Representation of Skin Color and Gender in Athletic Training Textbooks: An Image Analysis

This is the authors' abstract. We don't add key points for this paper.

Context A commitment to diversity, equity, and inclusion has been made in the profession of athletic training to combat disparities within the profession and the patients being treated. Objective To explore diversity, equity, and inclusion in athletic training publications to better understand skin color and gender representation. Design Quantitative, observational study. Setting Thirteen randomly selected athletic training textbooks were photographically analyzed. Patients or Other Participants Photos in commonly used athletic training textbooks were reviewed for skin color (White, non-White), gender (man, woman), and role (patient, clinician). Each text had 2 independent reviewers. A third reviewer was included in cases of nonagreement. Main Outcome Measures Descriptive statistics, using frequency counts and percentages, were calculated for the number of photos, gender, skin color, and depicted role. Results A total of 4351 photos from 13 different athletic training textbooks were included for analysis. For gender, 42% ( n = 1847) of photos were identified as men, 36% ( n = 1568) were women, and 22% ( n = 936) were not able to be recognized as either a man or woman. Skin color revealed a significant disparity in representation with 92% ( n = 4000) of the photos identified as White, 7% ( n = 312) as non-White, and 1% ( n = 39) unknown. Further analysis of images (4265 images included for this analysis) representing roles (clinicians or patients) revealed 2879 patients, 1328 clinicians, and 58 unknown. Of these images, there were more men (44.7%, n = 1289) than women (34.9%, n = 1006) patient images; however, there were more women (37.5%, n = 498) than men clinicians (36.3%, n = 483). White patients and White clinicians comprised 94% ( n = 2692) and 86% ( n = 1180) of the photos, respectively. Conclusions The need to promote diversity and inclusivity in educational materials is evident. Because athletic training textbooks overly represent lighter skin color and men, educators need to address these disparities.