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*—

THE ASSESSMENT OF FIRST AID AND INJURY PREVENTION KNOWLEDGE
AND THE DECISION MAKING OF YOUTH BASKETBALL, SOCCER, AND
FOOTBALL COACHES
By

Mary J. Barron

A THESIS

Submitted to
Michigan State University
In partial fulfillment of the requirements
For the degree of

MASTERS OF SCIENCE
Department of Kinesiology

2004

ABSTRACT
THE ASSESSMENT OF FIRST AID AND INHJRY PREVENTION KNOWLEDGE
AND THE DECISION MAKING OF YOUTH BASKETBALL, SOCCER, AND
FOOTBALL COACHES
By
Mary J. Barron
The purpose of this study was to measure the first aid and injury prevention

knowledge of youth basketball, soccer, and football coaches and to assess the decision
making ability of these youth coaches in determining the playing status of an injured

athlete.

Fifteen coaches (5.17%) out of 290 coaches earned a passing score on the First
Aid Assessment (FAA). Such a percentage is appalling. Of the 170 coaches that
completed the demographic sheet 21 (12.4%) coaches reported being current first aid
certified. Of those 21 coaches only five passed the FAA. This indicates that being
currently first aid certified does not significantly increase their first aid knowledge.
Apparently the information that is gained during first aid training is not being retained.
Coach’s decisions to return an injured athlete to competition are dependent upon the
game situation and the player involved (starter, backup, or bench player). Youth coaches
are making medical decisions without the medical knowledge needed to make such

decisions. 7

The information gained from this study needs to be transferred over into an injury
prevention and care program for youth coaches. Once a program is developed, that
program needs to be administered and evaluated for its effectiveness in the prevention

and care ofinjuries.

 

Copyright by
Mary J. Barron
2004

 

w -v

 

 

 

 

 

 

5%-

 

ACKNOWLEDGEMENTS

I would like to express my sincere gratitude to a number of individuals who
helped me to complete my Masters education.

First I would like to thank my committee who has encouraged and supported me
through my Masters degree. To John Powell who has provided me much insight into the
research process and the field of athletic training. I would also like to especially thank
Marty Ewing, who has probably read this thesis just as many times as I have. Marty
stepped in and aided me when I was stuck and unable to move.

To my friends (especially Heidi, Peggy, and Jen), who have been there through it
all. They have pushed me when I needed to be pushed, were an ear when I needed to
vent, and kept on me to complete my degree.

Lastlyl would like to thank my family. Even though we do not always see eye to
eye, they are always there to support me. Their enduring support and never ending love

has helped me accomplish this and my many other goals in life.

iv

 

 

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TABLE OF CONTENTS

LIST OF TABLES ............................................. ix
CHAPTER I
INTRODUCTION. ............................................. 1
Overview of the Problem. ........................................ 1
Need for the Study. ............................................ 3
Statement of the Problem ......................................... 3
Research Questions ............................................. 3
Overview of the Research Methods. ................................. 5
Limitations .................................................. 5
Assumptions. ................................................ 6
CHAPTER 11
REVIEW OF LITERATURE. ...................................... 7
Participation in Youth Sports ................................... 7
Statistics of Youth Sport Involvement ....................... 7
Benefits and Risks of Participation in Youth ................... 8
Youth Sports Injuries ........................................ 9
Types of Injuries in Youth Sports .......................... 9
Incidence of Injury in Youth Sports. ...................... 11
Injury Rate and Age .................................. 12
Severity of Injuries at the Youth Sports Level ................. 13
Factors that are Related and Cause Injury to Youth Athletes. ...... 15
Safety Equipment in Youth Sports ........................ 17
Coaching Education ....................................... 18
Prevention Programs ...................................... 18
Emergency First Aid Care ................................... 22
First Aid Knowledge of High School Coaches. ..................... 22
Decision Making of High School Coaches ........................ 23
Summary ............................................... 24
CHAPTER III
METHODS .................................................. 25
Research Design .......................................... 25
Participations ............................................ 25
Instrumentation ........................................... 29
Demographic Information Sheet ........................... 29
First Aid Assessment Test ........................ 29
Game Situation Data Sheet .............................. 29
Data Collection Procedures .................................. 3O

CHAPTER IV

RESULTS .................................................. 32
First Aid Assessment ...................................... 32
First Aid Constructs by Sport Coached ...................... 35
First Aid Constructs by Gender of Coaches ................... 37
First Aid Constructs by Age of Coaches ..................... 37
First Aid Constructs by Years of Coaching Experience ........... 40
First Aid Constructs by the Number of Sports Coached ........... 43
First Aid Constructs by the Educational Background of Coaches ..... 45
First Aid Constructs by Gender of Athletes Coached ............. 52
First Aid Constructs by Formal First Aid Training .............. 55
First Aid Constructs by American Red Cross First Aid Training ..... 56
First Aid Constructs by CPR Training ...................... 58
First Aid Constructs by Current First Aid Certification ........... 61
First Aid Constructs by Current CPR Certification .............. 62
Game Situation Data Sheet ................................. 64
Game Situation Data Sheet by First Aid Assessment Pass/F ail ...... 65
Game Situation Data Sheet by Sport Coached ................. 68
Game Situation Data Sheet by Gender ...................... 71
Game Situation Data Sheet by Age ........................ 75
Game Situation Data Sheet by Years of Coaching .............. 78
Game Situation Data Sheet by Number of Sports Coached ......... 81
Game Situation Data Sheet by Educational Background .......... 82
Game Situation Data Sheet by Gender of Athletes .............. 84
Game Situation Data Sheet by Formal First Aid Training .......... 85
Game Situation Data Sheet by American Red Cross First Aid Training 86
Game Situation Data Sheet by CPR Training .................. 88
Game Situation Data Sheet by Current First Aid Certification ....... 90
Game Situation Data Sheet by Current CPR Certification ......... 92
CHAPTER V
DISCUSSION ................................................ 94
First Aid Assessment ...................................... 95
Game Situation Data Sheet .................................. 106
Points of Interest ......................................... 113
First Aid Assessment .................................. 113
Game Situation Data Sheet .............................. 115
Implications ............................................ 1 19
APPENDICES
APPENDIX A
First Aid Assessment .................................. 123
APPENDIX B
Game Situation Data Sheet .............................. 131
APPENDIX C
Demographic Sheet ................................... 134

vi

APPENDIX D

Informed Consent F orm ................................ 136
APPENDIX E

Post hoc Sheffe test for Injury ID/General Medical Knowledge

Construct and Educational Background ...................... 138
APPENDIX F

Post hoc Sheffe test for Injury Management Construct and

Educational Background ................................ 149
APPENDIX G

Chi-Square Analysis of Game Situation Data Sheet by Pass/F ail

First Aid Assessment .................................. 160
APPENDIX H

Chi-Square Analysis of Game Situation Data Sheet by Sport

Coached. ......................................... 165
APPENDIX 1

Chi-Square Analysis of Game Situation Data Sheet by Gender ....... 170
APPENDIX J

Chi-Square Analysis of Game Situation Data Sheet by Age ......... 175
APPENDIX K

Chi-Square Analysis of Game Situation Data Sheet by Years

of Coaching ........................................ 184
APPENDIX L

Chi-Square Analysis of Game Situation Data Sheet by Number

of Sports Coached .................................... 193
APPENDIX M

Chi-Square Analysis of Game Situation Data Sheet by Educational

Background........................................203
APPENDIX N

Chi-Square Analysis of Game Situation Data Sheet by Gender

of Athletes ......................................... 2 13
APPENDIX 0

Chi-Square Analysis of Game Situation Data Sheet by Formal

FirstAidTraining....................................223
APPENDIX P

Chi-Square Analysis of Game Situation Data Sheet by American

Red Cross First Aid Training ............................. 229
APPENDIX Q

Chi-Square Analysis of Game Situation Data Sheet by CPR Training. .235
APPENDIX R

Chi-Square Analysis of Game Situation Data Sheet by Current

First Aid Certification. ................................ 240
APPENDIX S

Chi-Square Analysis of Game Situation Data Sheet by Current CPR

Certification........................................245

REFERENCES ................................................ 351

vii

LIST OF TABLES

T able 1
Educational Background of Coaches by Sport Coached ................ 27
Table 2
Numbers and Percentage of First Aid Training ...................... 28
Table 3
First Aid Assessment Score by Sport Coached. ..................... 33
Table 4
Type of Training for Coaches that Passed the FAA. .................. 33
Table 5
Means and Standard Deviation for the Five Constructs ................ 34
Table 6
Means and Standard Deviations of Five Constructs by Sport Coached ....... 36
Table 7
Post hoc Sheffe test for Injury identification/General Medical Knowledge and
Sport Coached. .......................................... 36
Table 8
Means and Standard Deviations of Five Constructs by Gender ............ 37
Table 9
Distribution of Coaches Based Upon Five Age Groups ................. 38
Table 10
Means and Standard Deviations of Five Constructs by Age .............. 39
Table 11
Post hoc Sheffe test for the CPR and Age. ........................ 40
Table 12
Distribution of Coaches Based Upon Four Coaching Experience. ......... 42
Table 13

Means and Standard Deviations of Five Constructs by Coaching Experience. . 42

viii

Table 14

Post hoc Scheffe test for Injury Prevention Construct and Years of Coaching
Experience .............................................. 43

Table 15
Distribution of Coaches Based Upon Number of Sports Coached .......... 44

Table 16

Means and Standard Deviations of Five Constructs by Number of Sports
Coached. .............................................. 45

Table 17

Means and Standard Deviations of Five Constructs by Educational
Background ............................................. 47

Table 18
Means and Standard Deviations of Five Constructs by Educational ‘
Background Groups ........................................ 49

Table 19

Post hoc Scheffe test for Injury Identification/General Medical Knowledge
Construct and Four Educational Background Groups .................. 50

Table 20

Post hoc Scheffe test for Injury Management Construct and Four Educational
Background Groups ........................................ 51

Table 21
Distribution of Coaches by Gender of Athletes Coached ................ 53

Table 22
Distribution of Gender of Athletes by Gender of Coaches ............... 53

Table 23

Means and Standard Deviations of Five Constructs by Gender of Athletes
Coached ............................................... 54

Table 24

Post hoc Sheffe test for Injury identification/ General Medical Knowledge
Construct and Gender of Athletes Coached. ....................... 55

Table 25

Means and Standard Deviations of Five Constructs by Fonnal First Aid
Training. .............................................. 56

Table 26
Means and Standard Deviations of Five Constructs by American Red Cross First

Aid Training. ........................................... 58
Table 27
Distribution of First Aid Training by CPR Training ................... 60
Table 28
Means and Standard Deviations of Five Constructs by CPR Training. ...... 60
Table 29
Means and Standard Deviations of Five Constructs by Current First Aid
Certification ............................................. 62
Table 30
Means and Standard Deviations of Five Constructs by Current CPR
Certification ............................................. 63
Table 31
Frequency of Responses to Game Situation Data Sheet ................. 65
Table 32
Pearson Chi-Square for Game Situation Data Sheet by Pass/F ail First Aid
Assessment. ............................................ 67
Table 33
Starter in 3 Clearly Winning Competition Situation by Pass/Fail of First Aid
Assessment. ............................................ 68
Table 34
Pearson Chi-Square for Game Situation Data Sheet by Sport ............. 70
Table 35
Bench Player in a Clearly Losing Situation. ....................... 71
Table 36
Pearson Chi-Square for Game Situation Data Sheet by Gender ............ 73
Table 37
Starter in a Clearly Winning Competition Situation by Gender ............ 74
Table 38
Starter in a Game that the Team is Down by 5 Points by Gender. ......... 75
Table 39
Pearson Chi-Square for Game Situation Data Sheet by Age .............. 77

 

T able 40
Bench Player in a Clearly Losing Situation by Age. .................. 78

Table 41
Pearson Chi-Square for Game Situation Data Sheet by Years of Coaching. . . . 80

Table 42
Starter in a Game that the Team is Down by 5 Points .................. 81

Table 43
Pearson Chi—Square for Game Situation Data Sheet by Number of Sports
Coached. ............... . ............................... 82

Table 44
Pearson Chi-Square for Game Situation Data Sheet by Educational
Background ............................................. 83

Table 45
Pearson Chi-Square for Game Situation Data Sheet by Gender of Athletes. . . . 85

Table 46
Pearson Chi-Square for Game Situation Data Sheet by Formal First Aid
Training. .............................................. 86

Table 47
Pearson Chi-Square for Game Situation Data Sheet by American Red Cross
First Aid Training ......................................... 87

Table 48
Pearson Chi-Square for Game Situation Data Sheet by CPR Training ....... 89

Table 49
Backup Player in a Close Winning Situation by CPR Training ............ 90

Table 50

Pearson Chi-Square for Game Situation Data Sheet by Current First Aid
Certification ............................................. 91

Table 51

First off the Bench in a Clearly Losing Competition Situation by Current
First Aid Certification. ..................................... 92

Table 52

Pearson Chi-Square for Game Situation Data Sheet by Current CPR
Certification ............................................. 93

xi

 

CHAPTER I
Introduction
Overview of the Problem

Participation in organized sports is important in the lives of many children and

adolescents. The level of participation in youth sports is astonishing. According to
Malina, Bouchard, and Bar-Or (2004) in the mid 19905 and early 20005 there were
approximately 46 million youth involved in some form of sports.

With such a large participation level, it is no wonder that there is a high frequency
of sports related injuries among children. According to O’Conner (1998), 40% of the
injuries that children experienced in 1988 were sports related. The National Youth Sports
Foundation stated the young girls who participate in sports have an estimated injury rate
of 20 to 22 per 100 participants per season (as stated in Ostrum, 1993) Boys, on the other
hand have a higher rate of injury while participating in youth sports at 39 per 100
participants per season (as stated in Ostrum, 1993).

A study by Chambers (1979) examined the “Orthopedic injuries in athletes (ages
6 to 17).” Eight hundred children participated in the study that was conducted at a US
military post. The total number of hours that the young athlete was under the supervision
Of a coach varied between sports. Football practiced an average of 14.5 hours/week for
12 weeks, making the total number of hours that the athletes were under a coach’s
SuDervision 174 hours. Using the same format the total amount of time that an athlete
Was under the supervision ofa coach for other sports are as follows: soccer 120,
basketball 72, baseball 201, swimming 416, and gymnastics 16 hours. Using the same

ideil, exposure per week multiplied by the number ofweeks, Brown and Butterfield

(1 992) estimated that a high school football player spends an average of 326 hours of
practice time under the supervision of a coach during one athletic season.

Because our children are under the supervision of these coaches for such an
extended amount of time, these coaches should be trained in basic injury prevention and
care. It has been identified that 85 per cent of coaches are parents or others who have no
formal training in how to coach (Engh, 1981). The National Youth Sports Safety
Foundation (NY SSF ), (Coaching Education, 2000) states that there are no federal laws
requiring coaching education at any level of competition. Prevention programs, coaching
education, and setting standards of practice are vital in the prevention of youth sports
injuries. According to the NYSSF, the “United States is the only country in the major
sporting world that does not have a national coaching education program” (Coaching
Education, 2000). There are no laws that require youth coaches to undergo any formal

training on how to coach, teach, develop training sessions, prevent, recognize, and treat
injuries. Even though there are no national requirements or regulations, some national
and local governing bodies, such as USA Swimming, do require coaching education,
Which includes safety education. Some states, such as Arkansas and Iowa, require some
01' all high school sport coaches to have a coaching certification.

Due to the fact there is not a nationally accepted youth first aid injury prevention
and care program for coaches to attend, one needs to be developed. Prior to the
development of an injury prevention and first aid program, an assessment of the current
first aid and injury prevention knowledge that is possessed by the typical youth sports
COach must be measured. First aid and injury prevention are the sole aspects that should

be included in a first aid and injury prevention program for youth sport coaches.

 

Need for the Study

To date, no study has been conducted to evaluate the first aid knowledge of youth
sports coaches. First aid and injury prevention knowledge of youth coaches need to be
evaluated. Additionally, how youth coaches use their first aid knowledge to determine
the playing status of an injured athlete needs to be assessed. In order to develop
standards for coaches to follow regarding the return of an athlete to activity, an
assessment of how coaches use their first aid and injury prevention knowledge to
determine the playing status of an injured athlete needs to be evaluated. A youth injury
prevention program may be developed from the information that will be gained from
such an assessment.

Once a youth injury prevention program is developed, youth coaches should be
required to take such a program. Most if not all youth coaches would like to be prepared
in case of an injury or emergency. The knowledge that will be gained by coaches taking
an injury prevention and care program will hopefully result in a reduction of injuries
suffered by the youth athlete during sports participation and increase the level of care
provided to those athletes.

Statement of the Problem
The purpose Of this study is to measure the first aid and injury prevention
knowledge of youth basketball, football, and soccer coaches and to assess the decision
making ability ofthese youth coaches in determining the playing status of an injured
athlete.
Research Questions

The following research questions directed this study:

0.)

10.

ll

12.

13.

What first aid and injury prevention knowledge do youth basketball, soccer, and
football coaches possess?

Is there a difference in the first aid knowledge based upon the sport that is
coached?

Is there a difference in the first aid knowledge based upon the coaches’ gender?
Is there a difference in the first aid knowledge based upon the coaches’ age?

Is there a difference in the first aid knowledge based upon the number of years of
coaching?

Is there a difference in the first aid knowledge based upon the number of sports
coached?

Is there a difference in the first aid knowledge based upon the educational
background of the coach?

Is there a difference in the first aid knowledge based upon the gender of the
athletes coached?

Is there a difference in the first aid knowledge based upon prior formal first aid
instruction?

Is there a difference in the first aid training based upon American Red Cross first

aid training?

. Is there a difference in the first aid knowledge based upon CPR training?

Is there a difference in the first aid knowledge based upon current first aid
certification?
Is there a difference in the first aid knowledge based upon current CPR

certification?

14. Is there a difference of when a coach would return an injured athlete to
competition based upon: passing/failing the First Aid Assessment (FAA), sport
coached, coaches’ gender, coaches’ age, years of coaching experience, number of
sports coached, educational background, gender of athletes coached, formal first
aid training, American Red Cross First Aid, CPR training, current first aid
certification, and current CPR certification.

Overview of the Research Methods
A testing session will be used to assess the first aid and injury prevention
knowledge and the decision-making abilities related to injuries and playing status. Two
hundred and ninety youth basketball, soccer, and football coaches, who coach in a
basketball league, various soccer leagues, and a pony football league. participated in this
study. Each coach signed consent to be tested and evaluated. The coaches filled out a
demographic information sheet and the revised American Red Cross First Aid
Assessment (Ransone & Dunn-Bennett, 1999) (Appendix A) to determine his/her first aid
and injury prevention knowledge. Each coach then completed the Game Situation Data
Sheet (Appendix B) to assess his/her decisions in nine different athletic situations that
involved sports related injuries and the players return to participation.
Limitations

1. Results of this study are limited to youth basketball, football, and soccer coaches
in the mid-Michigan area.

2. The results ofthe study are only applicable to the first aid knowledge areas in

which the coaches were tested.

Assumptions

. All participants will be truthfiil with regards to the information that they provide
on the demographic information sheet.

. All participants will try their best on the FAA.

. All participants will truly reply to the Game Situation Data Sheet.

CHAPTER II
Review of Literature
Participation in Youth Sports

Statistics of Youth Sport Involvement

In today’s society, young male and female athletes can choose from a variety of
sport activities. High schools offer as many as 32 male and 27 female competitive
scholastic sports. High school is not the only level of competitive sports for young males
and females. Approximately three-fourths of American junior and middle schools have
significant competitive sports programs (American Academy of Pediatrics, 1981). The
level of participation in youth sports had increased dramatically over the years.
According the American Academy of Pediatrics (1983), approximately one half of males
and one-fourth of females between the ages of 8 and 16 (7 million students) are engaged
in some type of competitive scholastic, or organized sport during the school year.
Godshall (1975) stated that an additional 20% of children in this age range are involved
in community sports programs. DuRant, Pendergrast, Conner, Seymore, and Gillard
(1991) reported that 20 million youth between the ages of 6 and 16 participated in
organized sports, and that 6 to 7 million high school students participated in school
sponsored athletic activity. More recently, in the mid 19905 and early 20005 there were
approximately 46 million youth involved in some form of sports (Malina, Bouchard, &
Bar-Or, 2004)

The level of female participation in sports has grown quite rapidly since the Title
IX Education Assistance Act of 1972, that required equal athletic opportunities for both

males and females. The enactment ofthis legislation boosted the involvement of women

in sports. According to Stanitski (1988), there was a 700% increase in the sport
participation of women from 1978 to 1988. In 1981, C. Carson Condrad, Executive
Director of the President’s Council on Physical Fitness and Sports, stated that
participation in exercise and sports had more than doubled in the past 20 years and that
more than one third of the participates were female (as cited in Mueller & Blyth, 1982)
Benefits and Risks of Participation in Youth Sports

Participation in organized sports is an important activity in the lives of many
children and adolescents. Participation in youth sports comes with its own benefits and
risks. Coaches and parents must be made aware of the potential benefits and risks of
youth sport participation so they can maximize the positives and help reduce the negative
aspects of sports. Brown, Clark, Ewing, and Malina (1998) have identified the benefits
and risks of sports participation. The benefits of sport participation reported are regular
physical activity, physical/physiological benefits, and the social and psychological
benefits. The risks associated with sport participation that were reported are the effects
on growth and maturation, psychological, potential for child abuse, injury, and the female
athlete triad.

Malina (2001) goes into detail about the benefits and risks involved in youth
Sports participation. He states that benefits of youth sports participation include growth
and maturation, regular physical activity, motor skill and physical fitness, self-concept,
social competence, moral development, and ethical competence. Sports participation can
positively influence body mass and body composition. Athletics also provides an
opportunity for a child to socialize with peers, learn what is wrong and right, and learn

how to play within the rules ofthe game. The possible risks of youth sports participation

deal with psychological stress and risk of injury. The psychological stresses that Malina
(2001) describe are “low self-esteem, elevated anxiety, aggressive behavior, possible

increased risk for injury and burn out” (p. 206).
Youth Sports Injuries
’ Types of Injuries in Youth Sports

There are three general categories of injury that could result from youth sport
participation: acute, overuse, and chronic. By definition an acute injury is one that has
“rapid onset, severe symptoms and a short course, not chronic” (Thomas, 1997, p. 34).
Examples of acute injuries include ankle sprains, fractures, and dislocations. Overuse
injuries are “caused by accumulated micro traumatic stress placed on a structure of body
area” (Starkey & Ryan, 1996, p.542). Tendonitis and stress fractures are two examples of
overuse injuries. Chronic injuries have a long onset and duration. Chronic injuries are

developed over time.

Youth athletes are unique individuals. In addition to acute, overuse, and chronic
injuries, youth athletes also experience age-related injuries. Age-related injuries are
those injuries that are experienced by an individual at certain age or biological
maturation. Youth athletes have age-related injuries that are the result of how their
growing, developing, and maturing body interacts with sport participation. Growth,
maturation, and development are three different aspects of a child and each aspect needs
to be understood and evaluated. Growth is the increase in size of the body, maturation is
the “progress towards the biologically mature state,” and development is “the acquisition
ofbehavioral competence” (Malina, 2001 ). The presentation of an age-related injury

may either have rapid onset (acute), clue to repetitive stresses placed upon the body

(overuse), or gradually developed over time (chronic injury). Age-related injuries are
unique in that they are due to the interaction of the athlete and their growing, developing,
and maturing body and the activities of sport. Osgood-Schlatter disease and Sever’s
disease are examples of age-related injuries that are commonly found in youth sports

participants.

In 1903, “Osgood and Schlatter described the traumatic disturbances in the
development of the tibial tuberosity” (Kujala, 1985, 236). Osgood-Schlatter disease
(OSD) can be related to the skeletal immaturity of the young athlete. Some young
athletes try to perform as their adult counterparts. Their bodies are not ready to perform
at that level, and in the process they injure their bodies. Girls develop OSD between the
ages of 8 tol3, and boys develop OSD between the ages of 10 to 15. The development of
OSD is related to the adolescent growth spurt. OSD is most commonly found in athletes
whose sports require repetitive running, jumping, and squatting.

Severe’s Disease (SD), also an age-related injury, is similar to OSD. Severe’s
Disease is an inflammatory condition of the apophysis of the calcaneus and occurs in
children that are actively engaged in sports (Stanitski, 1993). Presentation of this
condition is between the ages of 7 and 14, most commonly in the 10- to 11-year age
group. SD has a resolution time of 12 to 18 months.

Stress fractures are “a hairline fracture that appears without evidence of soft tissue
injury” (Thomas, 1997). Stress fractures are due to repetitive low load microtraurnas
caused by such activities as running andjumping. There are many factors that are part of

the development of a stress fracture. Such factors are improperly fitting shoes, hard

10

surfaces, insufficient rest time between activity sessions, insufficient warm up and
stretching, and improper conditioning.

Youth coaches need to know the different types of injuries, and be able to
recognize these injuries in the youth athlete. The knowledge of the different types of
injuries that youth athletes may experience may help coaches to recognize these injuries.
In addition, the knowledge of the injuries may help to reduce the prevalence and severity
of injury.

Incidence of Injury in Youth Sports

According to one study, the incidence of injury is extremely low in preadolescent
organized tackle football (Roser & Clauson, 1970). Two thousand seventy-nine boys
aged 9 to 15 participated in a tackle football program in 1968. Of those participants 48
(2.3%) sustained an injury that kept them out of a game or practice. Fractures, sprains,
and strains accounted for 70% of the injuries that occurred; contusions accounted for
17% of the injuries. Roser and Clauson’s (1970) study was done thirty years ago and
prior to the enactment of Title IX. Since that time there has been a large increase in
youth sports participation and injuries that are related to sports participation. Due to the
increased participation in youth sports, there has also been a rise in the incidence of sport
injuries (Cheng, 2000; Rome, 1995). According to Bijur, Trumble, Harel, Overpeck,
Jones, and Scheidt (1995), 32.3 per cent of all serious injuries to children ages 5 to 17
years are due to sports and recreational activities. A serious injury was defined as
injuries resulting in hospitalization, surgical treatment, missed school, or halfa day or

more in bed.

11

Gallagher, F inson, Guyer, and Goodenough (1984) conducted a yearlong study of
23 hospitals in Massachusetts. They found that one out of every 14 teenagers presented
to the hospital suffered an acute injury that was sustained from a sports accident.
Football (19.9%) and basketball (17.4%) had the highest injury rates of those that

required hospitalization.

