Implementation and Implications of Sickle Cell Trait Screening in the NCAA

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ABSTRACT In 2010 the National Collegiate Athletic Association (NCAA) adopted a mandatory sickle cell trait (SCT) screening policy for student-athletes in its Division I (DI) colleges and universities. Currently, schools in all three divisions of the NCAA are implementing the policy. To date, very little published research is available on SCT in student-athletes or on the actual implementation of the NCAA screening policy. Many important questions remain regarding this controversial mandated genetic screening program. Therefore, it is necessary to better understand the policy's challenges, limitations, and risks, and to develop strategies to address them. Our funded grant (R01HG010364-01A1) has two aims: 1) assess implementation, risks, and secondary benefits of the NCAA SCT screening policy and determine contributors and implications of variation within these domains using a mixed methods approach and 2) provide guidance on the current NCAA SCT policy and practice and other similar public health policies and practices. Currently, we have completed data collection and are working on data analysis to address Aim 1. To better interpret the results and develop strategies to address the challenges in the policy, we will convene a national summit involving selected researchers, practitioners, and decision-makers at institutional and policy levels. Summit participants will review the findings from Aim 1, examine existing SCT management guidelines from the NCAA and NATA, collaboratively develop recommendations for modifications to current procedures as needed, and identify and disseminate best practices for future implementation of the NCAA SCT policy. Grounding of our research in the policy implementation literature will also allow us to consider how our findings can inform other population-based genetic screening efforts. This supplement will facilitate the planning and execution of the national summit (Aim 2) and advance the interpretation, application, translation, and dissemination of the results from Aim 1. Specifically, the summit will provide a unique opportunity to share unprecedented information about the procedures, perceptions, and outcomes of the NCAA policy with a diverse group of experts. It will also enable critical examination of real and perceived benefits, risks, and effectiveness of the NCAA policy and other public health genetics policies, and expedite efforts to address areas of concern. Overall, the project will establish a useful empirical foundation for decision-making concerning future implementation of the NCAA policy and similar policies and programs aimed at preventing illness and protecting the public's health.