Attitudes and Beliefs of Sports Medicine Providers to Sickle Cell Trait Screening of Student Athletes

Objective: To describe the attitudes of members of the American Medical Society for Sports Medicine (AMSSM) toward the new National Collegiate Athletic Association (NCAA) policy to require all Division 1 student athletes be screened for sickle cell trait (SCT), have prior evidence of testing, or sign a waiver. Design: Cross-sectional survey of members of the AMSSM electronic mailing list was conducted. Descriptive, McNemar, and chi(2) statistics were performed. Setting: Internet survey. Participants: Of the 1765 AMSSM e-mail list members, 370 returned partial or completed surveys. Main Outcome Measures: Dependent variables included familiarity with the NCAA policy, support of universal or targeted screening programs, preferences regarding screening methodologies, and athletic restrictions or modifications for student athletes identified with SCT. Respondents' gender, race/ethnicity, and involvement as an NCAA team physician were independent variables. Results: Of the respondents, 76% were men, 85% were whites, and 53% served as NCAA Division 1 team physicians. Ninety percent were aware of the policy. There was greater support for targeted (76%, 267 of 353) compared with universal (39%, 137 of 353; P < 0.01) screening, with targeting based on race/ethnicity and sport. Respondents supported targeted screening of varsity and freshman athletes in all NCAA divisions, but most (88%) also supported waivers. Respondents favored using existing medical records (73%) or Sickledex screening (71%) methodologies despite concerns about inaccuracies (16% for each methodology). Most respondents agreed that there is discrimination in athletic participation and obtaining insurance. Conclusions: There is lack of consensus within the AMSSM regarding the current NCAA SCT screening policy. Implementation must take into consideration potential discrimination.