In the United States the National Ambulatory Medical Care Survey (NAMCS)
and the National Hospital Medical Care Survey (NHAMCS) collected data on the amount
of ambulatory medical care that is provided by physician offices, hospital outpatient and
emergency departments (Hootman, 2000). In 1997, the information that was gathered by
the NAMCS and the NHAMCS revealed that the 8-18 year old population accounted for
12.5 million ambulatory medical care visits. Of the 12.5 million visits, approximately 5
million (39%) visits were due to injuries that were acquired during participation in sport
and recreational activities. Physician office visits accounted for 53% of the sports related
visits, while hospital accounted for 41% of the sports related visits.

Approximately three to 1 1% of children are injured while participating in youth
sports (Goldberg, 1989). Additionally, sports injuries account for seven to 13% of the
acute injuries to children who are treated in hospitals (Gallagher, 1982; Micheli, 1983;
Muller, 1982). Youth sports injuries are a major issue that needs to be considered and
explored.

Injury Rate and Age

Numerous studies have determined that there is a positive relationship between

injury rate and age, i.e., increases in injury rate are noted with increases in age

(American Academy of Pediatrics, 1983; DcHaven & Lintner, 1986; Halpern, Thompson,

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& Curl, 1987; Keller, Noyes, & Buncher, 1987; Martin, Yesalis, & Foster, 1987; Mueller
& Blyth, 1982; Pettrone & Ricciardelli, 1987; Silverstein, 1979; Stricevic, Patel, Olazaki,
& Swain, 1983; Sullivan, Gross, Grana, & Grarcias-Moral, 1980; and Zaricznyj,
Shattuck, Mast, Roberton, & D’Elia, 1980). The increase in injury rate that is associated
with increased age is actually associated with the increased body size and speed of the
participants. In addition the increased injury rate is associated with the adolescent growth
spurt. According to Bijur et al. (1995) the injury rate for girls is stable from five to eight
years of age but is four times higher during the ages of eight and twelve. The injury rate
for boys is stable from five to eleven years of age, but increases threefold during the ages
of eleven to fifteen. Adding to the increased injury rate, is the increased intensity and
magnitude of competition, improper or non existent training techniques, poor coaching,
poor equipment, and unsafe sites of play (Halpem et al., 1987; Hoff & Martin, 1986; and
Jackson, Jarrett, Bailey, Kausek, & Swanson, 1978).

One aspect of the positive relationship between injury rate and age is the natural
skeleton growth and maturation. As the body grows and develops, there are demands and
stresses that are placed upon it that could result in injury. Participation in youth sport
activities may increase the incidence of such natural growth syndromes and injuries. A
study by Orava and Saarel (1978) found that the pain associated with overuse sports
injuries in children is typical of a syndrome proportional to age in one-third of the

injuries (Sever’s disease and Osgood-Schlatter’s disease).

Severity of Injuries at the Youth Sports Level
Garrick and Requa (1978) conducted a study that involved the participation of

certified athletic trainers in recording injury incidence, severity, and time 1055 from

13

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activity. The study consisted of over 3,000 participants in 19 high school sports. The
incidence of injury in this population was 39.3 per 100 athletes, of which 40% were
referred to a physician. When seen by a physician, 71% required diagnostic injury x- ‘
rays. Of the 1197 injuries identified, only 25 athletes were hospitalized, and 21 of the 25
were hospitalized for operative procedures. Also, 29% of those injured missed only 1
day of participation, 70% missed 5 or less, and fewer than one third of all injured athletes
missed more than 5 days.

Powell and Barber-Foss (1999) conducted a study examining the injury rates in
high school sports. During the three year study there were 75,298 player seasons and
23,566 reportable injuries. A reportable injury was one in which the athlete was removed
from participating in that practice or game, where the athlete was not able to fully
participate in the following day’s activities, all fractures and dental injuries, and any mild
brain injury that required observation. Football had the highest case rate per 1000 athlete
exposures, 8.1, followed by boys and girls soccer, 5.6 and 5.3 respectifully. Boys
basketball had a case rate per 1000 athlete exposures of 4.8, while girls basketball had a
case rate of 4.4.

The NAMCS and NHAMCS found that ankle sprain/strain, pelvis sprain/strain,
and closed phalangel fracture were the top three physicians’ diagnoses (Hootman, 2000).
Injury prevention counseling/education was ordered or provided for only 16.4% of the
visits to either the physician’s office or hospital visits. From the information that was
gathered by NAMCS and the NHAMCS, Hootman (2000) recommends, “public health
injury prevention programs should be targeted towards the teenage population engaged in

sports and recreation activities” (p. s-16).

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Factors that are Related and Cause Injury to Youth Athletes

Factors that contribute to injury can be classified as two different types: intrinsic
or extrinsic. Intrinsic injury factors are related to the athlete and come from the athlete.
Extrinsic injury factors are outside factors that are related to sports participation and may
cause or lead to injury to the athlete. Malina (2001) reported the following as intrinsic
injury factors: “physique, problems with structural alignment, lack of flexibility, lack of
muscular strength or strength imbalance, marginal or poor skill development, behavioral
factors, injury history, adolescent growth spurt, and maturity”(p. 224-225).

Micheli (1983) cites a multitude of factors that contribute to injury in youth sport
participants. The factors that are described are: the individual’s equipment, playing
environment, training, coaching miscues, rules and officials, and parental stresses.
Malina (2001) reports similar extrinsic factors as Micheli (1983) but also reports
inadequate rehabilitation fromiprior injury, training errors, playing conditions,
equipment, age groups, coach behaviors, parent behaviors, and sports organizations as
extrinsic injury factors. Inadequate rehabilitation from previous injury can result in a loss
of conditioning, strength, and flexibility of not only the injured body part but also the
body as a whole. This decrease in conditioning strength, and flexibility is a predisposing
factor for re-injury of the same body part or injury to another body part. Age groups are
a major extrinsic injury factor. Teams are usually based upon grade and or chronological
age. Basing teams on these principles does not take into consideration biological age.

There is difference in biological or skeletal age and chronological age. Skeletal
age reflects the maturity of the body as it relates to the biological development that the

body has attained. Chronological age is the number ofyears since one’s birth. Tanner

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(1962) discussed the concept of using skeletal age over chorological age. Tanner (1962)
states that the Tanner classification of physical maturity must be considered during pre-
participation evaluation and team formation. Teams should be created based on physical
maturity, rather than chronological age to prevent potential injury. Kreipe and Gewanter
(1985) stated that physical maturity and skeletal age are more important than
chronological age when determining if a child should be able to play a sport and at what

level this child should play the sport.

Kreipe and Gewanter (1985) conducted a “study to develOp a screening criteria
that would enable nonphysicians to detemiine physically immature boys prior to their
participation in sports”. Three hundred and seventy-four boys ages 12 to 18 participated
in the study. For this study a self-assessed Tanner stage of development was given, grip
strength was measured, and a physician-assessed Tanner stage was determined. Each
participant compared himself with standard photographs to determine the self-assessed
Tanner stage. Grip strength was determined by a spring dynamometer. One physician
was used to determine the physician-assessed Tanner stage of development. The
correlation between self-assessed and physician-assessed Tanner stage was .788. The
correlation between grip strength and physician-assessed Tanner stage was .803. “When
self-assessed Tanner stage and grip strength were discordant, grip correctly predicted the
level of maturity more often than did self-assessed Tanner stage” (Kreipe & Genwanter,

1985)

According to Stanitski (1989), the greatest source of sports injuries in the
preadolescent and adolescent age groups is training errors. Children and adolescents are

becoming more involved in sport at earlier ages and with higher levels ofintensity (Roser

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& Clauson, 1970). Children are not just smaller forms of adults. A youth athlete cannot
train nor play as an adult athlete. Most often the problem is that young athletes try to do

too much and in the process injure themselves.

Safety Equipment in Youth Sports

Safety equipment is vitally important in the prevention of athletic injuries. For
youth sports all of the participants should have equipment that is of the highest quality.
At times, the players that are not starters end up with equipment that is of a lower quality.
There is a team hierarchy, the best players get the best equipment, the good players get
the good equipment, and the okay players get the leftovers or whatever is available. In
addition some leagues do not provide the safety equipment for the participants, thus the
parents must purchase the safety equipment. The average cost to outfit a youth football
player in new equipment is $200-$250. Children are always growing and developing,
and the equipment that was worn the previous year may not fit, causing the parents to
bear the Cost of outfitting the player year in and year out. For this reason many parents
and leagues purchase previously used equipment. There is no way of making sure that
the Previously used equipment meets all safety requirements. Possessing the safety
CQUIPment is only one part in the injury prevention. Equipment also needs to be used
properly and correctly. Coaches, parents, and officials are in charge of making sure that

the athlfnes both use the equipment and use it properly.

The second aspect of safety equipment is the sporting environment. There are
many things out there that help to reduce the risk of injury while on the playing field, for
instance breakaway bases. J anda, Wojtys, Hankin, and Benedict (1988) report that

brcal{away bases in softball have helped to decrease the number of foot and ankle injuries

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when compared to use of more fixed styles bases. One aspect that will help with
reducing injury caused by the playing field would be to make sure that the playing

surface is prOperly seeded and watered, and that any objects that could cause injury, such

as rocks, are removed.

Coaching Education
It is not always the child?s fault. Coaches in youth leagues are most often
volunteers who have little education in strength and conditioning, prevention of injuries,
and how to treat injuries. According to the National Youth Sport Safety Foundation
(NYSSF), “less than 10% of the two and a half million volunteer coaches, and less than
one-third of the interscholastic coaches in the United States have had any type of
coaching education” (“Did You Know,” 2000). These coaches very rarely are given any
educational background on how to conduct conditioning and practice. This lack of
training may have and could result in injuries. Two stress-related injuries that can result
by the eXCessive demands of these coaches are stress fractures (Dickson & Kichline,
1987) and tendonitis (Curwin & Stanish, 1984). These coaches are not educated on how
10 cC’ndition and train an athlete, nor do they know about injury prevention, detection, and
treatment of injuries. According to Stanitski (1989), the ignorance of the types of injuries
or inability to recognize injuries other than grossly incapacitating ones are commonly
seen in Volunteer or supposedly trained coaches.
Prevention Programs
There are not many injury prevention programs for youth sports, where the main
t0131(33 are first-aid and injury prevention and care. There are some groups and

Orgarlizations that have developed programs that address the topics of first-aid and injury

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prevention and care. Some counties such as Anne Arundel, Maryland have seminars for
youth coaches. To be a youth sports coach in this county, one must attend the seminar.

Upon completion of the seminar coaches receive a certificate that must be renewed every

three years (Steele, 1996).

Those groups that have developed programs are the National Youth Sports
Coaches Association (NYSCA), American Coaching Effectiveness Program (ACEP),
Youth Sports Institute (YSI), and Little League Baseball. The National Youth Sports
Coaches Association’s, (NYSCA), offers a six-hour training program. The goal of the
NYSCA’S program is to help train volunteer coaches to deal with issues within youth
sports. Such issues include psychological aspects of coaching, first aid, care and
prevention of injuries, and some sport—specific skills (Quain, 1989). The American
Coaching Effectiveness Program (ACEP) deals with the physiological and psychological
35136913 of youth, and sports medicine (Quain, 1989). Little League Baseball provides

training for coaches in the areas of teaching skills and understanding child psychology

(Quain, 1 989).

The Youth Sports Institute of Michigan State University, East Lansing, MI offers
a coaches education program called PACE (Program for Athletic Coaches’ Education).
PACE is a program that is endorsed by Michigan High School Athletic Association and
MiChigan Interscholastic Athletic Administrator Association. PACE is a 12-hour
prOgram that covers a wide array of topics, after the program coaches are given a test and
upon passing the test coaches receive certification. Some topics that are covered during
the PACE program are; Legal Responsibilities of a coach, Emergency Procedures for

Victims of Accidents and Injuries, Essential Medical Records for Interscholastic Athletes,

19

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prevention, Care and Rehabilitation of Sports Injuries, Planning, Conducting and
Evaluating Effective Instruction, Physical Conditioning and Contraindicated Activities,
Motivating Athletes, and Positive Coaching. The PACE program is a good stepping stone
to the development of a first-aid and injury prevention program. A program that has a
solo emphases on first aid and injury prevention in youth sports, needs to be developed
and required for youth athletic coaches. Many articles and studies have cited the need for
the development of an injury prevention program for youth sports, or the increase in
education for coaches, parents, and participant (Antich, Clive & Brewster, 1985;

Congeni, 1994; Stanitski, 1993; Wall, 1998; Wells & Bell, 1995; Whiteside, Andrews, &

Fleisig, I 999).

Currently there are a number of ways to become a certified coach. One such way
is to complete a degree program in coaching at a college or university. There is also a
National Governing Body of Sports certification program that one can complete and
receive a certificate stating that they have met the standards set forth to be a coach. There
was no national standard of coaching education until 1996, when the National
ASSOCiation for Sport and Physical Education (NASPE) developed national coaching
education standards. NASPE is in the process for developing an accredited program in
coaching education.
Currently there is a manual entitled “Sideline Help” (Steele, 1996) that can be

used t0 aid coaches in dealing with injuries and emergency situations. Included in the
manual is information on the prevention, immediate care, treatment, and rehabilitation of

youth Sports injuries. In addition to the information that is contained in Dr. Steele’s

20

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manual, there are pretests and posttests to check one’s understanding and mastery of the

topic and the information given.

Stephens (1991) suggests that parents and guardians should find coaches that have
a safety and first aid certification. Stephens continues on to say that there are a number
of organizations that are available that could provide accurate and adequate instruction

for youth sports programs such as the American College of Sports Medicine and the

National Athletic Trainers Association.

Luschen and Moore (1987) state seven guidelines to make people more aware of
their responsibilities as a youth coach, youth league representative, or a youth sports
director. Three of the guidelines given are to provide a safety manual, provide safe
facilities and equipment, and provide proper care for sports injuries. Luschen and Moore
(1987) go on to state, “coaches and physical education instructors have the duty of

PTOVidtng reasonable medical assistance” (p. 3). The same durty applies to youth sport

coaches at all levels.

There has been a call for the involvement of many groups of people to help with
the Prevention of youth sport injuries. Stanitski (1983, 1993) reported that the
orthepedist must take an active role in preventive sports medicine to minimize the risks
0f YOUth sport participation and accentuate the benefits of participation. According to the
Amel'ican Academy of Pediatrics Committee on Pediatric Aspects of Physical Fitness,
Recreation and Sports (1981), orthopedic sports medicine specialists must act as a strong
positive voice for the high benefits and limited risks involved with sports for children and
adOlCscents. Also, Bernhardt and Landry (1995) noted that pediatricians and other

p r ”nary care providers need to take an active role in youth sports. Pediatricians and other

primary care providers should enhance their knowledge of the common sports-related

injuries and offer to be a medical advisor for youth sports programs.

Emergency First Aid Care
The American Red Cross offers a number of courses to train people in first aid.
Some of the courses offered are Cardiopulonmary Resuscitation (CPR) for infants,
children, and adults, Basic First-Aid, Community First-Aid and Safety, and the Sport
Safety Training. The Basic First-Aid course by the American Red Cross, which includes
four hours of instruction, teaches individuals “how to recognize emergencies, how to treat
wounds, burns, poisoning, sudden illness, muscle, bone, and joint injuries, splinting
methods, and weather related emergencies” (American Red Cross, 2001). In order to
pass the basic first aid class, one must pass all skill testing and a multiple-choice test.
The Community First-Aid and Safety course, nine hours of training, differs from the
Basic First Aid course by the addition of CPR instruction. For certification in
Community First-Aid and Safety, one must pass all skills testing and a multiple-choice
exam. The American Red Cross in conjunction with the US. Olympic Committee
(161610de the sport safety-training course, up to nine hours of instruction. During the
sport Safety training course one learns the “principles of sports injury prevention, first aid
steps for all sport related injuries, including weather-related emergencies and sudden
illness" (American Red Cross, 2001).
First Aid Knowledge of High School Coaches.
In 1986 Rowe and Robertson developed and administered a first aid test to
Alabama high school coaches. Only 34 (27%) of the 127 coaches tested earned a passing

Score. In 1991 Rowe and Miller administered the same test to Georgia high school

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coaches. Fifty (38%) of the 130 Georgia high school coaches passed the first aid test, in
light of 116 (89%) of the coaches having current first aid certification.

A recent study by Ransone and Dunn-Bennett (1999) assessed the first-aid
knowledge and decision-making of high school athletic coaches. Ransone and Dunn-
Bennett (1999) used an adapted form of American Red Cross’s First-Aid Assessment and
the Game Situation Data Sheet (Flint & Weiss, 1992) to assess the first aid knowledge
and decision making of 104 high school athletic coaches. Ninety-two percent of the
coaches surveyed had current first-aid certification, which is required by California state
law. Only 63% of the coaches received a passing grade on the First-Aid Assessment,
which shows that more than just first aid and CPR certification is needed. Coaches that
passed the First-Aid Assessment were more likely to return an injured starter back to play
than the coaches who did not pass the Assessment. Interestingly enough in most cases
“00361168 returned the injured athlete to play regardless of the game situation” (Ransone
& Dunrl--Bennett, 1999, p. 270). From the results of their study Ransone and Dunn-
Bennett (1999) recommended that coaches receive “additional knowledge on the
treatment and rehabilitation of athletic injuries” (p. 271), which will aid in the decision
making on playing status of an injured athlete.

Decision Making of High School Coaches
In many cases youth coaches will be determining if an injured athlete is to return
to Cornpetition. Flint and Weiss (1992) assessed the decisions made by high school
COttetles of when they would return an injured athlete to competition. Coaches were
PfeScnted with varying game situations (clearly winning, clearly losing, or close game)

and differing player status (starter, first offthe bench, bench player). Coaches were

23

 

 

 

 

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asked whether they would return the injured athlete to competition. The decision to
return an athlete to competition depended upon player status and game situation. In a
game situation where the outcome was already determined coaches were more likely to
return a first substitute or bench player than a starter. In a close game situation coaches
were more likely to return a starter than a bench player or first substitute.
Summary

With the increased participation in youth sports there is has been a rise in the
number of sports related injuries. Youth sport coaches are the individuals that are present
at the time of injury and need to be armed with the knowledge of how to handle these
situations. Not only do coaches need to be able to handle injury and emergency
situations but they also need to be able to prevent such situations. To enhance the
knowledge base of youth coaches, an injury prevention and care program needs to be
developed. Prior to the development of such a program the knowledge base of youth

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CHAPTER III
Methods
Research Design
The research design for this study was a static group comparison design, with data
collection consisting of the results of the First-Aid Assessment and Game Situation Data
Sheet. The independent variable was youth basketball, soccer, and football coaches. The
dependent variables were the responses to the First-Aid Assessment and Game Situation
Data Sheet. The static group comparison design was chosen for the current study
because it will illustrate the current first aid and injury prevention knowledge of youth
basketball, soccer, and football coaches, and assess situations in which coaches would
return an injured athlete to activity. Also, the static group comparison design allowed for
a comparison between coaches of different ages, towns, sports, number of years
coaching, and educational background.
Participants
A total of 290 youth football (N = 236), basketball (N = 35), and soccer (N = 19)

coaches participated in this study. Of the 290 coaches, 170 coaches, with a mean age of

39.61 years (SD = 6.30), completed the demographic information sheet. At some of the

testing sessions the demographic sheet was unavailable for use. Coaches at these

testing sessions were mailed a copy of the demographic sheet and a self addressed

stamped envelope. Not all of the coaches returned the completed demographic sheet,

thus the reason for the missing information on those coaches. Unless otherwise noted,

analysis was conducted on the 170 coaches that completed the demographic sheet. One

hundred and fifty-two were male, 15 were female, and three did not report a gender.

25

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The mean years of coaching experience were 6.65 years (SD = 5.55), with a range of 0-
27 years. Participants reported an average of 2.71 sports coached which ranged from 0-
7. The breakdown of the educational background information of the participants by
sport is reported in Table 1. Seven (4.1 1%) coaches, more than expected, reported
having a doctoral degree. Ninety-seven (57.1%) coaches reported having been trained
in American Red Cross First Aid and/or CPR (47.7%), American Heart CPR (5.3%), or
Emergency Medical Technician (4.1%). Twenty-seven (15.9%) reported having PACE
(Program for Athletic Coaches’ Education), physical therapy, or other type of training.
However, only twenty-one (12.4%) coaches reported being Currently certified in First
Aid and 30 (17.6%) coaches reported being currently certified in CPR. The distribution

of formal first aid training can be seen in Table 2.

Table 1

Educational Background of Coaches by Sport Coached

 

 

Football Basketball Soccer Total

N N N N %
High School
Diploma 58 13 6 77 45.3
H‘gt.‘ SChOOl 2 o 0 2 1.2
Equrvalent
Assoc‘ates 19 4 1 24 14.1
Degree
BaChelors 26 8 7 41 24.1
Degree
Mame“ 3 5 2 10 5.9
Degree
Doctoral 1 3 3 7 41
Degree
Other 2 0 O 2 1.2
Some High 7
School 2 O O T 1'2
Some 1 l 0 2 1 2
College '
Not 2 1 O 3 1 8
Specified ‘
Total 170 1001*

 

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Table 2

Numbers and Percentages of First Aid Training

 

 

Type of Training N Frequency
American Red Cross First 0
Aid and CPR 61 35'9 /0
American Red Cross First 4 2.4%
Aid

American Red Cross CPR 16 9.4%
American Heart CPR 9 5.3%
Emergency Medical 0
Technician 7 4'1 /0
Pace Training 8 4.7%
Physical Therapy 3 1.8%
Other Training 16 9.4%
None 75 44.1%
Total 199* ll7.l%**

 

* Total exceeds 170 because a coach can be trained in more than one organization/area
** Total exceeds 100 because a coach can be trained in more than one organization/area

28

 

 

 

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Instrumentation

Demographic Information Sheet

The Demographic Information Sheet (see Appendix C) was used to determine if
there were any differences in the youth basketball, soccer, and football coaches’
knowledge of first-aid and injury prevention based upon age, years of coaching, terminal
degree, age of the athletes he/she coaches, gender of athletes coached, sport coached, and
prior first aid knowledge.
First Aid Assessment Test

The American Red Cross developed the F irst-Aid Assessment (Appendix A) in
1988 to measure an individual’s proficiency after the completion of the Basic First-Aid
and Sport Injury courses. The test consisted of 38 multiple-choice questions. The
competency areas covered by the assessment are: anatomy, care and treatment,
prevention, assessment, equipment, and heat/cold related factors. For certification a
score of 80% or higher is required. Ransone and Dunn-Bennett (1999) revised the
American Red Cross First-Aid Assessment to assess the first-aid knowledge of high
school athletic coaches. The validity of the revised First-Aid Assessment was established
by expert review to determine the most appropriate questions related to athletic
competition.
Game Situation Data Sheet

Flint and Weiss (1992) developed the Game Situation Data Sheet (Appendix B) to
assess an individual’s decision making in hypothetical athletic situations. Composed of
nine different athletic situations, the Game Situation Data Sheet asks the individual

whether or not they would allow an athlete to return to activity. Participants check yes or

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no as to whether they would return an athlete to competition. The athletic situations
included players of different ranking (i.e., starter, first off the bench, or bench warmer).
In addition the athletic situations involved a number of different game situations, such as
close or blow out games, winning, and losing.
Data Collection Procedures

This study was conducted during the youth football 2001 fall season, the youth
basketball 2001-2002 winter season, and youth soccer 2002 spring season. The
participants were all coaches in the Mid-Michigan Basketball League, various soccer
leagues, and the Mid-Michigan Pony Football League, Inc. The coaches/leagues were
selected to be participants based upon community support, participant willingness, and

proximity to the research institution.

The individual towns within the Mid-Michigan Basketball and Mid-Michigan
Pony Football League have a number of general coaches’ meetings at which time the
tests were administered. At the coaches meeting, the description of the study and the
consent form were explained to the participants. The participants were free to ask any
questions about the study. The participants were asked to sign the consent form
(Appendix D) indicating whether they agree or decline to participate in the study after the
researcher had gone over the description of the study, the consent form, and allowed the
participants to ask any questions regarding the study. Coaches could choose to withdraw
their consent at any time prior, during, or after the collection of data. The coaches signed
the consent form. One coach was a minor; consent was given by his father to participate
in the study. The coaches were then asked to take the F irst-Aid Assessment and to

complete the Game Situation Data Sheet. These tests took approximately 30 minutes to

complete. After completing the F irst-Aid Assessment and the Game Situation Data Sheet
the coaches were thanked for their time. Upon request of the individual towns and sports,
a 30-60 minute lecture on first aid procedures was given.

Due to the original soccer league deciding not to participate, various individual
soccer teams were approached to participate in the current study. The researcher would
approach a soccer coach, ask for a minute of his/her time, describe the study, and ask if
the coach would like to participate in the study. If the coach agreed to participate, the
researcher reviewed the informed consent form, First-Aid Assessment test, and the Game
Situation Data Sheet. After answering any questions from the coaches the researcher
asked the coach to sign the infomred consent and complete the First-Aid Assessment and
the Game Situation Data Sheet. After completing the tests coaches were thanked for their
time and their help. If coaches refused to participate. they were thanked for their time

and the researcher left the coach alone.

 

 

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CHAPTER IV
Results
First Aid Assessment

On the First Aid Assessment (FAA) coaches scored an average of 24.96 points
(SD = 3.58) out ofa possible 38 points, with the scores ranging from 10 to 33. Table 3
indicates the average, range, and standard deviation on the FAA score by the sport
coached. The sport coached was known for all 290 participants. The range of scores for
the football coaches was very large, i.e., 10 to 32. Soccer coaches possessed more
knowledge (M = 26.74) than the football (M = 24.73) or basketball (M = 25.51) coaches.
The mean score on the FAA for male participants was 25.42 (SD = 3.41) with scores
ranging from 14-33. The mean score on the FAA for female participants was 25.40 (SD
= 3.20) with scores ranging from 21-31.

Research question one inquired about the first aid knowledge that youth
basketball, soccer, and football coaches possess. Of interest was whether a coach earned
a passing score on the FAA. A score of31 (80%) or higher is required to pass the FAA.
Fifteen coaches (5.17%) eamed a passing score (range 31 — 33). Ofthese 15 coaches
nine coached football (3.81%), one coached basketball (2.86%), and five coached soccer
(26.32%). Ofthe 15 coaches that passed the FAA, l3 coaches were male, one was
female, and one gender was not reported. Table 4 reports the frequency of coaches that
passed the FAA and the type of training that they possessed. Twelve (80%) coaches
reported having some form of formal first aid training, nine (60%) reported having been

trained in CPR, and five (33%) reported being currently first aid or CPR certified. The

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five people that had current first aid certification were also the five that had current CPR

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Table 3

First Aid Assessment Score by Sport Coached

 

 

N Range Mean SD
Football 236 10-32 24.73 3.57
Basketball 35 17-31 25.51 3.38
Soccer 19 21-33 26.74 3.68
Total 290 10-33 24.96 3.58

 

Table 4

Type of T raining for Coaches that Passed the FAA

 

Type of Training Yes No Missing
Formal First Aid 12 2 1
Training

American Red 4 10 1
Cross First Aid

Training

CPR Training 9 5 1
Current First Aid 5 9 1
Certification

Current CPR 5 9 1
Certification

 

To assess the reliability of the FAA Chrombac’s alpha was conducted on all 38
FAA questions. Chrombac’s alpha for the FAA was .5387, less than what was hoped for
.70 (Nunnelly, 1978). The reason why Chrombac’s alpha was so low may be due the fact
that the participants scored so low on the FAA. The end results needs to be interrupted

with caution.

