Mental health research exists for student-athletes in the areas of depression, anxiety, and self-esteem prevalence. However, updated prevalence rates and assessment of risks across sports, academic status, and genders are needed. Filling the gaps in research assists in the creation of patient-centered mental health screening and interventions designed for student-athletes. Therefore, the purpose is to examine the prevalence of depression, anxiety, and self-esteem in collegiate student-athletes and differences between sex, academic status, and sport type, and identify associations for risks. Using a cross-sectional design, collegiate student-athletes were surveyed to assess for risks of depression, anxiety, and self-esteem. With the use of SPSS, Chi-square analyses and multinomial logistic regressions were used. Student-athletes (22.3%) were at risk for depression, anxiety (12.5%), and low self-esteem (8%). No significant differences were found for sex, academic status, and sport type for depression or self-esteem; however, significant differences occurred for state and trait anxiety by sex. A significant association for depression and anxiety risk was found with females at risk. Depression and anxiety are present within student-athletes, regardless of sport type. Females are at a higher risk; however, all student-athletes would benefit from the creation of validated, patient-centered mental health screenings and psychotherapeutic interventions.

Telemedicine is the delivery of medical care from a distance using technology. The integration of telemedicine as a supplement to musculoskeletal-based patient encounters may be feasible in sports medicine. To investigate health care professionals' perceptions of and experiences with telemedicine. Cross-sectional explanatory sequential mixed-methods study. A purposeful sample of 17 athletic trainers from a National Collegiate Athletic Association Division 1 institution and 5 orthopaedic physicians from a sports medicine clinic located 92 miles from the campus. Participants were trained on the telemedicine platform and used it over 5 months for initial, follow-up, and discharge patient encounters. Participants completed a preintervention survey containing the Theory of Planned Behavior and Technology Acceptance Model tool. Responses were analyzed using descriptive statistics and an independent-samples t test. After the intervention period, participants completed individual semistructured interviews that we coded using the consensual qualitative research tradition. From the interviews, the clinicians were characterized as telemedicine adopters (n = 14) or nonadopters (n = 8). The adopters reported higher levels of agreement on the Theory of Planned Behavior and Technology Acceptance Model tool as compared with nonadopters for all constructs. When comparing adoption status, we identified a difference (P < .01), with nonadopters reporting a low level of agreement for the subjective norm construct. The interviews revealed 5 domains: integration challenges, integration opportunities, collaborative practice, anticipatory socialization to future use, and benefits of integration. The participants indicated that integration challenges centered on “buy in,” whereas opportunities aligned with the patient's condition and technology ease of use. They reflected that the telemedicine encounters required more preparation and yet allowed for cooperative behaviors between clinicians. The benefits of telemedicine included convenience and scheduling preferences that encouraged future use. The integration of telemedicine in sports medicine brought about both challenges and opportunities for collaboration among athletic trainers and physicians that were heavily predetermined by the social pressures of colleagues.

In December 2019, severe acute respiratory syndrome coronavirus 2, also known as the novel coronavirus disease 2019 (COVID-19), became a global public health crisis. Government officials in the United States subsequently responded by issuing lockdown orders that closed schools, terminated sports, and resulted in many people transitioning to working from home, immediately affecting the ability of athletic trainers (ATs) to practice clinically. To describe the job status, job duties, telemedicine use, and resiliency of ATs during the COVID-19 pandemic. Cross-sectional study. Mixed-methods survey. A total of 611 ATs (age = 32 ± 13 years). The survey consisted of 6 demographic questions, a job status assessment (3 questions, 1 open-ended prompt), a telemedicine use assessment (5 questions, 2 open-ended prompts), and the 6-item Brief Resilience Scale. Qualitative analyses were completed using Text iQ technology and descriptive statistics, and cross-tabulations were conducted using follow-up χ² comparisons of resiliency with job setting and telemedicine use. Most ATs continued to work in some capacity throughout the COVID-19 pandemic and expressed optimism about the likelihood that their job status and setting would return. However, participants shared financial and mental health concerns because of reduced pay, stress, and uncertainty about the future. We also identified versatility within the profession, as ATs were serving in new roles related to COVID-19 or adopting telemedicine (n = 251, 41.1%). Athletic trainers were implementing all domains of clinical practice using telemedicine, yet most did not consult legal counsel on or have formal training in the delivery method before implementation. Finally, most ATs exhibited normal resilience that was not affected by job setting (χ² = 26.901, P = .68) or the use of virtual health care (χ² = 2.597, P = .27). The COVID-19 pandemic has affected ATs' jobs, and in many cases, the ATs have demonstrated adaptability and value in assuming various roles in the larger health care system.

