's (NCAA) Sports Medicine Handbook Guideline 3c: The Student Athlete with Sickle Cell Trait. Effective August 2010, the NCAA Division I Proposal No. 2009-75-B mandated sickle cell trait testing in all Division I athletes unless documented results of a prior test are provided to the institution or the student-athlete declines the test and signs a written release. It is well-documented that in the United States, Sickle Cell Disease/Sickle Cell Trait primarily affects African Americans more than any other race or ethnicity (NIH, 2008). Sickle cell screening programs have been scrutinized since the 1970s (Pemberton & Wailoo, 2006) because of insensitivity to race. The recent change in NCAA Guideline 3c has been scrutinized partially for the same reason. The purpose of this mixed methods study was threefold. It was necessary to 1) determine perceptions of SCT and NCAA mandated SCT testing from college coaches and athletes' points of view; 2) determine the necessary components of the Sickle Cell Orientation and Education (S.C.OR.E) intervention that will be developed to educate intercollegiate athletes, as well as their coaches, about sickle cell trait from pre-participation screening to sickle cell trait diagnosis, and 3) to highlight the potential implications of an NCAA policy that mandates SCT testing. The PRECEDE-PROCEED (PRE-PRO) model of program planning was utilized to determine the necessary components of the intervention (Green & Kreuter, 1999). Constructs of the Health Belief Model (HBM) and Critical Race Theory (CRT) were utilized as the theoretical framework for this study. It was found that knowledge, perceived importance of an athlete knowing his/her SCT status, perception of NCAA 3c resulting in unfair treatment of athletes, perception of receiving less playing time, and perception of risk of having SCT were all associated with athletes' outlooks on SCT and NCAA SCT testing. Overall, athletes and coaches did not perceive that athletes with SCT would be discriminated against. Individual, organizational, and policy recommendations were made to address this issue.</p>","abstract_has_math":false,"creators":["Lawrence, Raymona Holloway"],"institution":null,"degree_name":"Doctor of Public Health (Dr.P.H.)","degree_level":"Dissertation (open access)","degree_discipline":"Jiann-Ping Hsu College of Public Health","degree_department":null,"school":null,"contributors":["Cassandra Arroyo","Alison Scott"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2010,"date_issued":"2010-01-01T08:00:00Z","date_published":"2010-01-01T08:00:00Z","updated_at":"2026-07-24T02:27:19Z","subjects":["ETD","Sickle cell anemia","Sickle cell trait","NCAA guidline 3c","Exertional rhabdomyolysis","Exercise","College","Athlete","Racism","Sports medicine","African American athletes","Racism in sports","Discrimination in sports","Community Health","Community Health and Preventive Medicine","Public Health","Public Health Education and Promotion"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digitalcommons.georgiasouthern.edu/etd/636","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Cassandra Arroyo","Alison Scott"]},{"key":"dc:creator","label":"Author","values":["Lawrence, Raymona Holloway"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2013-10-17T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Jiann-Ping Hsu College of Public Health"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation (open access)"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Public Health (Dr.P.H.)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["ETD","Sickle cell anemia","Sickle cell trait","NCAA guidline 3c","Exertional rhabdomyolysis","Exercise","College","Athlete","Racism","Sports medicine","African American athletes","Racism in sports","Discrimination in sports","Community Health","Community Health and Preventive Medicine","Public Health","Public Health Education and Promotion"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digitalcommons.georgiasouthern.edu/etd/636"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Individuals with Sickle Cell Trait have died suddenly after extreme exertion during military training, athletic practice or games (Kerle & Nishimura, 1996; Harrelson, Fincher & Robinson, 1995; Howe & Bowden, 2007). One of those deaths, Dale Lloyd, a football player at Rice University, prompted a change in the National Collegiate Athletic Association's (NCAA) Sports Medicine Handbook Guideline 3c: The Student Athlete with Sickle Cell Trait. Effective August 2010, the NCAA Division I Proposal No. 2009-75-B mandated sickle cell trait testing in all Division I athletes unless documented results of a prior test are provided to the institution or the student-athlete declines the test and signs a written release. It is well-documented that in the United States, Sickle Cell Disease/Sickle Cell Trait primarily affects African Americans more than any other race or ethnicity (NIH, 2008). Sickle cell screening programs have been scrutinized since the 1970s (Pemberton & Wailoo, 2006) because of insensitivity to race. The recent change in NCAA Guideline 3c has been scrutinized partially for the same reason. The purpose of this mixed methods study was threefold. It was necessary to 1) determine perceptions of SCT and NCAA mandated SCT testing from college coaches and athletes' points of view; 2) determine the necessary components of the Sickle Cell Orientation and Education (S.C.OR.E) intervention that will be developed to educate intercollegiate athletes, as well as their coaches, about sickle cell trait from pre-participation screening to sickle cell trait diagnosis, and 3) to highlight the potential implications of an NCAA policy that mandates SCT testing. The PRECEDE-PROCEED (PRE-PRO) model of program planning was utilized to determine the necessary components of the intervention (Green & Kreuter, 1999). Constructs of the Health Belief Model (HBM) and Critical Race Theory (CRT) were utilized as the theoretical framework for this study. It was found that knowledge, perceived importance of an athlete knowing his/her SCT status, perception of NCAA 3c resulting in unfair treatment of athletes, perception of receiving less playing time, and perception of risk of having SCT were all associated with athletes' outlooks on SCT and NCAA SCT testing. Overall, athletes and coaches did not perceive that athletes with SCT would be discriminated against. Individual, organizational, and policy recommendations were made to address this issue.