33

 

 

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The questions on the FAA are broken down into five constructs: Injury
prevention, injury identification/ general medical knowledge, CPR, injury management,
and wound care. The means and standard deviations for each of the constructs are
reported in Table 5. Coaches on average answered correctly 77% of the injury
prevention questions, 52% of the injury identification/ general medical knowledge
questions, 58% of the CPR questions, 70% of the injury management questions, and 78%
of the wound care information questions. The results of the analysis are reported in terms

of the individual constructs.

To assess the reliability of the FAA contructs, Chrombac’s alpha was calculated
on the five FAA constructs. The Chrombac’s alpha’s for the FAA constructs were: injury
prevention .2132, injury identification/ general medical knowledge .1856, CPR .0946,
injury management .2750, and wound care .2394. The reason why Chrombac’s alpha

was so low may be due the fact that the participants scored so low on the FAA.

Table 5

Means and Standard Deviation for the Five FAA Constructs

 

 

Number Of Mean SD % Correct
Questions
Injury Prevention 9 6.90 1.15 76.67
Injury
Identification/General 10 5.1 8 1 .52 5 1 .80
Medical Knowledge
CPR 4 2.32 0.90 58.00
Injury Management 9 6.29 1.20 69.89
Wound Care 6 4.69 0.98 78.17

 

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First Aid Constructs by Sport Coached

The second research question of this study was whether coaches differed in
knowledge on the five first aid constructs by sport that was coached. The means and
standard deviations of the five constructs by sport coached are presented in Table 6. A
one-way AN OVA with the injury prevention construct as the dependent variable and the
sport coached as the independent variable revealed no significant difference, F (2,287) =
2.76, p > 0.05. A one-way ANOVA with the injury identification/general medical
knowledge construct as the dependent variable and the sport coached as the independent
variable exposed a significant difference, F (2,287) = 5.99, p = .003. Table 7 reports the
results of a post hoc Scheffe test. The post hoc Scheffe test revealed that there was a
significant difference at thep = 0.05 level only between football and soccer coaches. A
one-way ANOVA with the CPR construct as the dependent variable and the sport
coached as the independent variable revealed no significant difference, F (2,287) = 0.000,
p = 1.0. No significant difference was found when an ANOVA was run that had the
injury management construct as the dependent variable and the sport coached as the
independent variable, F (2,287) = .596, p = .552. A one-way ANOVA with the wound
care construct as the dependent variable and the sport coached as the independent

variable exposed no significant difference, F (2,287) = 0.07, p = 0.933.

In summary the first aid knowledge of the youth coaches, by sport coached, differed
for the injury identification/general medical knowledge construct only. This difference
was found for football and soccer coaches. No difference was found between football
and basketball coaches or between basketball and soccer coaches. No other knowledge

differences were found.

35

 

 

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Table 6
, Means and Standard Deviations of Five FAA Constructs by Sport Coached

 

Football Basketball Soccer

Mean SD Mean SD Mean SD
firjury
Prevention 6.87 1.23 6.83 0.98 7.53 1.12
Injury
ldentification/
General 482* 1.56 5.37 1.42 595* 1.84
Medical
Knowledge
CPR 2.37 0.92 2.37 0.91 2.37 0.83
“Jury 6.08 1.28 6.31 1.25 6.21 1.13
Management
Wound Care

4.60 1.06 4.63 0.91 4.68 1.00

 

* significant difference at the p = 0.05 level

Table 7

Post hoc Sheffe test for Injury identification/General Medical Knowledge and Sport

 

 

Coached

95% Confidence
Interval

Sport Mean Std Significance Lower Upper
Coached Difference Error Bound Bound
Football Basketball -0.55 0.28 0.149 -1.25 0.14
Soccer -1 . l 3* 0.37 0.011 42.05 -0.21
Ba k tb ll Football 0.55 0.28 0.149 -0.14 1.25
s e a Soccer -0.58 0.45 0.434 -1.67 0.52
Socce Football 1.13* 0.37 0.011 0.21 2.05
r Basketball 0.58 0.45 0.434 0.52 1.67

 

* the mean difference is significant at the p = 0.05 level

36

 

 

 

First Aid Constructs by Gender of Coaches

Research question three pertained to whether coaches differed in their knowledge
of the five first aid constructs by the gender of the coaches. The means and standard
deviations of the five constructs by gender are presented in Table 8. Several one-way
ANOVA’s were run using each construct as the dependent variable and gender as the
independent variable. None of the ANOVA’s were significant: injury prevention, F
(1,165) = .279,p = .598; injury identification/general medical, F (1, 165) = 1.668, p =
.198; CPR, F(1,165) = .078,p = .780; injury management, F (l, 165) = 1.420,p = .235;
and wound care, F (1,165) = .993, p = .321. Knowledge ofthe five first aid constructs

did not differ by the gender of the coach.

Table 8

Means and Standard Deviations of Five FAA Constructs by Gender

 

N Injury Injury CPR Injury Wound
Prevention identification/ Management Care
General
Medical
Knowledge

Mean SD Mean SD Mean SD Mean SD Mean SD

 

Males 152 6.00 1.17 5.13 1.53 2.34 0.91 6.32 1.20 4.73 0.99

Females 15 7.07 0.96 5.67 1.50 2.27 0.88 5.93 1.28 4.47 0.83

 

First Aid Constructs by Age of Coaches
The fourth research question of this study was whether coaches differed in

knowledge ofthe five first aid constructs by age. The mean age was 39.61 (SD = 6.30)

37

and ages ranged from 15 to 61. Coaches were divided into five groups based upon age;
The distribution of the five groups is presented in Table 9. The five groups were

composed to have a similar number of group members across the five groups.

Table 9

Distribution of Coaches Based Upon Five Age Groups

 

 

Age Group N %
15-35 34 20
36-38 35 20.59
39-41 35 20.59
42-43 30 17.64
44-61 36 21.18
Total 170 100

 

The means and standard deviations of the five constructs by age groups are
presented in Table 10. A one-way ANOVA with the injury prevention construct as the
dependent variable and age group as the independent variable revealed no significant
difference, F (4,165) = .868, p = .484. A one-way ANOVA with the injury
identification/ general medical knowledge construct as the dependent variable and age
group as the independent variable revealed no significant difference, F (4,165) = .894,p
= .469. A one-way ANOVA with the CPR construct as the dependent variable and age
group as the independent variable exposed a significant difference, F (4,165) = 2.502, p =
.04. The results ofa post hoc Scheffe test are reported in Table 1 1. The post hoc Scheffe
test revealed that there was no significant difference at thep = 0.05 level for any ofthe

age groups. The largest mean difference was between the oldest and youngest age groups

of coaches. No significant difference was found when a one-way ANOVA was run with
injury management construct as the dependent variable and age group as the independent
variable, F (4,165) = 2.132, p = .079. A one-way ANOVA with the wound care construct
as the dependent variable and age group as the independent variable exposed no

significant difference, F (4,165) = l.051,p = 0.383.

In summary a significant difference in knowledge of the five first aid constructs,
based upon coaches’ age, was found only for the CPR construct. The conservative post
hoc Scheffe test, on the CPR construct, failed to reveal differences between the oldest and

youngest age groups which had the largest and smallest means respectively.

Table 10

Means and Standard Deviations of Five FAA Constructs by Age

 

15-35 36-38 39-41 42-43 44-61
Mean SD Mean SD Mean SD Mean SD Mean SD

 

 

Injury
Prevention
Injury
identification/
tGeneral 5.38 1.33 5.49 1.48 5.06 1.64 5.03 1.54 4.92 1.61
Medical

Knowledge

CPR 2.62 0.85 2.17 0.79 2.34 0.87 2.50 0.86 2.03 1.03

6.65 1.12 6.80 1.11 6.91 0.92 7.10 1.47 7.06 1.12

Injury

5.88 1.04 6.34 1.03 6.14 1.38 6.67 1.32 6.47 1.13
Management

WoundCare 4.44 1.02 4.91 1.04 4.71 0.96 4.73 0.98 4.64 0.90

 

39

Table 1 1

Post hoc Sheffe test for the CPR and Age

 

 

95% Confidence
Interval
Age Group Mean Std Significance Lower Upper
Difference Error Bound Bound
15-35 36-38 .45 .21 .361 -.22 1.11
39-41 .27 .21 .797 -.39 .94
42-43 .12 .22 .991 -.57 .81
44-61 .59 .21 .106 -6.98E-02 1.25
36-38 15-35 -.45 .21 .361 -1.11 .22
39-41 -.17 .21 .956 -.83 .49
42-43 -.33 .22 .695 -1.01 .36
44-61 .14 .21 .976 -.51 .80
39-41 15-35 -.27 .21 .797 -.94 .39
36-38 .17 .21 .956 -.49 .83
42-43 -.16 .22 .972 -.84 .53
44-61 .32 .21 .691 -.34 .97
42-43 15-35 -.12 .22 .991 -.81 .57
36-38 .33 .22 .695 -.36 1.01
39-41 .16 .22 .972 -.53 .84
44-61 .47 .22 .329 -.21 1.15
44-61 15-35 -.59 .21 .106 -1.25 6.98E-02
36-38 -.14 .21 .976 -.80 .51
39-41 -.32 .21 .691 -.97 .34
42-43 -.47 .21 .329 -1.15 .21

 

First Aid Constructs by Years of Coaching Experience

Research question five inquired if coaches differed in knowledge of the five first
aid constructs by the number of years of coaching experience. Three coaches did not
report the number of years of coaching experience and were excluded from the analyses.
The mean years of coaching experience, of the 167 that reported coaching experience,

was 6.65 (SD = 5.55) with a range of0—27 years. Coaches were divided into four nearly

40

 

N \lalnv

.sfhwu . . '.Kp..‘l..a D I \on. .41. ‘.ri|.v... .

fl‘h ‘. 34'2170

equal groups based upon the number of years of coaching experience. Table 12 presents
the distribution of the four groups. The means and standard deviations of the five
constructs by coaching experience are presented in Table 13. Several one-way
ANOVA’s were run using each construct as the dependent variable and years of coaching
experience as the independent variable. The ANOVA with injury prevention as the
dependent variable and the years of coaching experience as the independent variable was
significant, F (3,163) = 4.796, p = .003. Table 14 reports the results ofa post hoc Scheffe
test. The post hoc Scheffe test revealed that there was a significant difference at the p =
0.05 level only between coaches with 5-9 years of coaching experience and coaches with
10-27 years of coaching experience. The other four ANOVA’s were not significant:
injury identification/general medical, F (3, 163) = .388,p = .762; CPR, F (3,163) =
.1.031, p = .380; injury management, F (3, 163) = 1.609, p = .189; and wound care, F
(3,163)=1.021,p = .385.

In summary, of the five first aid constructs, a statistical difference was found only
for the injury prevention construct based upon the years of coaching experience. This
difference was only between coaches with 5-9 years ofcoaching experience and coaches

with 10-27 years of coaching experience.

41

Table 12

Distribution of Coaches Based Upon Four Coaching Experience

 

 

 

Years of Coaching N %
Experience

0-2 37 22.16
3-4 40 23.95
5-9 45 26.95
10-27 45 26.95
Total 167 100
Table 13

Means and Standard Deviations of Five FAA Constructs by Coaching Experience

 

Years of Coaching Experience

 

0-2 3-4 5-9 10-27

Mean SD Mean SD Mean SD Mean SD
Injury Prevention 6.73 1.10 6.78 1.29 660* 1.21 7.42* 0.84
Injury
Identification/
General Medical 5.11 1.41 5.30 1.73 5.00 1.43 5.29 1.56
Knowledge
CPR 2.51 0.77 2.27 0.96 2.38 0.89 2.18 0.96
“Jury 6.16 1.07 6.12 1.20 6.22 1.33 6.62 1.13
Management
Wound Care 4.65 1.09 4.85 0.95 4.49 1.01 4.73 0.89

 

* significant at thep = 0.05 level

Table 14

Post hoc Scheffe test for Injury Prevention Construct and Years of Coaching Experience

 

95% Confidence

 

Interval
Age Group Age Mean Std Significance Lower Upper
Group Difference Error Bound Bound
0-2 3-4 ~4.53E-02 .26 .999 -.77 .68
5-9 .13 .25 .965 -.57 .83
10-27 -.69 .25 .055 -1.39 8.93E-O3
3-4 0-2 4.53E—02 .26 .999 -.68 .77
5-9 .18 .24 .915 -.51 .86
10-27 -.65 .24 .073 -1.33 3.96E-02
5-9 0-2 -.13 .25 .965 -.83 .57
3-4 -.18 .24 .915 -.86 .51
10-27 -.82* .24 .008 -1.49 -.16
10-27 0-2 .69 .25 .055 -8.93E-O3 1.39
3-4 .65 .24 .073 -3.96E-02 1.33
5-9 .82* .24 .008 .16 1.49

 

* the mean difference is significant at the p < 0.05 level

First Aid Constructs by the Number of Sports Coached

Research question six inquired if knowledge of the five first aid constructs

differed by number of sports coached. The mean number of other sports coached was

2.71 sports (SD = 1.57), ranging from 0 to 7. Coaches were divided into four nearly

equal groups based upon the number of sports coached. Table 15 displays the

distribution of coaches based upon the number of sports coached. The means and

standard deviations of the five FAA constructs by number of sports coached for each of

the four groups are presented in Table 16. Several one-way ANOVA’s were run using

43

each construct as the dependent variable and number of sports coached as the
independent variable.

None ofthe ANOVA’s were significant: injury prevention, F (3,166) = 1.854, p =
.139; injury identification/general medical, F (3, 166) = .313,p = .816; CPR, F (3,166) =
1.004,p = .392; injury management, F (3, 166) = 1.178, p = .320; and wound care, F
(3,166) = .049, p = .986. Knowledge ofthe five first aid constructs did not differ by the

number of sports coached.

Table 15

Distribution of Coaches Based Upon Number of Sports Coached

 

 

Number of Sports Coached N %

0-1 44 25.9
2 33 19.4
3 43 25.3
4-7 50 29.4
Total 170 100

 

44

Table 16

Means and Standard Deviations of Five Constructs by Number of Sports Coached

 

0-1 2 3 4-7
Mean SD Mean SD Mean SD Mean SD

 

”Jury. 6.80 1.25 6.58 1.25 7.16 1.04 6.98 1.04
Prevention

Injury

Identification/

General 5.05 1.45 5.36 1.45 5.23 1.80 5.12 1.41
Medical

Knowledge

CPR 2.48 0.88 2.12 0.96 2.35 0.81 2.30 0.95
mm 6.09 1.03 6.21 1.34 6.28 1.14 6.54 1.28
Management

Wound Care 4.68 1.03 4.64 0.93 4.72 0.98 4.70 0.99

 

First Aid Construct by the Educational Background of Coaches

Research question seven examined the issue of whether knowledge of the five
first aid constructs differed based upon a coach’s educational background. The means
and standard deviations of the five constructs by coach’s educational background are
presented in Table 17. Several one-way ANOVA’s were run using each construct as the
dependent variable and educational background as the independent variable. The
ANOVA with injury identification/general medical knowledge was significant, F (9, 160)
= 1.979, p = .045. Appendix F reports the results ofa post hoc Scheffe test. The post hoc
Scheffe test revealed that there was no significant difference at the p = 0.05 level. The
largest mean difference was between the doctoral degree and high school equivalent

groups. The results of the post hoc Scheffe test need to be interpreted with caution due to

45

the low number of members in the high school equivalent, other, some high school, some
college and not specified groups. The AN OVA with injury management was significant
F (9, 160) = 3.320,p = .001. Appendix G reports the results ofa post hoc Scheffe test.
The post hoc Scheffe test revealed that there was no significant difference at the p = 0.05
level. The largest mean difference was between the doctoral degree and some high
school groups. The results of the post hoc Scheffe test need to be interpreted with
caution due to the low number of members in the high school equivalent, other, some
high school, some college, and not specified groups. The other three ANOVA’s were not
significant: Injury Prevention, F (9, 160) = 1.335, p = .223; CPR, F (9,160) = .482,p =

.885; and wound care, F (9,160) = 1.262, p = .262.

46

Table 17
Means and Standard Deviations of the Five FAA Constructs by Educational Background

 

 

Injury
Injury Idegtification/ Injury Wound
. - eneral CPR
Prevention M . Management Care
edical
Knowledge

M so M so M so M so M so
nghSChOOI 77 6.74 1.23 4.81 1.47 2.21 0.95 5.94 1.20 4.56 1.01
Dlploma
H‘gi‘SChOOI 2 7.00 0.00 3.50 0.71 2.50 0.71 6.00 0.00 4.50 0.71
Equ1valent
“5093‘“ 24 7.25 0.99 5.50 1.25 2.50 0.78 6.21 1.06 4.96 0.86
Degree
33mm“ 41 6.93 1.08 5.46 1.61 2.44 0.92 6.61 1.00 4.83 1.00
Degree
M3516“ 10 7.10 1.52 6.00 1.76 2.20 1.14 7.40 1.07 4.70 1.06
Degree
Doc‘oral 7 7.57 0.53 6.29 1.38 2.57 0.53 7.43 0.79 5.14 0.90
Degree

1.41 2.00 1.41 7.00 2.83 4.00 0.00

2 7.00 0.00 5.00

Other
Eggill-Iigh 2 7.50 0.71 4.50 2.12 2.50 0.71 5.50 0.71 5.00 1.41
Some College 2 5.50 0.71 5.00 1.41 2.50 0.71 6.00 1.41 3.50 0.71
Not Specified 3 6.00 0.00 4.67 0.58 2 0.00 6.00 1.73 4.00 0.00
170 6.90 1.15 5.18 1.52 2.32 0.90 6.29 1.20 4.69 0.98

Total

 

'7

Research question seven can also be examined using four groups; high school,

rollege, advanced degree, and other/not specified. The high school group would include

47

 

 

n

 

 

 

 

 

aches that had some high school, graduated high school, or had a high school
quiv alent. The college group contains those coaches that had some college experience,
in associate’s degree, or a bachelor’s degree. The advance degree group would consist of
those that have earned either a master’s or doctoral degree. The last group would consist
of those that had other types of education or that did not specify their educational
background. The means and standard deviations of the five constructs by coach’s
educational background are presented in Table 18. Several one-way ANOVA’s were run
using each construct as the dependent variable and the four educational background
groups as the independent variable. The ANOVA with injury identification/ general
medical knowledge was significant, F (3, 166) = 5.404, p = .001. Table 19 reports the
results of a post hoc Scheffe test. The post hoc Scheffe test revealed that there was a
significant difference at the p = 0.05 level, between the high school and college groups
and between the high school and advanced degree groups. The ANOVA with injury
management was significant, F (3, 166) = 8.944, p = .000. Table 20 reports the results of
apost hoc Scheffe test. The post hoe Scheffe test revealed that there was a significant
difference at the p = 0.05 level. The statistical difference was found between the high
school and advanced degree groups and between the college and advanced degree groups.
The other three ANOVA’S were not significant: injury prevention, F (3, ’166) = 1.535, p =
.207; CPR, F(3,166) = .1.097,p = .352; and wound care, F (3,166) = 1.990,p = .117.
In summary, of the five first aid constructs a significant difference was found for
the injury identification/ general medical knowledge and injury management constructs,
based upon educational background. The significant difference for the injury

identification/general medical knowledge was found between the high school and college

48

groups and between the high school and advanced degree groups. The significant
difference for injury management was between the high school and advanced degree
groups and between college and advanced degree groups.

Table 18

Means and Standard Deviations of Five Constructs by Educational Background Groups

 

Injury
. Identifieation/ .
N Injury General CPR Injury Wound
Prevention . Management Care
Medical
Knowledge

M SD M SD M SD M SD M SD

 

HighSchool 81 6.77 1.21 4.77* 1.47 2.22 0.94 593* 1.17 4.57 1.00

College 67 7.00 1.07 546* 1.47 2.46 0.86 645* 1.03 4.84 0.96
Advanced 17 7.29 1.21 612* 1.58 2.35 0.93 741* 0.94 4.88 0.99
Degree
OtheF/Nm 5 6.40 0.55 4.80 0.84 2.00 0.71 6.40 1.95 4.00 0.00
Spec1fied
Total 170 6.90 1.15 5.18 1.52 2.32 0.90 6.29 1.20 4.69 0.98

 

* significant at the p < 0.05 level

49

Table 19

Post/10c Scheffe test for Injury Identification/General Medical Knowledge Construct and

Four Educational Background Groups

 

 

95% Confidence
Interval
Educational Educational Mean Std Significance Lower Upper
Group Group Difference Error Bound Bound
High School College -.70* .24 .044 -1.38 ‘18:};-
Advanced -1.35* .39 .009 -2.46 -.25
Degree
Other/Not
Specified -3.46E-02 .68 1.000 -1.95 1.88
College High School .70* .24 .044 1.25E-02 1.38
Advance‘i -.65 .40 .443 -1.78 .47
Degree
Other/Not
Specified .66 .68 .814 -1.26 2.58
Advanced High School 135* .39 .009 .25 2.46
Degree
College .65 .40 .443 -.47 1.78
Other/Not
Specified 1.32 .75 .378 -.79 3.43
0316’me High School 3.46E-02 .68 1.000 -1.88 1.95
Spec1fied
College -.66 .68 .814 -2.58 1.26
Advanced -132 .75 .378 —3.43 .79
Degree

 

‘ the mean difference is significant at the p < 0.05 level

Table 20

Post hoc Scheffe test for Injury Management Construct and Four Educational

 

 

Background Groups
95% Confidence
Interval
Educational Educational Mean Std Significance Lower Upper
Group Group Difference Error Bound Bound
High School College -52 .19 .051 -1.05 2%7315-
Advanced -1.49* .30 .000 -233 -.64
Degree
Other/Not
Specified -.47 .52 .840 -1.94 .99
College High School .52 .19 .051 -2.07E-03 1.05
Advanced -.96* .31 .021 -1.83 -.10
Degree
Other/Not
Specified 4.78E-02 .52 1.000 -1.42 1.52
Advanced High School 149* .30 .000 .64 2.33
Degree
College .96* .31 .021 .10 1.83
Other/Not
Specified 1.01 .57 .374 -.60 2.63
Other/Not .
Specified High School .47 .52 .840 -.99 1.94
College -4.78E-02 .52 1.000 -1 .52 1.42
Advanced .101 .57 .374 -2.63 .60
Degree

 

* the mean difference is significant at the p < 0.05 level

51

fl” "

 

 

First Aid Constructs by Gender of Athletes Coached

Research question eight was concerned with whether coaches differed in
knowledge of the five constructs by the gender of the athletes they coached. The gender
of the athletes coached was known for all 290 participants. Table 21 illustrates the
distribution of coaches based upon the gender of athletes coached. Table 22 illustrates
the distribution of gender of athletes coached by gender of coach. The means and
standard deviations of the five FAA constructs by gender of athletes coached are
presented in Table 23. Several one-way AN OVA’s were run using each construct as the
dependent variable and gender of athletes coached as the independent variable. The
ANOVA with injury identification/ general medical knowledge was significant, F (2, 287)
= 4.017,p = .019. Table 24 reports the results of a post hoc Scheffe test. The post hoc
Scheffe test revealed that there was a significant difference at the p = 0.05 level only
between the coaches that coached predominantly male and predominantly female
athletes. The results of the post hoc Scheffe test need to be interpreted with caution due
to the low number of coaches in the even mix of males and females group. The other
four ANOVA’s were not significant: Injury Prevention, F (2, 287) = .661, p = .517; CPR,

F (2,287) = .549,p = .578; injury management, F (2, 287) = 2.156,p = .118; and wound
care, F (2,287) = .065, p = .937.

52

 

.A..n

...I-I4..aa. pla ...._...fl

. 97! final]...
4.

 

Table 21

Distribution of Coaches by Gender of Athletes Coached

 

 

 

 

 

Gender of Athletes N %
Predominantly Male 252 86.90
Predominantly Female 31 10.69
Even Mix of Males & 7 2.41
Females
Total 290 100
Table 22
Distribution of Gender of Athletes by Gender of Coaches
Gender of Athletes Gender of Coach
Female Male Missing
Predominantly Male 2 128 122
Predominantly 1 1 20 0
Female
Even Mix of Males 2 4 l
& Females
Total 15 152 123

 

53

Table 23

Means and Standard Deviations of Five Constructs by Gender of A thletes Coached

 

 

 

 

 

 

Predominantly Male Predominantly Even Mix of Males
Female and Females
Mean SD Mean SD Mean SD
Injury Prevention 6.88 1.22 7.13 1.12 6.71 0.76
Injury identification/
General Medical 486* 1.55 561* 1.65 5.71 1.98
Knowledge
CPR 2.37 0.91 2.32 0.91 2.71 0.76
Injury Management 6.07 1.27 6.55 1.21 5.86 1.07
Wound Care 4.60 1.05 4.65 0.91 4.71 1.11

 

* significant at thep < 0.05 level

54

Table 24
Post hoc Shefle test for Injury identification/ General Medical Knowledge Construct and

Gender of Athletes Coach ed

 

 

95% Confidence
Interval
Gender of Mean Std Significance Lower Upper
Athletes Difference Error Bound Bound
Coached
Predominantly Predominantly —.76* .30 .043 -1.49 -1.93E-
Male Female 02
Even Mix of -.86 .60 .365 -2.34 .63
Males and
Females
Predominantly Predominantly .76* .30 .043 1.93E- 1.49
Female Male 02
Even Mix of -.10 .66 .988 —1.72 1.52
Males and
Females
Even Mix of Predominantly .86 .60 .365 -.63 2.34
Males and Male
Females
Predominantly . 10 .66 .988 -1.52 1.72
Female

 

* the mean difference is significant at the p = 0.05 level

First Aid Constructs by Formal First Aid Training
Research question nine was concerned with whether coaches differed in
knowledge of the five constructs by formal first aid training. Coaches reported if they
had ever had any type of formal first aid training. The means and standard deviations of

the five constructs by fomlal first aid training are presented in Table 25. Several one-way

55

ANOVA’s were run using each construct as the dependent variable and formal first aid
training as the independent variable. The AN OVA with injury prevention as the

dependent variable was close to being significant, F (1, 168) = 3.397,p = .067. The
ANOVA with injury identification/ general medical knowledge as the dependent variable
was significant, F (1, 168) = 4.223, p = .041. The ANOVA with injury management was
significant, F (1, 168) = 5.382, p = .022. The ANOVA with wound management was
significant F= (1, 168) = 5.702,p = .018. The ANOVA with CPR was not significant, F
= .033, p = .856. In summary knowledge of injury identification/ general medical
knowledge, injury management, and wound management differed by whether a coach

had previous formal first aid training, with those that had previous formal first aid

training having more knowledge.

