Implementation of the National Collegiate Athletic Association (NCAA) Sickle Cell Trait Screening Policy: Methods and Staff and Athlete Perspectives

Introduction: This paper describes methods for a national study evaluating the implementation of the National Collegiate Athletic Association’s (NCAA) policy on sickle cell trait (SCT) screening of athletes and describes attitudes toward the screening. Methods: In Fall 2020, 343 Division I schools, 302 Division II schools, and 426 Division III schools were invited to participate in this national survey. Results: Across 123 participating schools, a total of 168 sport medicine administrators (121 head athletic trainers and 47 team physicians), 268 athletic staff (128 staff athletic trainers and 140 coaches), and 1424 athletes from basketball, football, soccer, lacrosse, track and field completed the survey. While the vast majority of respondents agreed/strongly agreed with the screening policy, there was varying support for how the policy was implemented including: prioritizing SCT screening versus screening for other conditions (40-50% agreed/strongly agreed), focusing on sports with higher risk of overexertion versus universal screening (50-75% agreed/strongly agreed), and focusing on racial and ethnic groups where SCT is more prevalent (25-40% agreed/strongly agreed). Perspectives varied by NCAA division and race. Higher SCT knowledge scores were associated with believing that screening all athletes for SCT is important. Conclusions: Discussion of these findings provides important context for assessing how genetic screening requirements are implemented within collegiate athletics and more broadly.