"]},{"key":"dc:title","label":"Title","values":["Athlete and Coach Knowledge, Attitudes, and Perceptions of Sickle Cell Trait and National Collegiate Athletic Association Mandated Testing: Recommendations for Intervention"]}]}],"canonical_facts":{"dc:contributor":["Cassandra Arroyo","Alison Scott"],"dc:creator":["Lawrence, Raymona Holloway"],"dc:date.available":["2013-10-17T07:00:00Z"],"dc:description.abstract":["Individuals with Sickle Cell Trait have died suddenly after extreme exertion during military training, athletic practice or games (Kerle & Nishimura, 1996; Harrelson, Fincher & Robinson, 1995; Howe & Bowden, 2007). One of those deaths, Dale Lloyd, a football player at Rice University, prompted a change in the National Collegiate Athletic Association's (NCAA) Sports Medicine Handbook Guideline 3c: The Student Athlete with Sickle Cell Trait. Effective August 2010, the NCAA Division I Proposal No. 2009-75-B mandated sickle cell trait testing in all Division I athletes unless documented results of a prior test are provided to the institution or the student-athlete declines the test and signs a written release. It is well-documented that in the United States, Sickle Cell Disease/Sickle Cell Trait primarily affects African Americans more than any other race or ethnicity (NIH, 2008). Sickle cell screening programs have been scrutinized since the 1970s (Pemberton & Wailoo, 2006) because of insensitivity to race. The recent change in NCAA Guideline 3c has been scrutinized partially for the same reason. The purpose of this mixed methods study was threefold. It was necessary to 1) determine perceptions of SCT and NCAA mandated SCT testing from college coaches and athletes' points of view; 2) determine the necessary components of the Sickle Cell Orientation and Education (S.C.OR.E) intervention that will be developed to educate intercollegiate athletes, as well as their coaches, about sickle cell trait from pre-participation screening to sickle cell trait diagnosis, and 3) to highlight the potential implications of an NCAA policy that mandates SCT testing. The PRECEDE-PROCEED (PRE-PRO) model of program planning was utilized to determine the necessary components of the intervention (Green & Kreuter, 1999). Constructs of the Health Belief Model (HBM) and Critical Race Theory (CRT) were utilized as the theoretical framework for this study. It was found that knowledge, perceived importance of an athlete knowing his/her SCT status, perception of NCAA 3c resulting in unfair treatment of athletes, perception of receiving less playing time, and perception of risk of having SCT were all associated with athletes' outlooks on SCT and NCAA SCT testing. Overall, athletes and coaches did not perceive that athletes with SCT would be discriminated against. Individual, organizational, and policy recommendations were made to address this issue.
"],"dc:identifier":["https://digitalcommons.georgiasouthern.edu/etd/636"],"dc:subject":["ETD","Sickle cell anemia","Sickle cell trait","NCAA guidline 3c","Exertional rhabdomyolysis","Exercise","College","Athlete","Racism","Sports medicine","African American athletes","Racism in sports","Discrimination in sports","Community Health","Community Health and Preventive Medicine","Public Health","Public Health Education and Promotion"],"dc:title":["Athlete and Coach Knowledge, Attitudes, and Perceptions of Sickle Cell Trait and National Collegiate Athletic Association Mandated Testing: Recommendations for Intervention"],"thesis:degree_discipline":["Jiann-Ping Hsu College of Public Health"],"thesis:degree_level":["Dissertation (open access)"],"thesis:degree_name":["Doctor of Public Health (Dr.P.H.)"]},"updated_at":"2026-07-24T02:27:19Z"}