Table 25
Means and Standard Deviations of Five Constructs by Formal First Aid Training

Formal First Aid Training

 

Yes No
Mean SD Mean SD

Injury Prevention 7.04 1.15 6.72 1.13
Injury Identification/ General Medical 539* 1.64 491* 1.32
Knowledge
CPR 2.31 0.94 2.34 0.85
Injury Management 648* 1.29 605* 1.03

484* 1.00 4.49* 0.93

Wound Care

* significant at thep < 0.05 level
First Aid Constructs by American Red Cross First Aid Training

Research question ten was concerned with whether first aid training by the

American Red Cross altered the responses to the questions on the FAA. There are three

56

classes that one can take to become American Red Cross First Aid Trained, i.e., Basic

First Aid Training, Infant/Child/Adult CPR with First Aid Training, or Community First
Aid. The three ways to be certified were combined for the analysis of the first aid

constructs by American Red Cross first aid training. Sixty-two coaches reported having
been American Red Cross first aid trained. The mean for the trained coaches was 25.58
(SD = 3.85) and ranged from 14-33. The means and standard deviations of the five FAA
constructs by those trained in American Red Cross first aid training and those not trained
are presented in Table 26. Several one-way ANOVA’s were run using each construct as
the dependent variable and American Red Cross first aid training as the independent
variable. None ofthe ANOVA’s were significant: injury prevention, F (1,168) = .518,p
= .473; injury identification/general medical, F (1, 168) = .012, p = .912; CPR, F (1 ,168)
= .799,p = .373; injury management, F (1, 168) = .010, p = .919; and wound care, F

(1,168) = 2.848,p = .093. Knowledge ofthe five first aid constructs did not differ by

whether a coach was American Red Cross first aid trained.

57

 

 

 

Table 26

Means and Standard Deviations of Five FAA Constructs by American Red Cross First

Aid Training

 

American Red Cross First Aid Training

 

Yes No
Mean SD Mean SD

Injury Prevention 6.98 1.19 6.85 1.13
Injury Identification/

General Medical 5- 19 1.68 5.17 1.44
Knowledge

CPR 2.24 0.92 2.37 0 .89
Injury Management 6.31 1.28 6.29 1.16
Wound Care 4.85 1.01 4.59 0.96

 

First Aid Constructs by CPR Training

Research question eleven inquired if there was a difference in the, knowledge of the

first aid constructs based on having CPR training. In the demographic sheet coaches

were asked if they had been American Red Cross CPR trained and/or American Heart

CPR trained. For this analysis it was not important where the coaches received their

training but rather was there a difference in the first aid knowledge based upon a coach

either being CPR trained or not being CPR trained. Coaches that were American Red

Cross and American Heart CPR trained were combined into one group, those having been

CPR trained. Seventy-nine coaches reported having been CPR trained, and had a mean

score on the FAA of 26.1 1, (SD = 3.70) with a range of 14-33. Table 27 illustrates the

distribution of coaches that had first aid training and CPR.

58

The means and standard deviations of the five FAA constructs by CPR training are
presented in Table 28. A one-way ANOVA with injury prevention construct as the
dependent variable and CPR training as the independent variable revealed no significant
difference, F (1,168) = 2.14l,p = .145. A one-way ANOVA with the injury
identification/ general medical knowledge construct as the dependent and CPR training as
the independent variable revealed a significant difference, F (1,168) = 4.609, p = .033. A
one-way ANOVA with the CPR construct as the dependent variable and CPR training as
the independent variable revealed no significant difference, F (1,168) = 1.255, p = .264.
A nearly significant difference was found when a one—way AN OVA was run that had the
injury management construct as the dependent variable and CPR training as the
independent variable, F (1, 168) =3.637,p = .058. A significant difference was found
when a one-way ANOVA was run that had the wound care construct as the dependent

variable and CPR training as the independent variable, F (1 , 168) = 7.959, p = .005.

In summary a significant difference in knowledge of the five first aid constructs,
based upon CPR certification, was found for injury identification/ general medical
knowledge and wound care. Coaches that were CPR trained had a higher mean score on
the injury identification/general medical knowledge and wound care constructs. While
knowledge ofinjury prevention, CPR, and injury management did not differ by a coach

being CPR trained.

59

Table 27

Distribution of First Aid Training by CPR Training

 

 

CPR Training
Yes No Total
Yes 61 18 79
First Aid Training No l 90 91
Total 62 108 170

 

Table 28

Means and Standard Deviations of Five Constructs by CPR Training

 

 

CPR Training
Yes No
Mean SD Mean SD

Injury Prevention 7.04 1.17 6.78 1.12
Injury identification/

General Medical 544* 1.62 495* 1.41
Knowledge

CPR 2.24 0.91 2.40 0.89
Injury Management 6.48 1.29 6.13 1.10
Wound Care 4.91* 0.94 4.49* 0.98

 

* significant at thep < 0.05 level

60

 

 

First Aid Constructs by Current First Aid Certification

Differences in the knowledge of the first aid constructs based upon currently
being First Aid certified was the focus of research question twelve. The means and
standard deviations of the five FAA constructs by current first aid certification are
presented in Table 29. The mean score on the FAA, for the twenty-one coaches that
reported being currently first aid certified, was 26.14 (SD = 5.28) with scores ranging
from 14-33. Several one-way AN OVA’s were run using each construct as the dependent
variable and current first aid certification as the independent variable. The one way
ANOVA with the wound care construct as the dependent variable and current first aid
certification as the independent variable exposed a significant difference, F (1, 168) =
6.491, p = .012. The other four ANOVA’s were not significant: injury prevention, F
(1,168) = .148,p = .701; injury identification/general medical, F(1, 168) = .2032, p =
.156; CPR, F(1,168) = .521,p = .471; and injury management, F (1, 168) = .025,p =
.873.

In summary, wound care knowledge differed by current first aid certification.
Those having current first aid certification had a higher mean score on the wound care
construct. The other four first aid constructs did not differ by whether a coach was

currently first aid certified.

61

Table 29

Means and Standard Deviations of Five Constructs by Current First Aid Certification

 

Current First Aid Certification

 

Yes No

Mean SD Mean SD
Injury Prevention 6-81 1-44 6.91 1.1 l
Injury Identification/ _
General Medical 5 92 1.94 5 .1 1 1.45
Knowledge
CPR 2.19 1.03 2.34 0.88
Injury Management 6.33 1.65 6.29 1.13
Wound Care 519* 1.12 4.62* 0.94

 

* significant at thep < 0.05 level
First Aid Constructs by Current CPR Certification.

Research question thirteen investigated whether there was a difference in
knowledge of the five first aid constructs based upon whether a coach was currently CPR
certified. Thirty coaches reported being current CPR certified, M = 26.33 (SD = 4.25),
with scores ranging from 14-33. The means and standard deviations of the five
constructs by current CPR certification are presented in Table 30. A one-way ANOVA
with the injury prevention construct as the dependent variable and current CPR
certification as the independent variable revealed no significant difference, F (1,168) =
.122, p = .727. A one-way AN OVA with the injury identifieation/ general medical
knowledge construct as the dependent variable and current CPR certification as the
independent variable revealed an almost significant difference, F (1,168) = 3.830, p =
.052. A one-way ANOVA with the CPR construct as the dependent variable and current

CPR certification as the independent variable revealed no significant difference, F

6

[Q

(1,168) = .683,p = .410. No significant difference was found when a one-way ANOVA
was run that had the injury management construct as the dependent variable and current
CPR certification as the independent variable, F (1, 168) = .752,p = .387. A significant
difference was found when a one—way ANOVA was run that had the wound care
construct as the dependent variable and current CPR certification as the independent

variable, F (l, 168) = 9.088,p = .003.

In summary, wound care knowledge differed based upon whether a coach was
currently CPR certified. Coaches that were currently CPR certified had a higher mean
score than those that were not currently CPR certified. Knowledge about the other four

first aid constructs did not differ based upon current CPR certification.

Table 30

Means and Standard Deviations of Five Constructs by Current CPR Certification

 

Current CPR Certification

 

Yes No
Mean SD Mean SD

Injury Prevention 6.83 1.32 6.91 1.12
Injury identification/

General Medical 5.67 1.84 5.07 1.43
Knowledge

CPR 2.20 1.00 2.35 0.88
Wound Care 517* .83 459* 0.98

 

* significant at the p = 0.05 level

63

Game Situation Data Sheet

The Game situation Data Sheet was completed by 284 (97.9%) of the 290
coaches. All nine of the scenarios were responded to by 223 (76.9%) of the 290 coaches.
Table 31 indicates the frequency of responses to each of the game scenarios. Coaches
returned an injured athlete 25% of the time. Coaches varied considerably based upon
game situations when deciding to return a starter to play. In a game that the team was
clearly winning, 31.7% of the coaches returned the starter, while when the team was
clearly losing the game, only 14.8% of coaches returned the starter. However, when the
game situation had their team was down by five points, 45.4% of the coaches returned the
starter. In a clearly winning situation or clearly losing situation, 13.4% and 10.9% of
coaches, respectively, returned a backup player. Similar to the close game situation with
a starter, 45.3% of coaches returned a backup player when it was a close game situation.
Coaches’ decisions to return a bench player varied based upon game situation and varied
from the decisions made for starters and backup players. In a game that the team is
clearly winning, 13.4% of the coaches returned an injured bench player, while in a game
that the team is clearly losing, 32.7% of the coaches returned an injured backup player.
When the game situation had the team down by four points, 23.2% of coaches returned
an injured back up player. The percentage of coaches that returned an injured athlete to
play varied not only by the game situation but the type (starter, backup, or bench player)
of athlete involved. To assess the reliability of the GSDS, Chrombac’s alpha was

calculated. Chrombac’s alpha for the nine game scenarios was .5445. The results need to

interrupted with caution.

64

Table 31

Frequency of Responses to Game Situation Data Sheet

 

 

Game Situation ' Not
Y

es No Answered Total
Player that is third off the
bench in a clearly losing 31 253 6 290
suuafion
Slam? ‘“ .a “69‘” 90 194 6 290
Winning Situation
Bench player in a clearly 38 246 6 290
Winning Situation
Starter in a game thatthe 129 155 6 290
team is down by 5 pornts
Bench player in a game
that the team is down by 4 66 218 6 290
points
Backup player in a clearly 38 246 6 290
Winning Situation
Starter in a clearly losrng 42 242 6 290
Situation
B‘i‘CkP‘p Player)“ a Close 101 122 67 290
Winning Situation
Bench player in a clearly 73 1 50 67 290
losrng Situation
Total 608 1826 176 2610

 

Game Situation Data Sheet by First Aid Assessment Pass/F ail

The first question pertaining to the Game Situation Data Sheet was whether or not
coaches differed in returning an injured athlete to competition based upon passing or
failing the First Aid Assessment. Chi-square analysis was conducted on the nine game

situations by pass/fail of First Aid Assessment. Table 32 presents the Pearson Chi-

65

Square value and the probability for each ofthe situations. Appendix H and Table 33

illustrate the actual and expected counts for each game situation.

Coaches differed by whether or not they passed or failed the First Aid Assessment in
returning an injured starter in a clearly winning game. Examining Table 34 (Starter in a
Clearly Winning Competition Situation by Pass/Fail First Aid Assessment), more
coaches that failed the First Aid Assessment than expected returned the injured starter,
while more coaches that passed the assessment than expected did not retum the injured

starter.

In summary, when the team was clearly winning those that failed the First Aid
Assessment were more likely to return the starter to play. Those that passed the First Aid
Assessment were more likely not to return the starter in a clearly winning situation.
Coaches did not differ, by passing/failing of First Aid Assessment, on the other eight

game situations.

66

Table 32

Pearson Chi-Square for Game Situation Data Sheet by Pass/F ail First Aid Assessment

 

Situation Pearson Chi-
Square Value df p

 

Player that is third off the

bench in a clearly losing .294 1 .588
situation

Starter in a clearly Winning 4.581 1 032*
Situation

Bench player in a clearly .616 1 .433
Winning Situation

Starter in a game that the team .188 1 .665
is down by 5 pornts

Bench player in a game that

the team is down by 4 points '104 1 '747
Backup player in a clearly .616 1 .433
Winning Situation

Starter in a clearly losmg 2.748 1 .097
Situation

Backup player in a close .847 1 .3 57
Winning Situation

Bench player in a clearly .060 1 .806

losing situation

 

* significant at the p = 0.05 level

67

Table 33

Starter in a Clearly Winning Competition Situation by Pass/Fail of First Aid Assessment

 

 

FlrSt Ald Game Situation Two T0131
Assessment
Yes N0
Count 89 180 269
F2111 Ex
pected
Count 852 183.8 269
Count 1 14 15
Pass Ex
pected
Count 48 10.2 15
Count 90 194 284
Total Ex
pected
Count 90 194 284

 

Game Situation Data Sheet by Sport Coached

The second question related to the Game Situation Data Sheet is whether there is a

difference when coaches return an injured athlete to competition based upon the sport

that they coach. Chi-square analysis was conducted on the nine game situations by sport

coached. Table 34 presents the Pearson Chi-Square value and the probability for each of

the situations. Appendix I and Table 35 illustrate the actual and expected counts for each

game situation. Coaches differed by sport in returning an injured bench player in a

clearly losing game situation. Table 35 (Bench Player in a Clearly Losing Situation by

Sport) reveals that more soccer coaches than expected returned the injured bench player,

while less than expected basketball and football coaches retumed the injured bench

68

player. Soccer coaches were more likely than expected to return an injured bench player
to competition in a clearly losing game situation, while basketball and football coaches
were less likely than expected to return the same athlete in the same situation back to

competition.

In summary, compared to football and basketball coaches, soccer coaches were more
apt to return an injured bench player in a losing game situation. Coaches did not differ,

by sport coached, in returning an injured athlete to play in the other eight game situations.

69

Table 34

Pearson Chi-Square for Game Situation Data Sheet by Sport

 

 

Situation Pearson Chi-

Square Value df p
Player that is third off the
bench in a clearly losing .128 2 .938
situation
Starter in a clearly Winning .474 2 .789
Situation
Bench player in a clearly 2.288 2 .319
Winning Situation
Starter in a game that the team 1.861 2 .394
is down by 5 pornts
Bench player in a game that
the team is down by 4 points 1044 2 '593
Backup player. in a clearly .308 2 .857
Winning Situation
Starter in a clearly losmg 2.305 2 .316
Situation
Backup playerin a close 4779 2 .092
Winning Situation
Bench player in a clearly 6.073 2 0. 48*

losing situation

 

* Significant at the p = 0.05 level

70

 

 

 

 

'§.q.’.xeuj:r: a. .
f.

S

m

Table 35

Bench Player in a Clearly Losing Situation

 

 

Sport Game Situation Nine Total
Yes N0
Count 57 125 182
Football Ezfiiited 59.6 122.4 182
Count 6 18 24
Basketball Egigted 7.9 16, 1 24
Count 10 7 17
Soccer Ezgiited 5 .6 1 1.4 17
Count 73 15 O 223
T0131 5:13;:th 73 150 223

 

Game Situation Data Sheet by Gender

It is of interest whether coaches differed by gender in returning an injured athlete to

competition. Chi-square analyses were conducted on the nine game situations by gender.

Table 36 presents the Pearson Chi-Square value and the probability for each of the

situations. Appendix J and Tables 37 and 38 illustrate the actual and expected counts for

each game Situation. Coaches differed by gender in returning an injured starter in a

clearly winning game and a close game. Examining Table 37 (Starter in a Clearly

Winning Competition Situation by Gender) more males than expected did not return the

71

L‘ P'AL nevu- - ".31-lash

 

‘O'i
. .
‘ :2
Sat.
,. ..
. r"
no 5
..,.
‘Att

W;\.'

“V.“

‘4‘ll

(Li

‘1.
'41.

 

 

injured starter, while more females than expected returned the injured starter. Examining
Table 38 (Starter in a Game that the Team is Down by 5 Points by Gender) more males
than expected returned the injured starter while more females than expected did not

return the injured starter.

In summary, male and female coaches differed in returning an injured starter to play
in two Situations. When the team was clearly winning, more female coaches than
expected returned the athlete to play, while more male coaches than expected did not
return the athlete to play. However, when the game is close and their team is down by
five points, more males than expected returned the injured athlete, while more females
than expected did not return the athlete to play. Coaches did not differ, by gender, in

returning an injured athlete in the other seven game situations.

Table 36

Pearson Chi-Square for Game Situation Data Sheet by Gender

 

 

Situation Pearson Chi-

Square Value df p
Player that is third off the
bench in a clearly losing .461 1 .497
Situation
Starter in a clearly Winning 6.936 1 .008*
Situation
Bench player in a clearly .091 1 .764
Winning Situation
Starter in a game that the team 4194 1 .041”,
is down by 5 pornts
Bench player in a game that
the team is down by 4 points '39] 1° '532
Backup player. in a clearly .457 1 .499
Winning Situation
Starter in a clearly losrng .581 1 .446
Situation
Backup player. in a close .377 1 .539
Winning Situation
Bench player in a clearly 2.506 1 .1 13

losing situation

 

* Significant at the p = 0.05 level

73

Table 37

Starter in a Clearly Winning Competition Situation by Gender

 

 

Gender Game Situation Two Total
Yes No
Count 40 107 147
Male EX
pected
Count 44.5 102.5 147
Count 9 6 15
Female Ex
. pected
Count 4.5 10.5 15
Count 49 113 162
Total Ex
pected
Count 49 113 162

 

74

 

Ii) .21-75 " '

 

Table 38

Starter in a Game that the Team is Down by 5 Points by Gender

 

 

Gender Game Situation Four Total
Yes No
Count 70 77 147
Male ExPeCte‘i 66 2 80 8 147
Count ' '
Count 3 12 15
Female Ex
pected
Count 6.8 8.2 15
Count 73 89 162
Total Ex
pected
Count 73 89 162

 

Game Situation Data Sheet by Age

The fourth question related to the Game Situation Data Sheet is whether there is a

difference when coaches return an injured athlete to competition based upon coaches’

age. Chi-square analyses were conducted on the nine game Situations by age. Table 39

presents the Pearson Chi-Square value and the probability for each of the Situations.

Appendix K and Table 40 illustrate the actual and expected counts for each game

Situation. Coaches differed by age in returning an injured bench player in a clearly losing

game situation. Table 40 (Bench Player in a Clearly Losing Situation by Sport) reveals

that more coaches than expected in the 44-62 age group withheld a bench player in a

75

 

JIIIE
4..

clearly losing Situation, while more coaches than expected in the 37 and below age group

returned an injured bench player in the same situation.

In summary, coaches in the 44-62 age group were more likely to keep an injured
bench player from returning in a game that they were clearly losing. However, coaches
in the 37 years of age and below group were more likely to return an injured bench player
in a losing contest. Coaches did not differ in returning an injured athlete in the other

eight game Situations.

76

Table 39

Pearson Chi—Square for Game Situation Data Sheet by Age

 

Situation Pearson Chi-
Square Value df p

 

Player that is third off the

bench in a clearly losing 1.891 3 .595

situation

Starter in a clearly Winning 3.778 3 .286
Situation

Bench player in a clearly .864 3 .834
Winning Situation

Starter in a game that the team 4250 3 .236
18 down by 5 pornts

Bench player in a game that

the team is down by 4 points 2362 3 '50]

Backup player. in a clearly .5 54 3 .907
Winning Situation

Starter in a clearly losrng .215 3 .975

Situation

Backup player. in a close 2795 3 .424
Winning Situation

Bench player in a clearly 9.969 3 .019...

losing situation

 

* Significant at the p = 0.05 level

77

 

 

 

 

. .Eii or. . iii: .

‘u

Table 40

Bench Player in a Clearly Losing Situation by Age

 

 

Age Game Situation Nine Total
Yes No

Count 18 22 40
37 and
below EXPCCted 13 6 26 4 40

Count ' '

Count 16 19 35
3840 ExPeCted 11 9 23 1 35

Count ' '

Count 6 21 27
41-43

ExPeCted 9.2 17.8 27

Count

Count 5 25 30
44-62

ExPeaed 10.2 19.8 30

Count

Count 45 87 132
Total

EXpeaed 45 87 132

Count

 

Game Situation Data Sheet by Years of Coaching

The fifth question related to the Game Situation Data Sheet is whether there is a
difference when coaches return an injured athlete to competition based upon years of
coaching experience. Chi-square analyses were conducted on the nine game Situations by

years of coaching experience. Table 41 presents the Pearson Chi-Square value and the

78

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. . . . ,. u
.' ~'."" on I . ‘4'2‘-

1

0
‘

.rx- ».

 

 

. .., .
N"fl,“\,"l" t‘
L.‘t.ul.r‘ru' i\.
l I

.‘t’h‘fl’ll ‘1 .
v‘.‘\{~\ \\\4 \0 N
1
Pruning. '
.t‘.t‘...l.il‘_ 3‘.
.
,-" v
2 1.3'7“ ‘HV
shunt Lin-4‘
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*"13 m we;

.11.» .11.;1‘

 

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1'1rl'ur7)'
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probability for each of the situations. Appendix L and Table 42 illustrate the actual and
expected counts for each game situation. Coaches differed by years of coaching in
returning a starter in a game when their team was down by 5 points. Table 42 (Starter in
a Game that the Team is Down by 5 Points) shows that more coaches than expected in
the 0-2 years of coaching experience group withheld the starter in a close game Situation,
while more coaches than expected in the 5-9 years of coaching experience group returned

an injured starter in the same Situation.

In summary coaches with 0-2 years of coaching experience were more likely to keep
an injured starter from returning in a close game. However, coaches with 5-9 years of
coaching experience were more likely to return an injured starter in a close contest.
Coaches did not differ on the other eight game Situations by years of coaching

experience.

79

Table 41

Pearson Chi-Square for Game Situation Data Sheet by Years of Coaching

 

 

Situation Pearson Chi-

Square Value df p
Player that is third off the
bench in a clearly losing 7.393 3 .060
Situation
Starter in a clearly Winning 4.048 3 .256
Situation
Bench player in a clearly 4.095 3 .25 1
Winning Situation
Starter in a game that the team 8.768 3 030*
IS down by 5 pornts
Bench player in a game that
the team is down by 4 points 3'145 3 '370
Backup player in a clearly 2.952 3 .399
Winning Situation
Starter in a clearly los1ng .863 3 .834
Situation
Riel?” player. ‘“ a Close 1.784 3 6.18
Winning Situation
Bench player in a clearly 1.605 3 .658

losing Situation

 

* Significant at the p = 0.05 level

80

. v1.46". «9 i

 

m‘b- -' ‘ " ‘2 " V". J.‘V- .

 

 

\‘\r!'\r r

Jun ~y! suk

«
an
§_(
if}-

P
v . ‘ r.
‘- «The

 

,
.‘gfi’
" 1 r
-‘u U‘
u .‘ )2
1 "-
2‘.
“-1: .2",
, 5‘ J‘s.
\
H
”a.

, "J'.
:- t-«M .
-~. .~
‘ ‘Mlfi ."r.
v

 

Table 42

Starter in a Game when the T eam is Down by 5 Points

 

 

Years .Of Game Situation Four Total
Coaching
Yes No

Count 10 25 35
0 - 2

Expected Count 16 19 35

Count 16 24 40
3 - 4

Expected Count 18.3 21.7 40
5 9 Count 26 17 43

Expected Count 19.6 23.4 43

Count 22 22 44
10 - 27

Expected Count 20.1 23.9 44

Count 74 88 162
Total

Expected Count 74 88 162

 

Game Situation Data Sheet by Number of Sports Coached

The sixth question associated with the game situation data sheet was whether

there was a difference in when a coach would return an injured athlete to competition

based upon the number of sports that the coach had experience coaching. Chi-square

analyses were conducted on the nine game situations by number ofsports coached. Table

43 presents the Pearson Chi-Square value and the probability for each ofthe situations.

81

 

. --
u.~.
-,.
,:...
in“.
H; y
dun-4

‘

~

\

a
>-/
.

1“

(f)

(I)

cu

(/)

l
A

(ll

 

Appendix M illustrates the actual and expected counts for each game situation. Coaches

did not differ on the nine game situations by number of sports coached.
Table 43

Pearson Chi-Square for Game Situation Data Sheet by Number of Sports Coached

 

Situation Pearson Chi-
Square Value df p

 

Player that is third off the

bench in a clearly losing 1.065 3 .785
situation

Starter in a clearly Winning 2.274 3 .517
Situation

Bench player in a clearly 6.005 3 .1 11
Winning Situation

Starter in a game that the team 3944 3 .268
is down by 5 pomts

Bench player in a game that

the team is down by 4 points 2'708 3 '439
Backup player. in a clearly .918 3 .821
Winning Situation

Starter in a clearly losmg 3.729 3 .292
Situation

Backup player in a close .920 3 .821
Winning Situation

Bench player in a clearly 2.570 3 .463

losing situation

 

Game Situation Data Sheet by Educational Background

The seventh question related to the Game Situation Data Sheet is whether there

was a difference when coaches return an injured athlete to competition based on

JW'L'S.

 

 

, .
‘39- \v'

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is J
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educational background. Chi-square analyses were conducted on the nine game situations
by educational background. Table 45 presents the Pearson Chi-Square value and the
probability for each of the situations. Appendix N illustrates the actual and expected
counts for each game situation. Coaches did not differ on the nine game situations by

educational background.
Table 44

Pearson Chi-Square for Game Situation Data Sheet by Educational Background

 

Situation Pearson Chi-
Square Value df R

 

Player that is third off the

bench in a clearly losing 5.778 3 .123
situation

Starter in a clearly Winning 4.022 3 .259
Situation

Bench player in a clearly 1.269 3 .737
Winning Situation

Starter in a game that the team .940 3 .81 6
18 down by 5 pomts

Bench player in a game that

the team is down by 4 points 1216 3 '749
Backup playerin a clearly 1.921 3 .589
Winning Situation

Starter in a clearly losmg 2.882 3 .410
Situation

Backup playernin a close 4519 3 .211
Winning Situation

Bench player in a clearly 2.320 3 .509

losing Situation

 

83

 

Ill‘ .1 W’L’j

.‘4‘ r J—‘yflwq

 

 

.A
'T“

M

in

, ~.
3";‘1i-09
. lb. “L...