Context: Collegiate student-athletes (SAs) experience psychological stressors due to rigid schedules, team conflict, and injury. These factors can result in symptoms of mental health conditions, decreased daily functioning, and suicidality. Objective: To explore National Collegiate Athletic Association Division I SAs’ experiences with mental health and access to and experiences with mental health resources at their university. Design: Consensual qualitative research study. Setting: One-on-one interviews. Patients or Other Participants: Twenty-three Division I SAs (18 women, 5 men; mean age = 20 ± 2 years). Main Outcome Measure(s): Participants completed a semistructured interview that focused on their experiences with mental health. The interviews were audio recorded and transcribed verbatim via Zoom. Credibility and trustworthiness were established via member checking, triangulation, and peer discussion among a 3-person coding team. Results: Two domains, increased expectations and resources and management, were identified. The participants shared how they balanced life as a college student, academic stressors, performance expectations, and a sport-first mindset they perceived from coaches and support staff. They discussed their experience with the internal support network of coaches, the athletic department, and sport psychology. Participants remarked on their external support network, which included their family, friends, and psychological services. The resources available at their institutions and their accessibility were perceived both positively and negatively. Some collegiate SAs described resources as helpful, whereas others portrayed a lack of timeliness for appointments, lack of advertisement, incomprehension by counselors of athlete demands, and no sport-specific counseling as barriers. Conclusions: Collegiate SAs expressed mental health concerns due to stress and the demands of sport participation. Self-regulated coping strategies and support networks continue to be powerful and helpful resources for mental health, with or without a diagnosed condition. Barriers to mental health service use were a lack of sport specificity and lack of access. Institutions need to focus on creating athlete-centered mental health resources with annual advertisements to increase use.

Injury risk is multifactorial including non-modifiable and modifiable factors such as nutrition and mental health. The purpose of this study was to estimate eating disorder risk and body image (BI) dissatisfaction among Reserve Officers Training Corps (ROTC) cadets. A total of 102 (male: n = 75, female: n = 27; age: 20 ± 2 years) ROTC cadets self-reported height, current and ideal weight, and completed the Eating Attitudes Test-26 (EAT-26) and self-perceived BI current and perceived sex-specific figural stimuli. The overall eating disorder risk for ROTC cadets was 32.4%. No significant differences were found when comparing sex, ethnicity, or military branch. Overall risk of pathogenic behaviors included 11.8% who reported binge eating; 8.8% who used laxatives, diuretics, or diet pills; 8.8% who exercised for >60 min to control their weight; and 8.8% who lost 9.1 kg or more within the last 6 months. We identified significant interactions (p ≤ 0.01) between sex of the solider, overall perceptions of male and female soldiers, and BI self-perceptions. The ROTC cadets in this study displayed eating disorder risk and BI dissatisfaction, which is concerning for tactical readiness, long-term behavioral health issues, and injury from pathogenic behaviors. Education and quality healthcare are necessary to mitigate the increased risk of eating and BI dissatisfaction within this population.

Telemedicine is the practice of providing diagnostic consultations and therapeutic interventions to patients at a distance using some form of technology. Typically, health care students do not have the opportunity to practice telemedicine. To investigate athletic training students' ability to transfer telemedicine skills confidently and accurately in a standardized patient (SP) encounter. Single cohort. Simulation center. Fifty-five second-year athletic training students (age = 25 ± 3 years) from 6 professional master's athletic training programs volunteered for the study after a 1-week online learning experience about telemedicine. We scheduled individual SP encounters that were completed at a distance using telepresence robots. Pre– and post–SP encounter validated confidence assessment and a 50-item content checklist (yes or no) scored by one evaluator. During the SP encounter, 87.3% of participants correctly diagnosed the SP actor with a lateral ankle sprain. We identified a significant improvement in confidence (P ≤ .001) for using telemedicine technology. On the content checklist, participants scored poorly in the constructs of data gathering (mean = 7.44 ± 2.36 of 15, 49.58% ± 15.75%) and telemedicine (mean = 6.02 ± 2.74 of 14, 42.99% ± 19.56%), but scored well in the constructs of communication/interpersonal skills (mean = 12.05 ± 2.00 of 15, 80.36% ± 13.36%) and patient education (mean = 4.64 ± 1.06 of 6, 77.27% ± 17.67%). The mean sum score of all constructs on the SP encounter was moderate (30.15 ± 5.79 of 50, 60.29% ± 11.59%). Exposure to telemedicine via an SP encounter improved confidence in performing the tech-based evaluation. Athletic training students performed well in demonstrating communication/interpersonal skills and patient education, yet struggled in their data gathering and telemedicine skills. Overall, participants accurately diagnosed a musculoskeletal condition using telemedicine.