N. -.... f

. \

v. \ ,-;"
Ll... 4L1

3"" ‘ 39

:e..\.5‘ U?

Game Situation Data Sheet by Gender of Athletes

The eighth question pertaining to the Game Situation Data Sheet is whether there
was a difference when coaches return an injured athlete to competition based upon
gender of the athletes. Chi-square analyses were conducted on the nine game situations
by gender of the athletes coached. Table 46 presents the Pearson Chi-Square value and
the probability for each of the Situations. Appendix 0 illustrates the actual and expected
counts for each game situation. Coaches did not differ on the nine game situations by

gender of athletes coached.

84

p4,:

' h? ~‘QV '3‘h'1"'W'"-‘T‘)IN"P :

 

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,~v

i'w ‘ x

n5uh¢sn\

Di '1‘. '3'

1 ”my,
.

5W1“ i

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z .
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A... ‘

Q. 1”,)?
I

~ nu .y
“9 9.
EHLQHL
agn‘aL
\u'sh]

"K1599“

““HAAE

Table 45

Pearson Chi-Square for Game Situation Data Sheet by Gender of Athletes

 

 

Situation Pearson Chi-

Square Value df p
Player that is third off the
bench in a clearly losing 2.801 2 .246
Situation
Starter in a clearly Winning 1.967 2 .374
Situation
Bench player in a clearly 1.820 2 .403
Winning Situation
Starter in a game that the team 2.848 2 .241
18 down by 5 pomts
Bench player in a game that
the team is down by 4 points 3877 2 '144
Backup player. in a clearly .332 2 .847
Winning Situation
Starter in a clearly losmg .094 2 .954
Situation
B‘i‘th‘p player. 1“ a Close 1.414 2 .493
Winning Situation
Bench player in a clearly 3.321 2 .190

losing situation

 

Game Situation Data Sheet by Formal First Aid Training

Whether there was a difference in when a coach returns an injured athlete to
competition based upon the coaches’ formal first aid training was of interest to this study.
Chi-square analyses were conducted on the nine game situations by formal first aid

training. Table 47 presents the Pearson Chi-Square value and the probability for each of

85

 

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the Situations. Appendix P illustrates the actual and expected counts for each game

situation. Coaches did not differ on the nine game situations by formal first aid training.
Table 46

Pearson Chi-Square for Game Situation Data Sheet by Formal First Aid Training

 

Situation Pearson Chi-
Square Value df p

 

Player that is third off the

bench in a clearly losing .303 1 .582
Situation

Starter in a clearly Winning 3.521 1 .061
Situation

Bench player in a clearly .007 1 .935
Winning Situation

Starter in a game that the team .515 1 .473
18 down by 5 pomts

Bench player in a game that

the team is down by 4 points 1574 1 '210
Backup player. in a clearly .002 1 .963
Winning Situation

Starter in a clearly losmg 1.373 1 .241
Situation

Backup player-1n a close 2.778 1 .096
Winning Situation

Bench player in a clearly .164 1 .685

losing Situation,

 

Game Situation Data Sheet by American Red Cross First Aid Training

The tenth question related to the Game Situation Data Sheet is Whether there was

a difference when coaches return an injured athlete to competition based on the coaches’

86

American Red Cross first aid training. Chi-square analysis was conducted on the nine
game situations by American Red Cross first aid training. Table 48 presents the Pearson
Chi-Square value and the probability for each of the situations. Appendix Q illustrates
the actual and expected counts for each game Situation. Coaches did not differ on the

nine game situations by American Red Cross first aid training.

Table 47

Pearson Chi-Square for Game Situation Data Sheet by American Red Cross First Aid

 

 

Training
Situation Pearson Chi-
‘ Square Value df p
Player that is third off the
bench in a clearly losing .010 1 .919
situation
Starter in a clearly Winning 1.496 1 .221
Situation
Bench player in a clearly 1.117 1 .291
Winning Situation
.Starter in a game that the team ‘ 008 1 .930
1 3 down by 5 pomts
Bench player in a game that
the team is down by 4 points ‘164 1 ‘685
Backup player in a clearly .486 1 .486
Winning Situation
S tarter in a clearly losing
3 i tuation .004 1 .950
Backup player in a close
Wi nning situation 34% 1 .065
B ench player in a clearly 2 769 1 096
1 O S i ng situation ' '
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Game Situation Data Sheet by CPR Training

The eleventh question related to the Game Situation Data Sheet is whether there was
a difference when coaches return an injured athlete to competition based on whether the

coach had CPR training. Chi—square analyses were conducted on the nine game situations

by CPR training. Table 49 presents the Pearson Chi-Square value and the probability for
each of the situations. Appendix R and Table 50 illustrates the actual and expected
counts for each game Situation. Table 50 (Backup Player in a Close Winning Situation
by CPR Training) reveals that more coaches than expected that had CPR training would
return the backup player in a close winning situation, while more coaches than expected
that did not have CPR training withheld the injured back up player in the same situation.
Coaches did not differ on the other eight game situations by CPR training.

In summary, coaches that had CPR training were more likely to return an injured
b ac kup player to a close game that they were winning. However, coaches that were not
C P R trained were more likely not to return an injured backup player in a close winning

0 ontest. Coaches did not differ in returning an injured athlete in the other eight game

3 i tuations.

88

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Table 48

Pearson Chi-Square for Game Situation Data Sheet by CPR Training

 

 

\

Situation Pearson Chi-

Square Value df p
Player that is third off the
bench in a clearly losing .046 1 .831
situation
Starter in a clearly Winning 1.522 1 .217
Situation
Bench player in a clearly .092 1 .762
Winning Situation
Starter in a game that the team 1233 1 .267
is down by 5 pomts
Bench player in a game that
the team is down by 4 points ”901 1 '342
Backup playerin a clearly .003 1 .954
Winning Situation
Starter in a clearly losmg .412 1 .521
Situation
Backup playerin a close 4.960 1 .026*
Winning Situation
Bench player in a clearly .881 1 .348

losing situation

* S i gni ficant at the p = 0.05 level

89

 

 

 

 

 

 

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Table 49

Backup Player in a Close Winning Situation by CPR Training

 

 

CPR Game Situation Eight Total
Yes No
Count 35 25 60
Yes
Expected Count 28.6 31.4 60
Count 28 44 72
No
Expected Count 34.4 37.6 72
Count 63 69 132
Total
Expected Count 63 69 132

 

Game Situation Data Sheet by Current First Aid Certification

Of interest to this study was Whether there is a difference when coaches return an

inj ured athlete to competition based on Whether their first aid certification is current or

n O t - Chi-square analyses were conducted on the nine game situations by current first aid
0 e rtification. Table 51 presents the Pearson Chi-Square value and the probability for
each of the situations. Appendix S and Table 52 illustrates the actual and expected

C O unts for each game situation. Table 52 (First off the Bench in a Clearly Losing

C O mpetition Situation by Current First Aid Certification) reports that more coaches than
e)(FWEECted that had current first aid certification would return the backup player in a clearly
I 0 S i ng situation, while more coaches than expected that did not have a current first aid
C erti f‘lczation did not return the injured back up player in the same situation. No statistical

(1 i F . . . . . .
Fe rence was found for the other eight game Situations by current first aid certification.

90

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In summary, coaches that are currently certified in first aid were more likely to return
an injured backup player to a game that they were clearly losing. However, coaches that
were not first aid certified trained were more likely not to return an injured backup player

in a clearly losing contest. Coaches did not differ in returning an injured athlete in the

other eight game situations.

Table 50

Pearson Chi-Square for Game Situation Data Sheet by Current First Aid Certification

 

Situation Pearson Chi-
Square Value df p

Player that is third off the

bench in a clearly losing 7.278 1 .007*
situation
Starter in a clearly Winning .1 05 1 .746
Situation
Bench player in a clearly 1.175 1 .278
Winning Situation
Starter in a game that the team 1.326 1 .250
is down by 5 pomts
Bench player in a game that
the team is down by 4 points '66] 1 ’416
Backup player. in a clearly .523 1 .469
Winning Situation
Starter in a clearly losmg .302 1 .583
Situation
B u
Wackup player. in a close .038 1 .846
inning Situation
Bench player in a clearly
lOsing situation .065 1 '798
\

 

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Table 51

First off the Bench in a Clearly Losing Competition Situation by Current First Aid

Certification

 

Current First
Aid

 

Game Situation One Total
Certification
Yes No
Count 5 16 21
Yes Ex
pected f
Count 1.8 19.2 21
Count 9 135 144
No
EXPGCth 12.2 131.8 144
Count
Count 14 151 165
Total EX
pected
Count 14 151 165

‘

Game Situation Data Sheet by Current CPR Certification

The thirteenth question related to the Game Situation Data Sheet was whether there

W as a difference when coaches return an injured athlete to competition based on Whether

t he coach was currently CPR certified. Chi-square analyses were conducted on the nine

garn e Situations by CPR certification. Table 53 presents the Pearson Chi-Square value

and the probability for each ofthe situations. Appendix T illustrates the actual and

expec ted counts for each game Situation. Coaches did not differ in returning an injured

at . . .
'1 I ete based upon the nine game Situations.

RE. {’31-

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Table 52

Pearson Chi-Square for Game Situation Data Sheet by Current CPR Certification

 

 

Situation Pearson Chi-

Square Value df p
Player that is third off the
bench in a clearly losing 3.161 1 .075
situation
Starter in a clearly Winning .159 1 .690
Situation
Bench player in a clearly 1.585 1 .208
Winning Situation
Starter in a game that the team 3129 1 .077
is down by 5 pomts
Bench player in a game that
the team is down by 4 points "295 1 '587
Backup player in a clearly .227 1 ‘ 634
Winning Situation
Starter in a clearly losmg .000 1 1.00
Situation
Backup player. in a close .221 1 .638
Winning Situation
Bench player in a clearly .006 1 .939

losing Situation

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CHAPTER V
Discussion

The purpose of this study was to measure the first aid and injury prevention
knowledge of youth basketball, soccer, and football coaches and to assess the decision-
making ability of these youth coaches in determining the playing status of an injured
athlete. A revised American Red Cross First Aid Assessment (Ransone & Dunn-Bennett,
1 999) was used to evaluate the first aid and injury prevention knowledge of the youth

coaches. The Game Situation Data Sheet (Flint & Weiss, 1992) was used to assess the

decision-making ability of the youth coaches in deciding Whether or not to return an

i nj ured athlete back to competition.
Currently, there is no nationally recognized injury prevention program that is

1‘ eq uired of youth coaches. In order to determine if there is a need for such a program, the
first aid and injury prevention knowledge that youth coaches possess needed to be
eValuated. The research questions of this study were: What is the first aid and injury
13 revention knowledge of youth coaches; is there a difference in the first aid knowledge
b as ed upon what sport was coached, coaches’ gender, coaches’ age, number of years

C O aching experience, educational background, and first aid and CPR training; When
W0 uld a coach return an injured athlete to competition; and is the decision to retum an
i nj ured player different based upon passing/failing the FAA, sport that was coached,

COZlChes’ gender, coaches’ age, number of years coaching experience, educational

background, and first aid and CPR training.

94

First Aid Assessment
Fifteen coaches (5.17%) out of 290 coaches earned a passing score on the First
Aid Assessment (FAA). Such a percentage is appalling. Youth coaches have our
children under their supervision for approximately 2-10 hours a week. One would not
bring their child to a daycare where only five percent of the staff had passed a first aid
examination, Why would parents allow their child to be coached by such inept coaches?
Most youth sport organizations require that a parent Sign a medical release form.
This medical release form is to be used in case their child needs to be treated at a hospital
and they are not available. Youth coaches are the ones that will be determining whether
or not to call the parent, take the child to the hospital, or alert the emergency medical
Services if an injury occurs during a practice or game. Youth coaches are making
medical decisions without the medical knowledge needed to make such decisions.
Of the 170 coaches who completed the demographic sheet 96 reported having
Some type of formal first aid training. Eighty-four (87.5%) of those coaches who
re p orted having formal first aid training failed the FAA. This indicates that having
f0 ma] first aid training at some time during one’S life does not increase their first aid

Knowledge. Apparently the information that is gained during first aid training is not

b ein g retained. Those taking the first aid courses may be learning the material in order to

p ass the examination that is given to become ceitified; they are not retaining the

1 n fo I‘Ination well enough to be competent in dispensing first aid.

Twenty-one (12.4%) coaches reported being current first aid certified. Of those
2 1 Coaches only five passed the FAA. Being currently first aid certified does not improve

0 r1 3 . . . . . .
e S score on a first aid examination. Currently, first aid certification has to be renewed

 

 

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every three years. Three years is a long time for one’s knowledge to be retained.
Additionally, first aid re-certification does not challenge one’s first aid knowledge.
Rather it is a matter of checking off skills and taking a short written examination. If one
does not practice the first aid skills that are taught during the first aid courses or that are
reviewed during re-certification courses, one is unlikely to be able to recall the necessary
skills when they are needed. Because many people do not practice their first aid skills on
a daily or weekly bases, first aid re-certification should be conducted more frequently.
Currently CPR re-certification is conducted on a yearly bases. Those in charge of CPR
certification see the need to review CPR skills on a yearly bases. First aid certification
should be done yearly, like CPR, and should be more comprehensive and challenging to
enhance the chance that the knowledge is retained.

Similar results have been found in previous investigations. Ransone and Dunn-
Bennett (1999) reported having a higher percentage of coaches passing the FAA. Thirty-
eight (36%) of the 104 coaches that participated passed the FAA. Of those 104 high
school coaches 96 (92%) were currently certified in first aid, as required by California
law. In 1986 Rowe and Robertson developed and administered a first aid test to Alabama
high school coaches. Only 34 (27%) of the 127 coaches tested earned a passing score. In
1 991 Rowe and Miller administered the same test to Georgia high school coaches. Fifty
(38%) ofthe 130 Georgia high school coaches passed the first aid test, in light of 1 16
(89%) ofthe coaches having current first aid certification.

The results of this study and other similar studies have found that, for some, a
Coach's score on a first aid examination does not appear to be enhanced by being

ITerltly first aid certified or haying formal first aid training. As preViously mentioned, a

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person may have not retained the information that they received during their first aid
certification. Additionally, some coaches may have been certified for many years and
others may have just been certified. Those coaches who have been certified for many
years have had more time to be exposed and to refine their first aid knowledge and
techniques. While those that have only been certified for a year or two may not have had
enough time and practice for the information to be retained.

Just because the coaches did not pass the FAA does not mean that they do not
possess the information or are capable of handling a situation in which they would need
to perform first aid skills, but it is less likely that they have the first aid knowledge.
Some coaches were nervous taking the examination. Nervousness in taking an exam may
transfer over to that coach being nervous and unable to handle a situation in which they
would need to provide first aid to a youth athlete. When dealing with youth athletes the
first aid provider needs to be calm, cool, and collected in order to aid the child in dealing
with the injury. Children are able to sense if an adult is nervous, and if they sense that
the adult is nervous they will be more upset, be unable to deal with the pain, or even go
into Shock. Children are interesting people, if the person helping them are calm and
reassuring, the youths are able to better handle the situation. None-the-less, further steps
need to be taken to enhance the first aid knowledge base of youth coaches.

Injury prevention is just as important as being able to provide first aid care.
Courses such as the American Red Cross Basic First Aid, Community First Aid, and First
Aid With CPR do not address the issue of injury prevention. Youth coaches may be
p thting their athletes in undue risk by the way they conduct practice. From the type of

d .
r1118 they conduct, the amount oftime they have the athletes do the drills, or to how

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many water breaks they provide for the athletes may all put the athlete at risk of injury.
Over the years it has been determined that some drills that were done in the past are not
safe. Youth coaches who have no formal training on how to coach will rely on how they
were coached, thus they might have the athletes perform unsafe drills. Having the
athletes do repetitive movements (drills) may put the athlete at risk for an overuse injury.
Overuse injuries are injures that require a lot of time, patience, and proper technique to
heal. Some coaches use water breaks as rewards for their team performing well. Thus, if
their team is not performing well, they will not get a water break. Such punishment puts
the athletes at risk for heat-related injuries. Such injuries could be fatal.

Youth coaches and youth organizations are placing themselves at risk for liability
lavvsuits. Youth coaches are liable for taking care of the youth athletes under their
supervision. That includes if the athlete gets hurt. In Duda v. Gaines, a high school
coach was found negligent for improper care when a football player dislocated his
shoulder (Shroyer, 1982). Rather than summoning emergency medical services the coach
relocated the shoulder. Three days later the child’s shoulder dislocated again, causing
more damage than the first dislocation. In the 1975 Thompson v. Seattle Public School
District case, Thompson was awarded 6.4 million because the high school coaches did
”0t Warn him of the danagers of participating in football and for teaching improper
tacklir'i g techniques (Lubell, 1987). As a result Thompson was left as a quadriplegic.

S ”Ch Cases can not only occur at the high school level but also at the youth level.
The youth coach needs to be able to not only prevent injuries from occurring but
they 1lave to be able to perform basic first aid care for the injured athlete. Youth coaches

at . . . . . . .
e rhost likely able to identify major injuries such as a fractured femur, due to the

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extreme pain and deformity that is associated with such an injury. In such cases youth
coaches know that further medical attention is needed and are able to ascertain such help.
There are many other major injuries that are not as obvious. Youth coaches need to know
when further medical attention is needed and be able to send for such help. In order to
know when further medical attention is needed a youth coach needs to be able to identify
an injury as being serious. Youth coaches may not be able to tell the difference between
a sprain and a contusion. Basic first aid courses do not distinguish between such injuries;
those that take such classes are instructed to treat all injuries as though they were the
most serious of injuries (fractures/dislocations). Additionally, youth coaches are not
knowledgeable in determining if the youth athlete can return to participation. Many
organizations do not have set standards or protocols for when an athlete can return to
participation following an injury.

There were significant findings when considering the five first aid constructs as
the dependent variables and the following independent variables: sport coached, coaches’
age, years of coaching experience, educational background, gender of athletes coached,
formal first aid training, CPR certification, and current first aid or CPR certification. Not
all of the dependent variables (injury prevention, injury identification/general medical
knovVledge, CPR, injury management, and wound care) were found to have a significant
relationship with each of the previously mentioned variables.

The injury identification/ general medical knowledge was significantly different
bet“’Veen soccer and football coaches. One reason for the difference in knowledge
b etVVEen soccer and football coaches may be due in part to the fact that travel soccer

CO . . . . . . . .
acl‘les in this study are required to have first aid training. It appears that such training

99

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increases a coach’s injury identification/ general medical knowledge, but does not
significantly increase their injury prevention, CPR, injury management, and wound care
knowledge. The training that the soccer coaches receive may focus on injury
identification rather than on the prevention and care of such injuries. The type of training
that travel soccer coaches undergo is not known. Such training may be conducted by
organizations other than the American Red Cross. Such programs may be conducted in
such a manner that allows for skills to be practiced.

No difference was found between soccer and basketball coaches or between
basketball and football coaches. Due to the fact that both basketball and football
programs do not require their coaches to have first aid training may be the reason for not
finding a difference between those groups. Thus, those that are not required to be trained
possess the same amount of first aid knowledge independent of whether they coach
basketball or football. The low number of basketball and soccer coaches may have been
a reason for not finding a significant difference between those two groups. Further
research is needed to examine this issue to determine the reason(s) for the differences in
injury identification/ general medical knowledge between soccer and football coaches and
if there is really a difference between soccer and basketball coaches. The difference in
knowledge may be due to the additional coaches’ training that soccer coaches receive.

Knowledge of injury prevention was significantly different based upon the years
of COaching experience. Post hoc analysis revealed a difference between the coaches in
the five to nine years and the 10-27 years of coaching experience groups. One would
think that the difference would have been between the coaches with the fewest years of

aching experience and the coaches With the most coaching experience. The coaches

100

 

 

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with 10-27 years of experience may have gained more injury prevention knowledge
through coaching over the years. Those coaches that have not been coaching very long,
zero to two years, may have benefited from injury prevention techniques that they were
exposed to during high school or college classes. Those that have coached between five
and nine years may not have benefited from coaching experience, nor have they benefited
from the latest injury prevention knowledge that is readily available at many high schools
and colleges.

Educational background impacts a coach’s score on some of the first aid
constructs. Coaches were divided into groups based upon their educational experience.
Coaches that had either graduated from high school, earned a high school equivalent, or
had some high school experience were grouped in the high school group. Those with any
college experience, an associates degree, or a bachelors degree were grouped under the
title of college. Those coaches that had earned an advanced degree, Masters or PhD,
were classified as the advanced degree group. All others composed the other category.

There was a significant difference among the educational background groups for
the inj ury identification/ general medical knowledge and the injury management
Constructs. There was no significant difference for the other three constructs with the
ind€13¢endent variable educational background.

The injury identification/general medical knowledge construct was significant.
The I‘Etsults of the post hoc Scheffe test indicated that there was a significant difference
b etvveen the high school and the college categories and between the high school and
advanced degree categories. Injury identification/ general medical knowledge increases

Fr . .
011') high school to college, but does not increase from college to an advanced degree

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education. Those that enter college may have taken classes related to such knowledge
compared to those that only completed some or all of high school. Advanced education,
college or advanced degrees, may refine a person’s ability to correctly answer questions
on a test.

An advanced degree does not increase a coach’s injury identification/ general
medical knowledge, however, one reason for this non-significant result between the
college and advanced degree groups may be explained by the type of education that one
has received. Earning an advanced degree in business most likely will not increase one’s
knowledge in the identification of injuries.

Inj ury management knowledge differed between the high school and advance
degree groups and between the college and advanced degree groups. This finding was
interesting, in that there is a difference between the college and advanced degree groups.
Thus, education beyond some college experience, an Associate’s or a Bachelor’s degree,
improves one’s injury management knowledge. One reason for this improvement may be
the area in which those with advanced degrees attained their degrees. Those that earned a
PhD- may have earned such degree in a field that deals with aspects ofinjury
management, such as large animal sciences. There was at least one coach that was in the
field 0 fstudy that dealt with the raising of cattle. This persons’ knowledge ofinjury
management in dealing with cattle may have transferred over to injury management
knowledge of youth athletes.

The injury identification/general medical knowledge construct was significantly
d i f‘fel‘ent for the gender of athletes coached. This difference was only found between

th . .
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athletes. Coaches who coached predominantly female athletes scored significantly higher
than those that coached predominantly male athletes. Eleven (73%) of the fifteen female
coaches coached predominately female teams. While only 20 (13%) of the 152 male
coaches coached predominantly female teams. One reason for the difference in
knowledge maybe due to the fact that females are the primary caretakers of children.
These women may have a maternal instinct or have more experience in handling general
medical issues compared to their male counterparts. The attitudes of coaches may differ
based upon the gender of their athletes. Those that coach female athletes may think of
their athletes being delicate and want to be over protective. While those that coach
predominately male athletes may have the mind set that it is alright to play with pain, or
that one should show that he is a man by playing through the pain.

Formal first aid training enhances the knowledge of youth sport coaches in some
of the first aid constructs. Injury identification/ general medical knowledge, injury
management, and wound care constructs were significantly different between those that
had some form of formal first aid training and those that did not have training. Those
coaches with the formal first aid training possessed more knowledge in those constructs
compared to those coaches that did not have formal first aid training. The injury
prevention construct approached significance.

The injury identification/general medical knowledge, injury management, and
wound care constructs were significantly different, and were areas that youth sport
coaches will encounter most often. It is important that these coaches know how to

PFeVent injuries from happening, identify injuries when they do happen, and manage

those injuries and wounds. Very rarely will a youth coach be in a situation that they will

103

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have to perform CPR. If a coach was in a situation that CPR needed to be performed,
he/she would contact the emergency medical services. Emergency medical services are
typically not contacted for minor injuries such as lacerations, abrasions, sprains, and
strains, but youth coaches need to be able to prevent, identify, and care for such injuries.

Youth sport coaches receiving CPR training had increased knowledge in the areas
of injury identification/ general medical knowledge and wound care. Of the 79 coaches
that reported being CPR trained, 61 (77%) coaches had reported having formal first aid
training. CPR training may have occurred in conjunction with first aid training. This
maybe the reason for the significant difference in injury identification/general medical
knowledge and wound care.

Interestingly, coaches who did not have CPR training had a higher mean score on
the CPR construct. This difference was not significant. One possible reason for this
finding is that those without CPR training may have randomly guessed correctly. The
mean score of the CPR construct was just over 50% correct for both groups for the four
CPR questions. The technique of CPR can be seen almost daily on television or on
posters in the work place. Those that are not CPR trained may have been influenced by
other factors or other ways of learning the basic technique of CPR.

Coaches with current first aid certification had a higher score on the injury
prevention, injury identification/ general medical knowledge, injury management, and
Wound care constructs compared to those coaches without training. The difference

between the two groups was significant for the wound care construct only. The majority

0f first aid training stresses injury and wound management. The fact that there was a

104

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significant difference in wound care knowledge, shows that first aid certification really
does enhance some of the areas that it focuses on.

It was surprising that there was not a significant difference in the injury
management construct. A reason for not finding a significant difference in the injury
management construct may be due to the low number, 21 (12%), of coaches that had
current first aid certification. Another reason for such a difference is that coaches are
more likely to treat the majority of non-wound injuries in the same cautious manner,
using RICE (rest, ice, compression, and elevation).

Coaches without first aid certification scored higher on the CPR construct than
coaches with first aid certification. First aid certification does not necessarily improve
one’s CPR knowledge. Most first aid certification processes do not contain information
about CPR. Theoricially, only those that are both CPR and first aid certified would have
done better on the CPR certification section. Out of the 21 coaches that were currently
first aid certified, 20 were currently CPR certified. Thus, there must be another reason
for this finding. One such reason for this finding may be due to coaches that are not
currently certified may have randomly selected the correct answers to the four CPR
construct questions. Additionally, those that are not currently CPR certified may have
been certified earlier in life and retained the knowledge necessary to answer the questions
on the FAA.

Like those that are currently first aid certified, those that are currently CPR
certified had a significantly higher knowledge level in the wound care construct
compared to coaches that were not CPR certified. Of the 30 coaches that were CPR

certified, 20 (67%) ofthese coaches also had current first aid certification. One reason

105

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why those with CPR certification scored higher on the wound care construct may be due
to a cross-over effect of being currently first aid certified. Interestingly, those that are
currently CPR certified scored lower on the CPR construct. As stated previously, this
may be due to non-certified coaches correctly guessing on the CPR questions.
Additionally, 55 (70%) of the 79 coaches that reported having been trained in CPR were
currently not CPR certified. Thus, those coaches may have been using prior knowledge
to answer the CPR construct questions.
I Game Situation Data Sheet

Coach’s decisions to return an injured athlete to competition are dependent upon
the game situation and the player involved (starter, backup, or bench player). The results
of the Game Situation Data Sheet in this study were similar to the results reported by
Flint and Weiss (1992). Youth coaches are likely to return an injured starter to
competition 14.8%, 31.7%, and 45.4% when the game situation is that their team is
clearly losing, clearly winning, or in a close competition respectively. In a clearly
winning situation or clearly losing situation 13.4% and 10.9% of coaches, respectfully
returned a first substitute. While in a close game situation, 45.3% of coaches would
return the first substitute to the game. When the injured athlete is a bench player, coaches
are likely to return them 32.7%, 13.4%, and 23.2% of the time in a clearly losing, clearly
winning, or close game situation respectively.

In a close game, coaches were more apt to return an injured starter and first
substitute to the game than an injured bench player. A reason for these decisions by the
coaches could be due to a role conflict. Many coaches feel that it is their main

responsibility is to win the game, and they would do anything to succeed at that goal.

106

Coaches want their best athletes on the court/ field at the time when the game is in the
balance. That is why coaches would return an injured starter or first substitute while
keeping an injured bench player out in a close game situation.

A coach’s responsibility is not only to win the competition but to enhance the
skills of lesser players. In a clearly losing situation youth coaches are more likely to
return an injured bench player than a starter or first substitute. A clearly losing situation
is a perfect opportunity to allow the players with less skill a chance to have game
experience and refine their skills in a game situation.

Youth coaches differ from high school coaches in their decisions to return athletes
to competition in a game situation that they are clearly winning. High school coaches
(Flint & Weiss, 1992) were more likely to return an injured bench player and first
substitute than a starter in a clearly winning situation. A good reason for doing so is not
to put the starter in a situation that they may further injure themselves when the game is
already determined. Youth coaches on the other hand were more likely to return an
injured starter, compared to first substitute and bench player, to a clearly winning
situation. High school coaches appear to err on the side of caution with their starters in a
clearly winning situation. Youth coaches do not follow their high school counterparts.
Youth coaches are more likely to return an injured starter to a winning contest. One
reason for returning an injured starter to competition in a game in which the team is
winning is to maintain the lead. Youth coaches may replace the injured starter towards
the end of the contest when the final game outcome has been determined.

There were significant findings when considering the nine game scenarios and the

following: pass/fail the FAA, sport coached, coaches’ gender, coaches’ age, years of

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coaching experience, CPR training, and current first aid certification. Not all of the game
situations were found to have a significant relationship with each of the previously
mentioned variables.

The decision to return an injured starter to a winning competition differed by
whether a coach passed or failed the FAA. Coaches that passed the FAA were more
likely to not return the injured starter, while those that failed the FAA were more likely to
return the injured starter. The coaches that passed the FAA had a better understanding of
the injury, the game situation, and the rank of the injured player. The game situation was
one in which the team was winning easily. A prudent coach would not risk further injury
to a player that is good enough to start.

Those that passed the FAA had more of a first aid knowledge base to make the
decision on whether or not to return the injured starter to competition. The injury in this
particular situation was that the athlete had a dislocated finger that was reduced and
checked for a fracture. All dislocations should be evaluated by a doctor for reduction and
examination for fractures or other potentially serious injuries. Thus keeping the injured
athlete out was the correct decision to make no matter what the rank of the player.
Coaches that did not pass the FAA either did not understand the severity of the injury or
were affected by the athlete wishing to return to competition.

Youth coaches not only have the coach/first aid provider conflict, what to do as a
coach and what to do as a first aid provider, but they also have to deal with the youth
athletes themselves and the parents of those athletes. Coaches may be affected by how
the youth athlete acts or what they say. A youth athlete may lie and say that they are not

in any pain in order to return to the game. A youth coach may also be pressured by

108

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parents to return an athlete to competition. It is up to the coach to be able to read the
athletes’ other behaviors to determine if the athlete is really experiencing pain. When in
doubt the coach should always err on the side of caution.

Soccer coaches were more apt to return an injured bench player to a losing
competition than basketball and football coaches. Out of the 15 coaches that passed the
FAA five (33.33%) of them were soccer coaches, this is an interesting finding because
there were so few soccer coaches in the subject pool. The youth soccer coaches possessed
significantly more injury identification/general medical knowledge than football and
basketball coaches. Soccer coaches also possessed more injury prevention and wound
care knowledge, though these differences were not significant. The increase in the
knowledge base of soccer coaches made them feel more able to evaluate an injured
athlete and decide whether to return them to competition. Youth basketball and football
coaches lacked the first aid knowledge in being able to identify this injury, but this lack
of knowledge lead them to be more likely to withhold the injured athlete.

Soccer coaches may have been affected by the coach/first aid provider role
conflict in a game situation that involves a losing contest and an injured bench player. A
losing contest is a perfect opponunity for those with less skill to gain real game
experience. Soccer coaches value the game experience over the care for an injured
athlete.

The injured bench player had a groin pull that was not causing more than some
minor discomfort for the player. As long as the athlete is experiencing pain they should
not be allowed to return to competition, especially iftlie injury had just happened (as in

this game situation). With all three sports there is sprinting involved, such explosive

109

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maneuvers may cause additional injury to the groin. The athlete in this situation should
not have been returned to competition.

Male and female coaches differed in returning an injured starter in a clearly
winning and a close game situations. When their team was clearly winning, more female
coaches than expected returned the athlete to play, while more male coaches than
expected did not return the athlete to play. When the game is close and their team is
down by five points, more males than expected returned the injured athlete, while more
females than expected did not retum the athlete to play. These results need to be
evaluated with respect to the low number of female coaches that participated in this study
and the type of injury the athlete suffered.

With the team clearly winning and the injury being a dislocated finger, more
female coaches than expected returned the injured starter to competition, while more
males than expected did not return the injured starter in the same game scenario. Males
were more reluctant to return an injured starter when they are easily winning the game.
Either the male coaches do not want to risk further injury to one of their best athletes or
realized the severity of the injury. On the other hand female coaches returned the injured
athlete despite the athlete having a dislocated finger. All dislocations need to be seen by
a doctor for reduction and further evaluation. Female coaches may have wanted their
starter to continue playing to possibly make sure that they continue to easily win this
competition.

When the team is down by four points and the injury is a sprained ankle, more
male coaches than expected returned the injured starter, while more female coaches than

€Xpected withheld the athlete. It appears that the male coaches were influenced by the

110

game situation in their decision to return the athlete or not to return the athlete. Female
coaches are not affected by the game situation, but rather are concerned with the injury
the athlete has suffered.

In both game situations the injured body segment was supported with tape and the
athlete either asks to return the game or assures the coach that they are fine. Male and
female coaches seem to be influenced by the combination of the game situation and the
athlete informing them that they are all right.

The decisions made by the female coaches are intriguing. It does not make sense
to return an athlete with a dislocated finger and withhold an athlete with a sprained ankle.
This would lead one to think that the female youth coaches do not understand the serious
nature of a dislocation injury. They know that an ankle sprain is not a minor injury, and
that an athlete with such an injury should be held out, but they do not know that a player
with a dislocated finger should be sent to the hospital.

Older coaches, age categories 41-43 and 44-62, were more likely to err on the side
of caution when a bench player was injured in a clearly losing situation. Coaches in the
younger two age categories were more likely to return the injured athlete to the game.
This may be due to more life eXperience with age or the older coaches having a better
perspective on a game situation and an injured athlete. The injury in this game situation
was a groin pull that appears to be causing minor discomfort. This athlete should have
been withheld from competition due to them experiencing pain. The younger coaches see
this as an opportunity for this player to have game experience.

When a starter is injured in a close game situation coaches with zero to two years

of coaching experience are more cautious about returning the athlete back to competition

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compared to coaches with five to nine years of coaching experience. Coaches with five
to nine years of coaching experience may have relied on their observations of other
athletes that a child can play with a minor ankle sprain. Coaches in the five to nine years
of coaching experience had the lowest injury prevention knowledge. Their knowledge
was significantly less than that of the coaches with 10-27 years of coaching experience.
The lack of injury prevention knowledge may have transferred over to them thinking that
a sprained ankle is a minor injury that can be played with even if it is causing pain.

Just a few more coaches than expected with 10-27 years of coaching experience
returned the injured starter in the same game situation. It appears that an increase in
coaching experience increases one’s confidence in deciding that an injured athlete may
return to participation.

Coaches who had CPR training were more likely to return an injured backup
player to a close game that they were winning. CPR training does not enhance one’s
knowledge of low back injuries. Coaches may have become over confident due to their
training. This finding is interesting due to the fact that there was no significant finding
for coaches that were currently CPR certified. Thus, those coaches that have had CPR
training but are not currently CPR certified are more likely to return an injured backup
player.

Coaches who were currently first aid certified were more cautious about returning
an injured back up player in a clearly losing game situation. The knowledge gained
through being currently first aid certified transferred over to youth coaches being careful
about returning an injured bench player with a hyper-extended elbow injury. One would

think that the knowledge gained from current first aid certification would cause a youth

coach to be cautious in returning any level athlete in any game situation. From these
results youth coaches that are certified in first aid certification also experience the
coach/first aid provider conflict.

Points of Interest
First Aid Assessment

Examination of the score on the first aid assessment in relationship to gender,
number of sports coached, coaches’ age, and American Red Cross First Aid Training
revealed no statistically significant differences. There were no significant findings for all
five of the first aid constructs when considering these variables. One would not expect
there to be a difference in first aid knowledge based upon the number of sports coached.
Increased knowledge would be expected with the coach’s gender, an increase in age, and
if the coach had been American Red Cross First Aid Trained.

Increased number of sports does not significantly increase first aid knowledge.
Exposure to the potential for more injuries does not mean that one’s knowledge would be
improved. A youth coach may have coached three different sports, each for one season,
but that does not mean that he/she has had more experiences with injuries compared to a
coach that has coached for 5 years. Years of coaching experience is a more important
variable than the number of sports coached. Coaches may not have experienced many
injuries during their time as a coach. Most parents attend games and many parents attend
practices on a regular bases. Parents of children may be present at practices and games
and are able to care for their injured child. Additionally, there may be a parent that is in
charge of providing first aid to the athletes, thus the coach does not have to worry about

taking care of an injured athlete.

113

Knowledge of the five first aid constructs did not differ by the gender of the
coach. Females are the primary care takers for children. One would expect that females
would have a higher first aid knowledge than their male counterparts because of their
experiences. One possible reason for these non-significant results may be due to the low
number of female participants in this study. There were only 15 coaches that reported
being female out of the 170 that completed the demographic sheet.

When comparing the age groups of coaches and their knowledge on the five first
aid constructs only the CPR construct was significant. Further analysis using the Scheffe
test failed to reveal a significant difference. One reason may be due to the fact that the
Scheffe test is a very conservative test. If there was to be a significant difference, it
would have been between the lowest and highest mean scores, youngest and oldest age
groups, with the oldest group having more knowledge. The oldest coaches may have
more knowledge on the CPR construct because of more exposure to being trained, at one
time during their life, in CPR. Younger coaches may not have as many opportunities to
learn CPR when compared to older coaches.

American Red Cross First Aid training did not significantly improve one’s
knowledge of the five first aid constructs. The mean score for those coaches with
American Red Cross First Aid training was higher, although not statistically different,
than the mean scores for those coaches without the training for four of the constructs:
injury prevention, injury identification/ general medical knowledge, injury management,
and wound care. American Red Cross first aid training will not enhance a coach’s CPR

knowledge.

114

American Red Cross First Aid courses may not be taught in the best possible
manner. Courses offered through the American Red Cross are lecture based classes.
Such a format focuses on providing the students with the information, in a short amount
of time (4-8 hours), about how to perform a skill with very little time devoted to the
practice of such skills. Perhaps an alteration in the way first aid courses are taught would
lead to peOple being able to retain more of the information and feel more confident in
being able to apply their skills in real life situations. Students should be given the book
prior to attending class and asked to read over the necessary material. That way class
time can be utilized for review, demonstration, the practicing of the skills, and scenarios.
Scenarios will allow those taking the course to evaluate a situation and determine what
steps need to be taken to aid the injured party.

Game Situation Data Sheet

Examination of the variable, whether to return an injured athlete to competition,
in relationship to the variables; number of sports coached, coaching location, education,
gender of athletes coached, formal first aid training, American Red Cross first aid
training , and if a coach was currently CPR certified revealed no statistically significant
difference. There were no significant findings for all nine of the game situations when
considering these variables.

There was no significant difference of when a coach would return an injured
athlete based upon the number of sports coached. The more sports that the coach has
coached does not in turn mean more coaching experience. A coach may have coached 3

different sports each for a season, which does not mean that they have more experience in

115

knowing when to return an injured athlete to play. Years of coaching experience is a
more important variable than the number of sports coached.

Advanced education does not alter the decisions of a youth coach to return an
injured athlete to competition. Coaches must use other knowledge, besides the
knowledge gained from further education, to decide on whether or not to return an
injured athlete to competition. Advanced education does not change the role conflict
that youth coaches have in deciding to return an injured athlete. No matter the
educational background of a youth coach there is still a role conflict, between what to do
as a coach and what is best for the injured athlete. This poises a problem, because with
advanced education one should be able to objectively see the situation and make the best
possible decision concerning the safety of the injured athlete.

A coach’s decision to return an injured athlete did not differ based upon the
gender composition of the team that they were coaching. Whether a coach is coaching an
all female, all male, or an even mix of males and females team, they did not differ in
when to return an injured athlete to competition. Thus coaches treat males and females in
the same manner with respect to returning them to competition from an injury. This
finding is interesting because one would think that those coaching predominately male
athletes would be more inclined to return an injured athlete. The socially accepted idea
of playing through the pain is seen throughout male sports or that a male athlete needs to
show that he is a man by playing through the pain. Another possible explaination ofthis
finding is that those that coach female athletes have the same old fashion mind set of

playing through the pain no matter the gender of the athlete.

116

There were no significant findings when considering the nine game situations
with respect to whether a coach had formal first aid training. This finding is interesting
because there was a significant difference in the first aid knowledge of youth coaches
based upon whether they had formal first aid training. One would think that the coaches
with the formal first aid training would use that knowledge and err on the side of caution
when dealing with an injured athlete. Coaches with formal first aid training still
experience the coach/first aid provider conflict, what to do as a coach and what to do as
the first aid provider for the injured athlete. Future research is needed to examine the
coach/first aid provider conflict.

Criteria of when to return an injured athlete to competition is not covered in
formal first aid training. So it is not surprising that there was no difference when coaches
would return an injured athlete to competition based upon whether they had formal first
aid training. First aid training for youth coaches needs to address the issue of when it is
safe to allow an injured athlete to return to competition. Additionally first aid training for
youth coaches need to instruct coaches on how to bring an injured athlete back to
competition.

In many youth sports it is required that before an athlete can return from an injury
they must have a doctor’s note saying that it is safe for them to return to activity. Caution
needs to be taken when a child presents such notification. The doctor has evaluated them
and found that they are structurally sound, but they may not be ready for full competition.
Ifthe athlete has been out for any amount oftime, they will need to be reconditioned and

reintroduced into the sporting environment.

117

American Red Cross first aid training does not alter the decision making of youth
coaches. Coaches that have been first aid trained by the American Red Cross return
injured athletes to participation in the same manner as those coaches without the training.
One reason for not finding a significant difference is that those coaches with training may
be utilizing their first aid knowledge to assess and care for the injured athlete. Being able
to assess and care for some of the minor injuries that happen in youth sports allow those
coaches to return athletes to competition with the knowledge that the youth athlete is all
right to participate. Those coaches, without American Red Cross first aid training, that
return the injured athletes are doing so without the knowledge that the athlete is going to
be safe.

American Red Cross training does not include specifications on when to return an
injured athlete. The majority of the first aid training offered by the American Red Cross
focuses on the immediate care of injuries and not the decision process to determine if a
person can continue activity. Youth coaches are constantly determining the playing
status of athletes. They need to be instructed on when and how to return an injured
athlete back to competition.

Coaches did not differ in returning an injured athlete in the nine game scenarios
based upon them being currently CPR certified. Because none of the game scenarios
dealt with an athlete needing CPR, one would think that there would be no difference in
deciding to return and injured athlete to participation based upon being currently CPR

certified.

118

Implications

Youth coaches lack the first aid and injury prevention knowledge needed to
prevent, evaluate, and care for sporting injuries. Injury prevention and care needs to not
only be addressed at the coaching level but rather at all levels within the youth sporting
environment. Youth coaches, administrators, parents, professionals (doctors/certified
athletic trainers), and professional organizations (National Athletic Trainer’s
Association/Michigan Athletic Trainer’s Association) all need to take an active role in
the prevention and care of youth sport injuries.

Youth coaches need to take an active role in learning the necessary skills to aid
them in injury prevention and care. Coaches should improve their coaching techniques
through programs that help to develop age appropriate practice programs. This will not
only help to prevent injuries from occurring but will also aid in the children learning
about the sport. By advancing their first aid skills coaches will not only benefit from
increased knowledge but they will also feel more comfortable when dealing with an
injury situation. The ability to handle an injury situation is just as important, if not more
important, than being able to perform the first aid skills to aid the injured athlete.

Youth sport administrators should not only encourage youth coaches but should
provide opportunities for coaches to advance their first aid knowledge. Youth
administrators are the ones that are in charge of developing the rules and regulations of
the youth sports program. Those administrators can decide that in order for someone to
be a coach they must take a course that is related to injury prevention and care. Youth
administrators can organize such courses on the local level with the help of physicians,

emergency medical technicians, and certified athletic trainers.

119

Parents should demand that their children’s coaches be knowledgeable in the
areas of injury prevention and care. Parents need to voice their concerns about the safety
of their children. Safety is one of the top priorities for most parents. If parents only
knew that their child’s coach was not knowledgeable in injury prevention and care, they
may not allow their child to participate.

Certified athletic trainers (ATC’s) need to take an active role in youth sports.
Most youth sport programs do not have access to an ATC. Certified athletic trainers need
to make themselves available to the youth sports programs. For a nominal fee ATC’s can
be a first aid liaison or teach injury prevention and care programs for youth coaches.
Groups such as the Michigan Athletic Trainers Association (MATS) have developed an
injury prevention presentation. Such programs need to be administered at the youth
level.

The information gained from this study needs to be transferred over into an injury
prevention and care program. Such a program should be developed to stress the areas in
which youth coaches are deficient. Once a program is developed, that program needs to
be administered and evaluated for its effectiveness in the prevention and care of injuries.
Additionally rules and regulations need to be developed for coaches to follow when
deciding to return an injured athlete to competition. Further research needs to be

conducted on the FAA, to evaluate if it truly assesses the first aid knowledge of coaches.

APPENDICES

APPENDIX A

First Aid Assessment

122

First Aid Assessment

 

Water should be

a. Withheld during practices, available during games.
b. Withheld during games, available during practices.
c. Available only on hot days.
(1. Available at all times.

The behavior of the first aid provider
a. Should be calm and reassuring.
b. Should be hurried and tense.
c. Does not matter because it has no effect on the injured athlete.
(1. Both a and b

Ice should always be used after an injury occurs, unless otherwise
directed by a physician or athletic trainer.

a. After the first 48 hours

b. During the first 48 hours

c. During the first 24 hours only

d. During the first 12 hours only

 

Shock is
a. Not life-threatening.
b. Possible with all types ofinjuries.
c. Possible with head and heat-related injuries only.
(1. More likely in chronic injuries.

. An athlete who is knocked unconscious may return to play if he or she
a. Regains consciousness within 2 minutes.

b. Presents no signs and symptoms of a head injury.

c. Is cleared by a physician.

(1. Feels capable of returning to play.

. Twisting or stretching ajoint beyond its normal range of motion is the most
common cause of

a. Sprains.

b. Fractures.
c. Strains.

d. Contusions.

7. Heat stroke can result from
a. Too little salt.
b. Too high carbohydrates.
c. Dehydration.
d. Hyperhydration.

8. A musculotendinous tissue injury is a

a. Fracture.
b. Sprain.
c. Strain.

d. Contusion.

9. Contusions occur most frequently to the
a. Chest.
b. Quadriceps.
c. Abdomen.
(1. Shin.

10. The greatest danger for an athlete who has mononucleosis is
a. Seizures.
b. A punctured liver.

c. A ruptured spleen.
d. Shock.

11. Proper treatment for chronic problems, such as shin splints, is
a. Ice before activity, ice after activity.
b. Heat before activity, heat after activity.
c. Ice before activity, heat after activity.
d. Heat before activity, ice after activity.

12. Standard first aid for a sprained ankle does not include
a. Ice.
b. Compression.
c. Percussion.
d. Elevation.

13. Pregame meals should contain foods
a. High in carbohydrates.
b. High in protein.
c. Low in carbohydrates.
(1. Balanced in protein and carbohydrates.

14.

15.

16.

17.

18.

19.

Mouth guards protect an athlete against
a. Tooth fractures and tongue lacerations.
b. Jaw fractures.
c. Concussions.
d. Both a and c.

Characteristics of heat exhaustion include
a. Slow pulse.

b. Pale, cool, clammy skin.

c. Red, hot, sweaty skin.

(1. Bounding pulse.

Heat stroke is
a. Preventable.
b. Unpreventable.
c. Not life-threatening.
d. Seldom seen in athletics.

Heat stroke is best prevented by
a. Limited salt intake.
b. Limited water breaks.
c. Unlimited water intake
d. No way to prevent it.

Dressings and bandages are used to
a. Reduce pain.
b. Reduce internal bleeding.
c. Help control bleeding and prevent infection.
d. Make it easier to move the injured athlete.

You have tried to control bleeding with direct pressure and elevation, but bleeding
does not stop. Where would you apply pressure to slow the flow of blood to a
wound on the forearm?

a. Outside of the arm midway between the shoulder and elbow

b. On the inside of the elbow

c. Inside of the arm midway between the shoulder and elbow

(1. Any of the above will slow the flow of blood

20.

21.

22.

23.

24.

25.

How can you reduce the risk of disease transmission when caring for open,
bleeding wounds?

a. Wash your hands immediately after giving first aid.

b Avoid direct contact with blood and other body fluids.

c. Use protective barriers such as gloves or plastic wrap.

d All of the above.

Which is the first step in caring for bleeding wounds?
a. Apply direct pressure on the wound with a clean or sterile dressing.
b. Apply pressure at the pressure point.
c. Apply bulky dressings to reinforce blood-soaked bandages.
d. Elevate the wound above the level of the heart.

What should you do if you think an athlete has internal bleeding?
a. Apply heat to the injured area.
b. Call your local emergency phone number for help.
0. Place the victim in a sitting position.
(1. Give fluids to drink to replace the blood loss.

Which should be part of your care for a severely bleeding open wound?
a. Allow the wound to bleed in order to cleanse it and minimize infection.
b. Apply direct pressure and elevate the injured area, if no broken bones.

c. Use a tourniquet to stop all blood flow.
d. Both b and c.

After being tackled, an athlete does not get up. The conscious athlete is face
down and appears badly hurt. First, you send someone for help. Then, you
a. Roll the athlete to his side, in case he starts to vomit.
b. Roll the athlete to his back and elevate the head and chest.
c. Position the athlete so he is in a comfortable position.
d. Have the athlete remain still.

Which should you do when caring for someone having a seizure?
a. Remove nearby objects that might cause injury.
b. Place small object, such as a rolled-up piece of cloth between the
individual’s teeth.
0. Try to hold the person still.
(1. All ofthe above.

26.

27.

28.

29.

30.

31.

Generally, a splint should be

Loose, so that the injured athlete can still move the injured limb.
Snug, but not so tight that it slows circulation.

Tied with fasteners directly over the injured area.

None of the above.

999‘!”

An athlete who is a diabetic is drowsy and seems confused. He is not sure if he
took his insulin today. What should you do?

a. Suggest he rest for an hour or so.

b. Tell him to go take his insulin.

c. Give him some sugar.

d. Both a and b.

Two soccer players collide on the field. Although there is no visible bleeding, the
upper left leg of one player is very red and swelling fast. She probably has what
type of wound?

a. Abrasion

b. Bruise
c. Strain
d. Sprain

When caring for an athlete with hypothermia, you should
a. Rewarrn the body gradually.
b. Remove wet clothes.
c. Give warm fluids if fully conscious.
d. All of the above.

What should you do for an athlete who is experiencing heat exhaustion?
a. Force the athlete to drink lots of cool water.
b. Get the athlete into a cooler environment.
0. Have the athlete rest until the feeling passes.
d. All ofthe above.

An athlete has a severe muscle cramp in the calf. Proper care would be to
a. Bend the knee and point the toes and foot.
b. Bend the knee and flex toes and foot.
0. Straighten the knee and point the toes and foot.
d. Straighten the knee and flex the toes and foot.

127

32.

33.

34.

35.

36.

37.

An athlete’s front teeth are knocked out during practice. The teeth should be
a. Washed in water and replaced in the sockets.

b. Stored in saline until dentist can replace.

c. Stored in milk until dentist can replace.

d. Any of the above is acceptable.

An athlete comes to you after being stepped on by an opponents spikes. The type
of injury you suspect is a (n)

a. Abrasion.

b. Puncture.

c. Avulsion.

d. Laceration.

Before attempting to resuscitate an athlete using CPR, which of the following
conditions must exist?

a. Dilated pupils

b. Absence of breathing

c. Unconscious

(1. Irregular respirations

At what rate should chest compressions be performed during CPR efforts on an
adolescent?

a. 50 -7O compressions per minute

b 80 — 100 compression per minute

c. 100 — 120 compression per minute

d 60 - 8O compression per minute

What is the breath (ventilation) to compression ratio when performing CPR on an
adolescent?

a. 12 compressions to 2 ventilations

b. 5 compressions to l ventilation

c. 15 compressions to 2 ventilations

d. 10 compressions to 2 ventilations

The first action that should be taken when approaching a collapsed, injured athlete
is to

a. Move the athlete off of playing surface.

b. Determine responsiveness.

c. Check for breathing.

d. Check for pulse.

38. Complications which may occur as a result of external chest compressions when
properly performed include
a. Rib and sternum fractures.
b. Punctured lungs and liver lacerations.
c. Both a and b
d. None of the above

129

APPENDIX B

Game Situation Data Sheet

130

Game Situations

1.

During the last 10 minutes in the game with your team
clearly losing, your 8’h player (usually 3rd into the game)
gets a hand in the way of a hard pass and hyperextends
an elbow. It is checked and taped. The player is eager to
get back on the floor.

One of your starters, during a game you are winning
easily, suffers a dislocated finger. After reduction (being
returned to its normal position) the finger is checked for
fractures. It doesn’t appear as if there are any fractures
present. The finger is given some support and the player
asks to return to the game.

One of the bench players, who rarely sees the floor,
finally gets a chance to play during a game you are

winning easily. After two minutes on the floor the player

suffers a hamstring strain. It doesn’t appear to be a
serious problem after some treatment on the bench. The
player is eager to return and shows that the muscle injury
only causes a minor limp.

In a game in which you are only down by 5 points, your
starting guard goes down with a sprained ankle. It
appears to be a mild sprain and taping has given it some
support. The player assures you everything is fine and
can perform cuts and turns with only minor discomfort.

The game is close and your team is down by 4 points.
You have a “bench player” on the floor replacing a tired
starter when the bench player begins hyperventilating.
After being helped at the bench, the player indicates
everything is okay.

Your team is winning handily when your backup center
grabs a rebound, but comes down awkwardly on a
teammates foot. It appears as if the center has a strained
Achilles tendon. After being check and a mild strain
indicated, taping is used for support. The player appears
eager to play again.

Your starting guard dives after a loose ball and bruises
the right kneecap. The game is far out of your team’s
reach at this point. The knee is slightly stiff and is
showing some signs ofa bruise, but the player can move
fairly well without too much problem. The player
indicated a readiness to return to the game.

 

Yes

 

Yes

 

Yes

 

Yes

 

Yes

 

Yes

 

Yes

Return to Game

 

No

 

No

 

No

 

No

 

No

 

No

 

No

With 10 minutes to go in a close game, and your team up
by only 3, your starting guard needs a rest. The backup
player at that position had gone out with a strained lower
back muscle. The backup player has been moving

 

around behind the bench and appears fine. It appears to 7; No
be only a mild strain and isn’t causing the player a great

deal of problems. The backup player wants to play again

in the game.

In a losing cause, you want to platoon in all 5 of the
players who have seen less than 2 minutes in the game.
Your 10th player had played very briefly early in the
game, but suffered a “groin pull”. The muscle strain
appears to be mild and isn’t causing more than some
minor discomfort at this point. The player wants a
chance to play more in the game.

 

Yes No

 

APPENDIX C

Demographic Sheet

133

The Assessment of First-Aid and Injury Prevention Knowledge and the Decision Making of
Youth Basketball, Soccer and Football Coaches

 

Your Gender
0 Male

Your e

 

 

 

 

0 Female

 

How many years have you been a
coach?

 

 

 

 

 

 

Office Use Only
‘ ‘ ID Number

 

 

 

 

 

 

 

 

Highest Dggree Attained
0 High School Diploma

0 High School Equivalent

O Associates Degree (2 years post high school)
0 Bachelor's Degree (4 years post high school)
0 Master’s Degree (6 years post high school)
0 Doctoral Degree (10 years post high school)
0 Other (please specify)

 

Coachin Location

0 Bellevue O lonia
0 Catholic Central 0 Lansing
. 0 Charlotte O Mason
0 DeWitt 0 Maple Valley
0 Eaton Rapids 0 Okemos
O Fulton-Middleton O Olivet
0 Grand Ledge O Ovid—Elsie
O Holt O Perry

0 Pewamo-W.
0 Portland

0 St. Johns
O Saranac

O Sprinspon
O Waverly

 

 

Athletes you are coaching this season?
0 Predominantly Male

0 Predominantly Female

O Even mix ofmalec & females

Grade CurrerLtly Coaching
0 4th & 5th grades 0 8th grade

0 6th grade 0 9th grade

07thgrade 010thgradeorhigher
Grades Previously Coached
O4th&5thgrades OSthgrade

0 6th grade 0 9th grade

0 7th grade 0 10th grade or higher

 

 

Smrts Coached in the last 10 years

0 Soccer 0 Wrestling

0 Basketball 0 Swimming
0 Football 0 Ice Hockey
0 Teoball 0 Field Hockey
0 Baseball 0 Volleyball
0 Softball 0 Other

 

 

Have you ever had any formal first-aid training? If yg,
please fill in circle of all that apply and please provide

the date of certification.

0 American Red Cross First-Aid and CPR Training

0 American Red Cross First-Aid Training

0 American Red Cross CPR Training

0 American Heart Association CPR Training

0 MSU-PACE

(Program for Athletic Coaches Education)

Q EMT (Emergency Medical Technician Training)

O Paramedics] Training

0 Other (please specify)

Month/Year

 

 

/

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you currently certified in first-aid? (completed
the course or a refresher course in the last 3 years)

OYes ONO

(If yes please write the date that your certification

Month/ Year

/

will expire.

 

 

 

 

 

 

 

 

 

0 Yes 0 No

Are you currently certified in CPR? (completed the

course or a refresher course in the last car

If yes please write the date that your certification

will expire. Month/Year

 

 

/

 

 

 

 

 

 

 

 

 

134

62465

 

APPENDIX D

Informed Consent Form

135

INFORMED CONSENT FORM
Michigan State University

The Assessment of F irst-Aid and Injury Prevention Knowledge and the Decision Making of Youth
Basketball, Soccer, and Football Coaches

 

Primary Investigators: John Powell, Ph.B., ATC Mary Barron
Department of Kinesiology Department of Kinesiology
40 IM Sports Circle 38 1M Sports Circle
(517) 432-5018 (517) 353-0892
flirelljnltrgnisucdu barronm3(almsuedu

 

 

Project Description:

 

This study assesses the first-aid and injury prevention knowledge of youth coaches. Addtionally how a
coach uses their first aid and injury prevention knowledge in determining if an injured athlete can return to
practice or competition will also be assessed.

Your participation will involve filling out a demographic information sheet to inform the researchers of
sport, gender, and age of athletes you coach, number of year’s coached, previous first-aid knowledge and
your educational background. You will also be asked to take the revised American Red Cross First-Aid
Assessment. The American Red Cross Assessment measures a persons’ knowledge in a number of areas
such as anatomy, care and treatment, prevention, and assessment of injuries. You will also be asked to take
the Game Situation Data Sheet. The Game Situation Data Sheet will present different scenarios in which
you will be asked whether an injured player should be allowed to return to practice/competition.

All identities and information gathered from the study will remain confidential. You will be provided with
an identification number at the beginning of the study. All data will be analyzed using individual
identification numbers. Participants will remain anonymous in any reporting of the data from the study.
All data will be maintained in a secure location, accessible only to the investigators of the study. You will
be shown group and individual results at the conclusion of the study. Your privacy will be protected to the
maximum extent possible. Participation in this study is voluntary. You may choose to withdraw from the
study at any time. Any questions concerning participation in this study should be directed to Mary Barron,
ATC, 517 349-0487 or John Powell, ATC, 517 432-5018.

Informed Consent: This section indicates that you are giving your informed consent to participate in
the research.

Participant: I have read and agree to participate in the research study as described above.
Name: Signature: Date:

 

 

For addition information and the rights and roles ofparticipants in research projects please fell free to
contact:
David E. Wright. Ph.D.
Chair Person
University Committee on Research Involving Human Subjects
246 Administration Building
(517) 355-2180

Researcher: I certify that the informed consent procedure has been followed, and that I have
answered any and all questions from the participants as fully as possible.

Name: Signature: Date:

 

 

136

APPENDIX E

Post hoc Sheffe test for Injury ID/General Medical Knowledge Construct and

Educational Background.

137

 

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
High School High School _
Diploma Equivalent 1.31 1.06 .997 3.14 5.75
Ass°c'ates -.59 .35 .909 -2.15 .75
Degree
BaChe'O'S -.66 .29 .810 -1.86 .54
Degree
MaSters -1 .19 .50 .765 -3.28 .89
Degree
Doc‘ora' -1.48 .59 .701 -393 .97
Degree
Other -.19 1.06 1.000 -4.64 4.25
some High .31 1.06 1.000 -4.14 4.75
School
50m -.19 1.05 1.000 -454 4.25
College
Not
Specified .14 .87 1.000 -3.51 3.79

138

95% Confidence

 

Interval
Educational Educational Mean Std Si gnificance Lower Upper
Background Background Difference Error Bound Bound
High School High School _ _
Equivalent Diploma 1.31 1.06 .997 5.75 3.14
A55°°iates -2.00 1.09 .947 -6.57 2.57
Degree
BaChe'Ors -1.96 1.08 .948 -6.46 2.53
Degree
MaSters -2.50 1.15 .856 -7.31 2.31
Degree
D°°t°'a' -279 1.19 .790 -7.76 2.19
Degree
Other -1.50 1.49 .999 -7.71 4.71
some “'9“ -1.00 1.49 1.000 -721 5.21
School
some -1.50 1.49 .999 -7.71 4.71
College
Not Specified -1.17 1.36 1.000 —6.83 4.50

first.) I... rllr .Nvu...» . n.. ..

95% Confidence

 

Interval
Educational Educational Mean Std Si gnifrcance Lower Upper
Background Background Difference Error Bound Bound
Associates High School
Degree Diploma .69 .35 .909 -.76 2.15
High .SChC’O' 2.00 1.09 .947 -2.57 6.57
Equrvalent
BaChe'ors 3.66E-02 .38 1.000 -1.56 1.63
Degree
MaSte'S -.50 .56 1.000 -2.84 1.84
Degree
00mm” -.79 .64 .997 -3.45 1.88
Degree
Other .50 1.09 1.000 -4.07 5.07
some “'9“ 1.00 1.09 1.000 -3.57 5.57
School
some .50 1.09 1.000 -407 5.07
College
Not Specified .83 .91 1.000 -2.97 4.63

140

95% Confidence

 

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Bachelors High School -
Degree Diploma .66 .29 .810 .54 1.86
High SChOO' 1.96 1.08 .948 -2.53 6.46
Equ1valent
ASSOCiateS -3.66E-02 .38 1.000 -1.63 1.56
Degree
MaSters -.54 .52 .999 -2.73 1.65
Degree
Doc‘ora' -.82 .61 .993 -3.36 1.72
Degree
Other .46 1.08 1.000 -4.03 4.96
some High .96 1.08 1.000 -3.53 5.46
School
80”“ .46 1.08 1.000 -4.03 4.96
College
Not Specified .80 .89 1.000 -2.92 4.51

141

 

95% Confidence
Interval

 

Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Masters High School
Degree Diploma 1.19 .50 .765 -.89 3.28
High .SChOO' 2.50 1.15 .856 -2.31 7.31
Equ1valent
Assoc'ates .50 .56 1.000 -1.84 2.84
Degree
BaChe'ors .54 .52 .999 -1.65 2.73
Degree
D°°t°ra' -.29 .73 1.000 -3.34 2.77
Degree
Other 1.00 1.15 1.000 -3.81 5.81
some High 1.50 1.15 .995 -331 6.31
School
some 1.00 1.15 1.000 ~3.81 5.81
College
Not Specified 1.33 .98 .993 -2.75 5.42

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Doctoral High School
Degree Diploma 1.48 .59 .701 -.97 3.93
High .SChOO' 2.79 1.19 .790 -2.19 7.76
Equ1valent
Assoc'ates .79 .64 .997 -1.88 3.45
Degree
BaChe'm .82 .61 .993 -1.72 3.36
Degree
Mas‘e's .29 .73 1.000 -2.77 3.34
Degree
Other 1.29 1 .19 .999 -3.69 6.26
some High 1.79 1.19 .986 -3.19 6.76
School
S°me 1.29 1.19 .999 -3.69 6.26
College
Not Specified 1.62 1.03 .980 -2.66 5.90
143

—~I

I h-r‘fi

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
High School
Other Diploma .19 1.06 1.000 -4.25 4.64
High $°h°°' 1.50 1.49 .999 -4.71 7.71
Equ1valent .
Assoc'ates -.50 1.09 1.000 -5.07 4.07
Degree
Bacm'ms -.46 1.08 1.000 -4.96 4.03
Degree
MaSters -1.00 1.15 1.000 -5.81 3.81
Degree
DOCtO'a' -129 1 .19 .999 -6.26 3.69
Degree
some High .50 1.49 1.000 -5.71 6.71
School
some .00 1.49 1.000 -6.21 6.21
College
Not Specified .33 1.36 1.000 -5.33 6.00

144

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Some High High School - _
School Diploma .31 1.06 1.000 4.75 4.14
High SChOO' 1.00 1.49 1.000 -5.21 7.21
Equrvalent
ASSOClateS -1.00 1.09 1.000 -5.57 3.57
Degree
BaChe'o's -.96 1.08 1.000 -5.46 3.53
Degree
Mame” -150 1.15 .995 -6.31 3.31
Degree
D°°t°'a' -179 1.19 .986 -6.76 3.19
Degree
Other -.50 1.49 1.000 -6.71 5.71
some -.50 1.49 1.000 -6.71 5.71
College
Not Specified -.17 1.36 1.000 -5.83 5.50

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
3°” ”'9“ .SChOO' .19 1.06 1.000 -4.25 4.64
College Diploma
High .SChOO' 1.50 1.49 .999 -471 7.71
Equ1valent
ASS°°'ateS -.50 1.09 1.000 -5.07 4.07
Degree
BaCheIO’s -.46 1.08 1.000 -4.96 4.03
Degree
MaSte‘S -1.00 1.15 1.000 -5.81 3.81
Degree
DOCtO'a' -129 1.19 .999 -6.26 3.69
Degree
Other .00 1.49 1.000 -6.21 6.21
some ”'9“ .50 1.49 1.000 -5.71 6.71
School
Not Specified .33 1.36 1.000 -5.33 6.00

146

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
. . High School
Not Specrfled Diploma ‘-14 -87 1000 ‘3'79 3'51
High School 1.17 1.36 1000 -450 6,83
Equ1valent
Associates -.83 .91 1.000 -453 297
Degree
Bachelors -.8O .89 1000 -451 2,92
Degree
Mas‘ers -133 .98 .993 -5.42 2.75
Degree
Doctoral -1.62 1.03 .980 -590 2.66
Degree
Other -.33 1.36 1.000 -6.00 5.33
Some High .17 1.36 1.000 -5.50 5.83
School
some -.33 1.36 1.000 -6.00 5.33
College

 

147

APPENDIX F

Post hoc Sheffe test for Injury Management Construct and Educational Background.

148

 

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
High School High School _ _ _
Diploma Equivalent 6.49E 02 .81 1.000 3.45 3.32
Ass°°'ates -.27 .26 .999 -1 .38 .83
Degree
Bacmm” -.67 .22 .398 -1 .59 .24
Degree
Mama's -1.46 .38 .106 -305 .12
Degree
D°°t°ra' -1 .49 .45 .274 -3.36 .37
Degree
Other -1.06 .81 .995 -4.45 2.32
8"” ”'9“ .44 .81 1.000 -2.95 3.82
School
SOme -6.49E-02 .81 1.000 -3.45 3.32
College
.5“ -6.49E-02 .67 1.000 -2.85 2.72
Specrfled

149

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
High School High School - _
Equivalent Diploma 6.49E 02 .81 1.000 3.32 3.45
ASS°°'ateS -21 .83 1.000 -3.69 3.27
Degree
BaChe'O'S -.61 .82 1.000 -4.03 2.81
Degree
Mama’s -1.40 .88 .979 -5.06 2.26
Degree
D°°t°’a' -1.43 .91 .981 -5.22 2.36
Degree
Other -1.00 1.13 1.000 -5.73 3.73
some ”'9“ .50 1.13 1.000 -4.23 5.23
School
some .00 1.13 1.000 —4.73 4.73
College
Not Specified .00 1.03 1 .000 -4.32 4.32

150

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Associates High School
Degree Diploma .27 .26 .999 -.83 1.38
High $°h°°' .21 .83 1.000 -327 3.69
Equ1valent
BaChe'O'S -40 .29 .992 -1.62 .81
Degree
Meme“ -1 .19 .43 .554 -2.97 .59
Degree
0°Ct0'a' -122 .49 .708 -3.25 .81
Degree
Other -.79 .83 1.000 -4.27 2.69
30m ”'9“ .71 .83 1.000 -2.77 4.19
School
Some
College .21 .83 1.000 -3.27 3.69
Not Specified .21 .69 1.000 -2.69 3.10

151

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Bachelors High School
Degree Diploma .67 .22 .398 -.24 1.59
High School
Equivalent .61 .82 1.000 -2.81 4.03
Assoc'ates .40 .29 .992 -.81 1.62
Degree
MaSte’S -.79 .40 .914 -2.46 .88
Degree
DOCtO’a' -.82 .46 .957 -2.75 1.11
Degree
Other -.39 .82 1.000 -3.81 3.03
some “'9“ 1.11 .82 .993 -2.31 4.53
School
some .61 .82 1.000 -2.81 4.03
College
Not Specified .61 .68 1.000 -2.22 3.44

UI

to

95% Confidence

 

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Masters High School
Degree Diploma 1.46 .38 .106 -.12 3.05
High .SC“°°' 1.40 .88 .979 -2.26 5.06
Equ1valent ‘;
Ass°°iates 1.19 .43 .554 -59 2.97 -.
Degree
BaChe'0's .79 .40 .914 -.88 2.46
Degree
DOCtO'a' -2.86E-02 .56 1.000 -2.36 2.30
Degree
Other .40 .88 1.000 -3.26 4.06
some “'9“ 1.90 .88 .857 -1.76 5.56
School
50'“ 1.40 .88 .979 -2.26 5.06
College
Not Specified 1.40 .75 .938 -1.71 4.51

| rrfi'

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Doctoral High School
Degree Diploma 1.49 .45 .274 -.37 3.36
High .SChOO' 1.43 .91 .981 -2.36 5.22
Equ1valent
ASSOCiateS 1.22 .49 .708 -.81 3.25
Degree
BaChe'O’S .82 .46 .957 -1.11 2.75
Degree
MaSte'S 2.86E-02 .56 1.000 -2.30 2.36
Degree
Other .43 .91 1.000 -3.36 4.22
some “'9“ 1.93 .91 .872 -1.86 5.72
School
some 1.43 .91 .981 -2.36 5.22
College
Not Specified 1.43 .78 .947 -1.83 4.69

154

95% Confidence
Interval

 

Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
High School
Other Diploma 1.06 .81 .995 -2.32 4.45
High SChOO' 1.00 1.13 1.000 -3.73 5.73
Equ1valent
Assodates .79 .83 1.000 -2.69 4.27
Degree
BaChe'Ors .39 .82 1.000 -3.03 3.81
Degree
MaSte’S -.40 .88 1.000 -4.06 3.26
Degree
Down“ -.43 .91 1.000 -422 3.36
Degree
some High 1.50 1.13 .994 -323 6.23
School
some 1.00 1.13 1.000 -373 5.73
College
Not Specified 1.00 1.03 1.000 -3.32 5.32

155

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Some High High School _
School Diploma .44 .81 1.000 -3.82 2.95
High School
Equivalent -.50 1.13 1.000 -5.23 4.23
ASSOCia‘es -.71 .83 1.000 -4.19 2.77
Degree
BaChe'O'S -1.11 .82 .993 -453 2.31
Degree
MaSters -190 .88 .857 -5.56 1.76
Degree
DSCtma' -1.93 .91 .872 -5.72 1.86
egree
Other -1.50 1.13 .994 -6.23 3.23
some -.50 1.13 1.000 -5.23 4.23
College
Not Specified -.50 1.03 1.000 -4.82 3.82

156

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound
Some High 50““ 6.49E-02 .81 1.000 -3.32 3.45
College Diploma
”‘9“ .5Ch00' .00 1.13 1.000 -413 4.73
Equnvalent
Associates ‘21 .83 1.000 -359 327
Degree
Bachelors -.61 .82 1.000 .403 2.81
Degree
MaSters -1 .40 .88 .979 -5.06 2.26
Degree
Doctoral _1 ‘43 '91 .981 -522 236
Degree
Other -1.00 1.13 1.000 -5.73 373
Some High .50 1,13 1.000 -4.23 5.23
School
Not Specified .00 1.03 1.000 -4.32 4.32
157

 

[Fl “5..

 

 

95% Confidence

 

Interval
Educational Educational Mean Std Significance Lower Upper
Background Background Difference Error Bound Bound

. . High School

Not SpeCIerd Diploma 6.49E-O2 .67 1.000 -2.72 2.85

High School '

Equivalent .00 1.03 1.000 -4.32 4.32

ASSOCiates -.21 .69 1.000 -3.10 2.69
Degree

BaChe'O’S -.61 .68 1.000 -3.44 2.22
Degree

Meme“ -1 .40 .75 .938 -451 1.71
Degree

Doc‘ora' -1 .43 .78 .947 -459 1.83
Degree

Other —1.00 1.03 1.000 -5.32 3.32

some “‘9“ .50 1.03 1.000 -3.82 4.82
School

S°me .00 1.03 1.000 -4.32 4.32
College

 

 

 

APPENDIX G

Chi-Square Analysis of Game Situation Data Sheet by Pass/F ail First Aid Assessment

159

 

 

First of the Bench in a Clearly Losing Competition Situation

 

 

 

 

 

FlrSt Ald Game Situation One Total
Assessment
Yes No

Count 30 239 269
Fail

Expected Count 29.4 239.6 269

Count 1 14 15
Pass

Expected Count 1.6 13.4 15
Total Count 31 253 284

Expected Count 31 253 284
Bench Player in a Clearly Winning Situation
FlrSt Ald Game Situation Three Total
Assessment

Yes No

Count 37 232 269
Fail

Expected Count 36 233 269

Count 1 14 15
Pass

Expected Count 2 13 15
Total Count 38 246 284

Expected Count 38 246 284

 

160

Starter in a Game that the Team is Down by 4 Points

 

First Aid

 

 

 

 

Game Situation Four Total
Assessment
Yes No
Count 123 146 269
Fail
Expected Count 122.2 146.8 269
Count 6 9 15
Pass
Expected Count 6.8 8.2 15
Total Count 129 155 284
Expected Count 129 155 284
Bench Player in a Game that the Team is Down by 4 points
FlrSt Ald Game Situation Five Total
Assessment
Yes No
_ Count 62 207 269
Fall
Expected Count 62.5 206.5 269
Count 4 11 15
Pass
Expected Count 3.5 1 1.5 15
Count 66 218 284
Total
Expected Count 66 218 284

 

161

 

Backup Player in a Clearly Winning Situation

 

First Aid

 

 

 

 

Game Situation Six Total
Assessment
Yes No

Count 37 232 269
Fail

Expected Count 36 233 269

Count 1 14 15
Pass

Expected Count 2 13 15

Count 38 246 284
Total

Expected Count 38 246 284
Starter in 3 Clearly Losing Situation
FlrSt Ald Game Situation Seven Total
Assessment

Yes No

Count 42 227 269
Fail

Expected Count 39.8 229.2 269

Count 0 15 15
Pass

Expected Count 2.2 12.8 15
Total Count 42 242 284

Expected Count 42 242 284

 

162

 

Backup Player in a Close Winning Situation

 

 

 

 

 

FlrSt Ald Game Situation Eight Total
Assessment
Yes No

Count 93 116 209
Fail

Expected Count 94.7 114.3 209

Count 8 6 14
Pass

Expected Count 6.3 7.7 14

Count 101 122 223
Total

Expected Count 101 122 223
Bench Player in a Clearly Losing Situation
FlrSt Ald Game Situation Nine Total
Assessment

Yes No

Count 68 141 209
Fail

Expected Count 68.4 140.6 209

Count 5 9 14
Pass

Expected Count 4.6 9.4 14
Total Count 73 150 223

Expected Count 73 150 223

 

APPENDIX H

Chi-Square Analysis of Game Situation Data Sheet by Sport Coached

164

 

First of the Bench in a Clearly Losing Competition Situation

 

 

 

 

 

Sport Game Situation One Total
Yes No

Count 26 207 233
Football

Expected Count 25.4 207.6 233

Count 3 30 33
Basketball

Expected Count 3.6 29.4 33

Count 2 16 18
Soccer

Expected Count 2 16 18

Count 31 253 284
Total

Expected Count 31 253 284
Starter in a Clearly Winning Situation
Sport Game Situation Two Total

Yes No

Count 73 160 233
Football

Expected Count 73.8 159.2 233

Count 12 21 33
Basketball

Expected Count 10.5 22.5 33

Count 5 13 18
Soccer

Expected Count 5.7 12.3 18
Total Count 90 194 284

Expected Count 90 194 284

 

Bench Player in a Clearly Winning Situation

 

 

 

 

 

 

Sport Game Situation Three Total
Yes No

Count 28 205 233
Football

Expected Count 31.2 201.8 233

Count 7 26 33
Basketball

Expected Count 4.4 28.6 33

Count 3 15 18
Soccer

Expected Count 2.4 15.6 18

Count 38 246 284
Total

Expected Count 38 246 284
Starter in a Game that the Team is Down by 5 Points
Sport Game Situation Four Total

Yes No

Count 107 126 233
Football

Expected Count 105.8 127.2 233

Count 12 21 33
Basketball

Expected Count 15 18 33

Count 10 8 18
Soccer

Expected Count 8.2 9.8 18
Total Count 129 155 284

Expected Count 129 155 284

166

 

| [If -_n

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

 

 

Sport Game Situation Five Total
Yes No

Count 52 181 233
Football

Expected Count 54.1 178.9 233

Count 10 23 33
Basketball

Expected Count 7.7 25.3 33

Count 4 14 18
Soccer

Expected Count 4.2 13.8 18

Count 66 218 284
Total

Expected Count 66 218 284
Backup Player in a Clearly Winning Situation
Sport Game Situation Six Total

Yes No

Count 30 203 233
Football

Expected Count 31.2 201.8 233

Count 5 28 33
Basketball

Expected Count 4.4 28.6 33

Count 3 15 18
Soccer

Expected Count 2.4 15.6 18
Total Count 38 246 284

Expected Count 38 246 284

 

167

 

Starter in a Clearly Losing Situation

 

 

 

 

 

Sport Game Situation Seven Total
Yes No

Count 34 199 233
Football

Expected Count 34.5 198.5 233

Count 7 26 33
Basketball

Expected Count 4.9 28.1 33

Count 1 17 18
Soccer

Expected Count 2.7 15.3 18

Count 42 242 284
Total

Expected Count 42 242 284
Backup Player in a Close Winning Situation
Spon . . .

Game Situation Eight Total
Yes No

Count 79 103 182
Football

Expected Count 82.4 99.6 182

Count 10 14 24
Basketball

Expected Count 10.9 13.1 24

Count 12 5 17
Soccer

Expected Count 7.7 9.3 17

Count 101 122 223
Total Expected Count 101 122 223

 

168

APPENDIX I

Chi-Square Analysis of Game Situation Data Sheet by Gender

169

First of the Bench in a Clearly Losing Competition Situation

 

 

 

 

 

 

Gender Game Situation One Total
Yes No

Count 12 135 147
Male

Expected Count 12.7 134.3 147

Count 2 13 15
Female

Expected Count 1.3 13.7 15
Total Count 14 148 162

Expected Count 14 148 162
Bench Player in a Clearly Winning Situation
Gender Game Situation Three Total

Yes No

Count 24 123 147
Male

Expected Count 23.6 123.4 147

Count 2 13 15
Female

Expected Count 2.4 12.6 15
Total Count 26 136 162

Expected Count 26 136 162

170

l‘F-_

Bench Player in a Game that the Team is Down by 4 points

 

 

 

 

 

 

Gender Game Situation Five Total
Yes No

Count 38 109 147
Male

Expected Count 39 108 147

Count 5 10 15
Female

Expected Count 4 11 15

Count 43 1 19 162
Total

Expected Count 43 119 162
Backup Player in a Clearly Winning Situation
Gender Game Situation Six Total

Yes No

Count 20 127 147
Male

Expected Count 20.9 126.1 147

Count 3 12 15
Female

Expected Count 2.1 12.9 15

Count 23 139 162
Total

Expected Count 23 139 162

 

171

 

 

Starter in a Clearly Losing Situation

 

 

 

 

 

Gender Game Situation Seven Total
Yes No

Count 19 128 147
Male

Expected Count 20 127 147

Count 3 12 15
Female

Expected Count 2 13 15

Count 22 140 162
Total

Expected Count 22 140 162
Backup Player in a Close Winning Situation
Gender Game Situation Eight Total

Yes No

Count 55 61 116
Male

Expected Count 54 62 116

Count 5 8 13
Female

Expected Count 6 7 13

Count 60 69 129
Total

Expected Count 60 69 129

 

172

Bench Player in a Clearly Losing Situation

 

 

 

Gender Game Situation Nine Total
Yes No

Count 37 79 116
Male

Expected Count 39.6 76.4 116

Count 7 6 13
Female

Expected Count 4.4 8.6 13

Count 44 85 129
Total

Expected Count 44 85 129

173

I ;

 

I":

ifs-1.

APPENDIX J

Chi-Square Analysis of Game Situation Data Sheet by Age

174

First off the Bench in a Clearly Losing Competition Situation

 

 

Age Game Situation One Total
Yes No

Count 5 47 52
37 and below .

Expected Count 4.4 47.6 52

Count 4 38 42
38-40

Expected Count 3.6 38.4 42

Count 4 32 36
41-43

Expected Count 3.1 32.9 36

Count 1 34 35
44-62

Expected Count 3 32 35

Count 14 151 165
Total

Expected Count 14 151 165

 

175

 

Starter in a Clearly Winning Competition Situation

 

 

 

Age Game Situation Two Total
Yes No
Count 19 33 52
37 and below
Expected Count 15.8 36.2 52
Count 15 27 42
38-40
Expected Count 12.7 29.3 42
Count 9 27 36
41-43
Expected Count 10.9 25.1 36
Count 7 28 35
44-62
Expected Count 10.6 24.4 35
Count 50 115 165
Total
Expected Count 50 115 165
176

 

Bench Player in a Clearly Winning Situation

 

 

 

 

Age Game Situation Three Total
Yes No
Count 8 44 52
37 and below
Expected Count 8.2 43.8 52
Count 8 34 42 E
38-40 :1
Expected Count 6.6 35.4 42
Count 6 3O 36
41-43
Expected Count 5.7 30.3 36
Count 4 31 35
44-62
Expected Count 5.5 29.5 35
Count 26 139 165
Total
Expected Count 26 139 165
177 I

m

o
'x‘ «kai

 

 

Starter in a Game that the Team is Down by 5 Points

 

 

 

Age Game Situation Four Total
Yes No

Count 19 33 52
37 and below

Expected Count 23.6 28.4 52

Count 20 22 42
38-40

Expected Count 19.1 22.9 42

Count 21 15 36
41-43

Expected Count 16.4 19.6 36

Count 15 20 35
44-62

Expected Count 15.9 19.1 35

Count 75 90 165
Total

Expected Count 75 90 165

178

 

FF -_'

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

 

 

Age Game Situation Five Total
Yes No
Count 10 42 52
37 and below
Expected Count 13.6 38.4 52
Count 11 31 42
38-40
Expected Count 10.9 31.1 42
Count 12 24 36
41-43
Expected Count 9.4 26.6 36
Count 10 25 35
44-62
Expected Count 9.1 25.9 35
Count 43 122 165
Total
Expected Count 43 122 165
179 "

1-

Backup Player in a Clearly Winning Situation

 

 

 

Age Game Situation Six Total
Yes No
Count 6 46 52
37 and below
Expected Count 7.2 44.8 52
Count 6 36 42 1
38-40 1.
Expected Count 5.9 36.1 42
I
Count 5 31 36
41-43
Expected Count 5 31 36
Count 6 29 35
44-62
Expected Count 4.9 30.1 35
Count 23 142 165
Total
Expected Count 23 142 165

 

180

 

Starter in a Clearly Losing Situation

 

 

 

Age Game Situation Seven Total
Yes No
Count 6 46 52
37 and below
Expected Count 6.9 45.1 52
Count 6 36 42
38-40
Expected Count 5.6 36.4 42
Count 5 31 36
41-43
Expected Count 4.8 31.2 36
Count 5 30 35
44-62
Expected Count 4.7 30.3 35
Count 22 143 165
Total
Expected Count 22 143 165
181

 

Backup Player in a Close Winning Situation

 

 

 

 

Age Game Situation Eight Total
Yes No

Count 20 20 40
37 and below

Expected Count 19.1 20.9 40

Count 20 15 35 p
38-40 .

Expected Count 16.7 18.3 35

Count 10 17 27 H
41-43

Expected Count 12.9 14.1 27

Count 13 17 30
44-62

Expected Count 14.3 15.7 30

Count 63 69 132
Total

Expected Count 63 69 132

182 I,

APPENDIX K

Chi-Square Analysis of Game Situation Data Sheet by Years of Coaching

183

m

First off the Bench in a Clearly Losing Competition Situation

 

 

 

Years 9f Game Situation One Total
Coaching
Yes No

Count 2 33 35
0 - 2

Expected Count 3 32 35

Count 2 38 4O
3 ~ 4

Expected Count 3.5 36.5 40
5 9 Count 8 35 43

Expected Count 3.7 39.3 43

Count 2 42 44
10 - 27

Expected Count 3.8 40.2 44

Count 14 148 162
Total

Expected Count 14 148 162

184

 

.1
.1

L

Starter in a Clearly Winning Competition Situation

 

 

 

 

Years .Of Game Situation Two Total
Coaching
Yes No
0 2 Count 13 22 35
- Expected Count 10.4 24.6 35
3 4 Count 13 27 40 i
- Expected Count 1 1.9 28.1 40 1
l
5 9 Count 14 29 43
- Expected Count 12.7 30.3 43
Count 8 36 44
10 - 27
Expected Count 13 31 44
Count 48 114 162
Total
Expected Count 48 114 162
185 if

Bench Player in a Clearly Winning Situation

 

 

 

 

Years 9f Game Situation Three Total
Coaching
Yes No
Count 2 33 35
0 - 2
Expected Count 5.4 29.6 35
Count 9 31 40
3 - 4
Expected Count 6.2 33.8 40
5 9 Count 7 36 43
- Expected Count 6.6 36.4 43
Count 7 37 44
10 - 27
Expected Count 6.8 37.2 44
Count 25 137 162
Total
Expected Count 25 137 162
186 'E'

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

Years .Of Game Situation Five Total
Coachmg
Yes No

Count 6 29 35
0 - 2

Expected Count 9.1 25.9 35

Count 11 29 40
3 - 4

Expected Count 10.4 29.6 40
5 9 Count 10 33 43

Expected Count 1 1.1 31.9 43

Count 15 29 44
10 - 27

Expected Count 1 1.4 32.6 44

Count 42 120 162
Total

Expected Count 42 120 162

187

‘_l

Backup Player in a Clearly Winning Situation

 

 

 

Years .Of Game Situation Six Total
Coaching
Yes No

Count 3 32 35
0 - 2

Expected Count 4.8 30.2 35

Count 5 35 40
3 - 4

Expected Count 5.4 34.6 40
5 9 Count 9 34 43

Expected Count 5.8 37.2 43

Count 5 39 44
10 - 27

Expected Count 6 38 44

Count 22 140 162
Total

Expected Count 22 140 162

188

139"“,

Starter in a Clearly Losing Situation

 

Years of

 

Coaching Game Situation Seven Total
Yes No

Count 3 32 35
0 - 2

Expected Count 4.3 30.7 35

Count 6 34 40
3 - 4

Expected Count 4.9 35.1 40
5 9 Count 6 37 43

Expected Count 5.3 37.7 43

Count 5 39 44
10 - 27

Expected Count 5.4 38.6 44

Count 20 142 162
Total

Expected Count 20 142 162

 

189

Backup Player in a Close Winning Situation

 

 

 

Years 9f Game Situation Eight Total
Coaching
Yes No
Count 13 14 27
0 - 2
Expected Count 12.9 14.1 27
Count 16 15 31 b
3 - 4
Expected Count 14.8 16.2 31 I
5 9 Count 13 21 34 I
Expected Count 16.2 17.8 34
Count 20 18 38
10 ~ 27
Expected Count 18.1 19.9 38
Count 62 68 130
Total
Expected Count 62 68 130

 

190 I

Bench Player in a Clearly Losing Situation

 

 

Years 9f Game Situation Nine Total
Coaching
Yes N0

Count 11 16 27
0 - 2 Expected

Count 91 17.9 27

Count 11 20 31
3 - 4 Expected 10 5 20 5 31

Count ' .

Count 12 22 34
5 - 9 Expected

Count 115 22.5 34

Count 10 28 38
10 - 27 Expected

Count 129 25.1 38

Count 44 86 130
T0131 EXPCCICd 44 86 130

Count

 

191

 

APPENDIX L

Chi-Square Analysis of Game Situation Data Sheet by Number of Sports Coached

 

192

“—11

First off the Bench in a Clearly Losing Competition Situation

 

 

 

Number of
Sports Game Situation One Total
Coached
Yes No

Count 3 40 43
0 - 1

Expected Count 3.6 39.4 43

Count 2 30 32
2

Expected Count 2.7 29.3 32
3 Count 5 36 41

Expected Count 3.5 37.5 41
4 7 Count 4 45 49

Expected Count 4.2 44.8 49

Count 14 151 165
Total

Expected Count 14 151 165

193

 

l mar—q

Starter in a Clearly Winning Competition Situation

 

 

 

Number of
Sports Game Situation Two Total
Coached
Yes No
0 1 Count ' 11 32 43
- Expected Count 13 30 43
2 Count 10 22 32
Expected Count 9.7 22.3 32
3 Count 16 25 41
Expected Count 12.4 28.6 41
4 7 Count 13 36 49
- Expected Count 14.8 34.2 49
Count 50 115 165
Total
Expected Count 50 115 165
194

 

L.

Bench Player in a Clearly Winning Situation

 

 

 

Number of
Sports Game Situation Three Total
Coached
Yes No
Count 6 37 43
0 - 1
Expected Count 6.8 36.2 43
Count 9 23 32
2
Expected Count 5 27 32
3 Count 3 38 41
Expected Count 6.5 34.5 41
4 7 Count 8 41 49
- Expected Count 7.7 41.3 49
Count 26 139 165
Total
Expected Count 26 139 165
195

 

l E‘E‘fiq]

Starter in a Game that the Team is Down by 5 Points

 

 

 

Number of
Sports Game Situation Four Total
Coached
Yes No

Count 15 28 43
0 - 1

Expected Count 19.5 23.5 43

Count 17 15 32
2

Expected Count 14.5 17.5 32
3 Count 22 19 41

Expected Count 18.6 22.4 41
4 7 Count 21 28 49

- Expected Count 22.3 26.7 49

Count 75 90 165
Total

Expected Count 75 90 165

196

{amt r' I. f

 

it F"—lll

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

Number of
Sports Game Situation Five Total
Coached
Yes No

Count 13 30 43
0 - 1

Expected Count 1 1.2 31.8 43

Count 11 21 32
2

Expected Count 8.3 23.7 32
3 Count 9 32 41

Expected Count 10.7 30.3 41
4 7 Count 10 39 49

Expected Count 12.8 36.2 49

Count 43 122 165
Total

Expected Count 43 122 165

197

 

| 5?“:

Backup Player in a Clearly Winning Situation

 

 

 

 

Number of
Sports Game Situation Six Total
Coached
Yes No
Count 5 38 43
0 - 1
Expected Count 6 37 43
1
Count 6 26 32
2
Expected Count 4.5 27.5 32 i
3 Count 5 36 41
Expected Count 5.7 35.3 41
4 7 Count 7 42 49
- Expected Count 6.8 42.2 49
Count 23 142 165
Total
Expected Count 23 142 165
198 if

|l

Starter in a Clearly Losing Situation

 

 

 

Number of
Sports Game Situation Seven Total
Coached
Yes No

Count 4 39 43
0 - 1

Expected Count 5.7 37.3 43

Count 2 30 32
2

Expected Count 4.3 27.7 32
3 Count 8 33 41

Expected Count 5.5 35.5 41
4 7 Count 8 41 49

Expected Count 6.5 42.5 49

Count 22 143 165
Total

Expected Count 22 143 165

199

 

I. ”q!

ll

Backup Player in a Close Winning Situation

 

 

 

 

Number of
Sports Game Situation Eight Total
Coached
Yes No
Count 13 19 32
0 - 1
Expected Count 15.3 16.7 32
1'
Count 12 13 25 :
2 1
Expected Count 1 1.9 13.1 25 I
3 Count 18 18 36
Expected Count 17.2 18.8 36
4 7 Count 20 19 39
Expected Count 18.6 20.4 39
Count 63 69 132
Total
Expected Count 63 69 132
200 I
i

Bench Player in a Clearly Losing Situation

 

 

 

Number of
Sports Game Situation Nine Total
Coached
Yes No

Count 9 23 32
0 - 1

Expected Count 10.9 21.1 32

Count 11 14 25
2

Expected Count 8.5 16.5 25
3 Count 10 26 36

Expected Count 12.3 23.7 36
4 7 Count 15 24 39

- Expected Count 13.3 25.7 39

Count 45 87 132
Total

Expected Count 45 87 132

201

 

1 -—~

APPENDIX M

Chi-Square Analysis of Game Situation Data Sheet by Educational Background

 

First off the Bench in a Clearly Losing Competition Situation

 

 

 

 

Educational Game Situation One Total
Background
Yes No
Count 11 69 80
High School
Expected Count 6.8 73.2 80
Count 2 63 65 i
College
Expected Count 5.5 59.5 65
Advanced Count 1 15 16 I
Degree Expected Count 1.4 14.6 16
Other/Not Count 0 4
Specified Expected Count .3 3.7
Count 14 151 165
Total
Expected Count 14 151 165
203 I

Starter in a Clearly Winning Competition Situation

 

 

 

 

 

Educational Game Situation Two Total
Background
Yes No
High School Count 30 50 80
Expected Count 24.2 55.8 80
College Count 16 49 65
Expected Count 19.7 45.3 65
Advanced Count 3 13 16
Degree
Expected Count 4.8 1 1.2 16
Other/Not
Specified Count 1 3 4
Expected Count 1.2 2.8 4
Total Count 50 1 15 165
Expected Count 50 1 15 165

 

ix)
4C3

Bench Player in a Clearly Winning Situation

 

 

Educational Game Situation Three Total
Background
Yes No

Count 12 68 80
High School

Expected Count 12.6 67.4 80

Count 12 53 65
College

Expected Count 10.2 54.8 65
Advanced Count 2 14 16
Degree Expected Count 2.5 13.5 16
Other/Not Count 0 4
Specified Expected Count .6 3.4

Count 26 139 165
Total

Expected Count 26 139 165

 

 

 

Starter in a Game that the Team is Down by 5 Points

 

 

 

Educational Game Situation Four Total
Background
Yes No

Count 39 41 80
High School

Expected Count 36.4 43.6 80

Count 28 37 65
College

Expected Count 29.5 35.5 65
Advanced Count 6 10 16
Degree Expected Count 7.3 8.7 16
Other/Not Count 2 2
Specified Expected Count 1.8 2.2 4

Count 75 90 165
Total

Expected Count 75 90 165

206

 

t1

 

 

_l

Bench Player in a Game that the Team is Down by 4 Points

 

 

Educational Game Situation Five Total
Background
Yes No

Count 23 57 80
High School

Expected Count 20.8 59.2 80

Count 14 51 65
College

Expected Count 16.9 48.1 65
Advanced Count 5 1 1 16
Degree Expected Count 4.2 11.8 16
Other/Not Count 1 3
Specified Expected Count 1 3.0 4

Count 43 122 165
Total

Expected Count 43 122 165

 

207

 

Backup Player in a Clearly Winning Situation

 

 

Educational Game Situation Six Total
Background
Yes No

Count 11 69 80
High School

Expected Count 11.2 68.8 80

Count 11 54 65
College

Expected Count 9.1 55.9 65
Degree Expected Count 2.2 13.8 16
Other/Not Count 0 4
Specified Expected Count .6 3.4

Count 23 142 165
Total

Expected Count 23 142 165

 

208

 

Starter in a Clearly Losing Situation

 

 

 

Educational Game Situation Seven Total
Background
Yes No

Count 14 66 80
High School

Expected Count 10.7 69.3 80

Count 7 58 65
College

Expected Count 8.7 56.3 65
Advanced Count 1 15 16
Degree Expected Count 2.1 13.9 16
Other/Not Count 0 4
Specified Expected Count .5 3.5

Count 22 143 165
Total

Expected Count 22 143 165

 

209

Backup Player in a Close Winning Situation

 

Educational

 

 

Background Game Situation Eight Total
Yes No
Count 26 37 63
High School
Expected Count 30.1 32.9 63
Count 31 22 53
College
Expected Count 25.3 27.7 53
Advanced Count 5 7 12
Degree Expected Count 5.7 6.3 12
Other/Not Count 1 3
3139911169 Expected Count 1.9 2.1
Count 63 69 132
Total
Expected Count 63 69 132
210

 

 

 

l

Bench Player in a Clearly Losing Situation by Age

 

 

Educational Game Situation Nine Total
Background
Yes NO
Count 19 44 63
HiUh School
e Expected 21.5 41.5 63
Count
Count 22 31 53
College
EXPCCth 181 349 53
Count
Count 3 9 12
Advanced
Degree EXPECtEd 4.1 7-9 12
Count
Count 1 3 4
Other/Not
Specified Expect“ 1.4 2.6 4
Count
Count 45 87 132
Total
Expected 45 87 132
Count

 

 

 

ET

APPENDIX N

Chi-Square Analysis of Game Situation Data Sheet by Gender of Athletes

 

 

First off the Bench in a Clearly Losing Competition Situation

 

 

Gender of . .
Athletes Game Situation One Total
Yes No
Predominantly Count 27 220 247
Male Expected Count 27 220 247
Predominantly Count 2 28 30
Female Expected Count 3.3 26.7 30
Even Mix of Count 2 5 7
Males &
Females Expected Count .8 6,2 7
Count 31 253 284
Total
Expected Count 31 253 284

 

Is.)
;_a
DJ

 

 

 

 

Starter in a Clearly Winning Competition Situation

 

 

Gender of . .
Athletes Game Situation Two Total
Yes No
Predominantly Count 77 170 247
Male Expected Count 78.3 168.7 247
Predominantly Count 12 18 30
Female Expected Count 9.5 20.5 30
Even Mix of Count 1 6 7
Males &
Females Expected Count 2.2 4.8 7
Count 90 194 284
Total
Expected Count 90 194 284

 

214

 

 

Bench Player in a Clearly Winning Situation

 

 

 

Gender of . .
Athletes Game Situation Three Total
Yes No
Predominantly Count 31 216 247
Male Expected Count 33 214 247
Predominantly Count 5 25 30
Female Expected Count 4 26 30
Even Mix of Count 2 5 7
Males &
Females Expected Count .9 6,1 7
Total
Count 38 246 284
Expected Count 38 246 284

 

 

215

 

Starter in a Game that the Team is Down by 5 Points

 

 

 

Gender of . .
Athletes Game Situation Four Total
Yes No
Predominantly Count 1 13 134 247
Male Expected Count 112.2 134.8 247
Predominantly Count 1 1 19 30
Female Expected Count 13.6 16.4 30
Even Mix of Count 5 2 7
Males &
Females Expected Count 3.2 3.8 7
Count 129 155 284
Total
Expected Count 129 155 284
216

 

 

FT?

 

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

Gender of . . .
Athletes Game Situation F ive Total
Yes No
Predominantly Count 56 191 247
Male Expected Count 57.4 189.6 247
Predominantly Count 10 20 30
Female Expected Count 7 23 30
Even Mix of Count 0 7 7
Males &
Femalgs Expected Count 1.6 5,4 7
Count 66 218 284
Total
Expected Count 66 218 284
217

 

 

Backup Player in a Clearly Winning Situation

 

 

 

 

 

2:113:25“ Game Situation Six Total
Yes No
Predominantly Count 34 213 247
Male Expected Count 33 214 247
Predominantly Count 3 27 30
Female Expected Count 4 26 30
Even Mix of Count 1 6 7
Males &
Females Expected Count .9 6.1 7
Count 38 246 284
Total
Expected Count 38 246 284
218 J; .
.. J

Starter in a Clearly Losing Situation

 

 

 

Gender of . .
Athletes Game Situation Seven Total
Yes No
Predominantly Count 36 21 1 247
Male Expected Count 36.5 210.5 247
Predominantly Count 5 25 30
Female Expected Count 4.4 25.6 30
Even Mix of Count 1 6 7
Males &
Females Expected Count 1 6 7
Count 42 242 284
Total
Expected Count 42 242 284
219

 

 

 

Backup Player in a Close Winning Situation

 

 

 

Gender of . . .
Athletes Game Situation Eight Total
Yes No
Predominantly Count 86 109 195
Male Expected Count 88.3 106.7 195
Predominantly Count 1 1 1 1 22
Female Expected Count 10 12 22
Even Mix of Count 4 2 6
Males &
Females Expected Count 2.7 3.3 6
Count 101 122 223
Total
Expected Count 101 122 223

 

 

 

 

Bench Player in 8 Clearly Losing Situation

 

 

Gender of . . .
Athletes Game Situation Nine Total
Yes No
Predominantly Count 60 135 195
Male Expected Count 63.8 131.2 195
Predominantly Count 11 11 22
Female Expected Count 7.2 14.8 22
Even Mix of Count 2 4 6
Males &
Females Expected Count 2 4 6
Count 73 150 223
Total
Expected Count 73 150 223

 

ts.)
k)
H

 

 

 

 

APPENDIX O

Chi-Square Analysis of Game Situation Data Sheet by Formal First Aid Training

 

 

 

 

First off the Bench in a Clearly Losing Competition Situation

 

Formal First

 

 

 

 

 

 

 

Aid Training Game Situation One Total
Yes No

Count 7 87 94
Yes

Expected Count 8 86 94

Count 7 64 71
No

Expected Count 6 65 71

Count 14 151 165
Total

Expected Count 14 151 165
Starter in a Clearly Winning Competition Situation
Formal 1211“ Game Situation Two Total
Aid Training

Yes No

Count 23 71 94
Yes

Expected Count 28.5 65.5 94

Count 27 44 71
No

Expected Count 21.5 49.5 71

Count 50 115 165
Total

Expected Count 50 1 15 165

 

223

 

Bench Player in a Clearly Winning Situation

 

Formal First

 

 

 

 

 

Aid Training Game Situation Three Total
Yes No

Count 15 79 94
Yes

Expected Count 14.8 79.2 94

Count 1 1 60 71
No

Expected Count 11.2 59.8 71

Count 26 139 165
Total

Expected Count 26 139 165
Starter in a Game that the Team is Down by 5 Points
Formal .FIFSt Game Situation Four Total
Aid Training

Yes No

Count 45 49 94
Yes

Expected Count 42.7 51.3 94

Count 30 41 71
No

Expected Count 32.3 38.7 71

Count 75 90 165
Total

Expected Count 75 90 165

224

 

 

 

7’31

Bench Player in a Game that the Team is Down by 4 Points

 

Formal First

 

 

 

 

 

Aid Training Game Situation F 1ve Total
Yes No
Count 28 66 94
Yes
Expected Count 24.5 69.5 94
Count 15 56 71
No
Expected Count 18.5 52.5 71
Count 43 122 165
Total
Expected Count 43 122 165
Backup Player in a Clearly Winning Situation
Formal First . . .
Aid Training Game Situation Six Total
Yes No
Count 13 81 94
Yes
Expected Count 13.1 80.9 94
Count 10 61 71
No
Expected Count 9.9 61.1 71
Count 23 142 165
Total
Expected Count 23 142 165
225

 

 

 

”111

Starter in 3 Clearly Losing Situation

 

Formal First

 

 

 

Aid Training Game Situation Seven Total
Yes No

Count 10 84 94
Yes

Expected Count 12.5 81.5 94

Count 12 59 71 _ d
No

Expected Count 9.5 61.5 71

Count 22 143 165
Total

Expected Count 22 143 165

 

Backup Player in a Close Winning Situation

 

Formal First

 

 

Aid Training Game Situation Eight Total
Yes No

Count 41 35 76
Yes

Expected Count 36.6 39.7 76

Count 22 34 56
No

Expected Count 26.7 29.3 56

Count 63 69 132
Total

Expected Count 63 69 132

 

226

 

Bench Player in a Clearly Losing Situation

 

Formal First

 

 

 

 

 

Aid Training Game Situation Nine Total
Yes No

Count 27 49 76
Yes

EXpected Count 25.9 50.1 76

Count 18 38 56
No

Expected Count 19.1 36.9 56

Count 45 87 132
Total

Expected Count 45 87 132

227 1‘

APPENDIX P

Chi-Square Analysis of Game Situation Data Sheet by American Red Cross First Aid

Training

 

 

 

 

First off the Bench in a Clearly Losing Competition Situation

 

 

 

 

 

 

American Red
Cross First Game Situation One Total
Aid Training
Yes No
Count 5 56 61
Yes
Expected Count 5.2 55.8 61
Count 9 95 104
No
Expected Count 8.8 95.2 104
Count 14 151 165
Total
Expected Count 14 151 165
Starter in a Clearly Winning Competition Situation
American Red
Cross First Game Situation Two Total
Aid Training
Yes No
Count 15 46 61
Yes
Expected Count 18.5 42.5 61
Count 35 69 104
No
Expected Count 31.5 72.5 104
Count 50 115 165
Total
Expected Count 50 115 165
229

 

 

 

Bench Player in 3 Clearly Winning Situation

 

 

 

 

American Red
Cross First Game Situation Three Total
Aid Training
Yes No

Count 12 49 61
Yes

Expected Count 9.6 51.4 61

Count 14 90 104
No

Expected Count 16.4 87.6 104

Count 26 139 165
Total

Expected Count 26 139 165

 

 

Starter in a Game that the Team is Down by 5 Points

 

 

American Red
Cross First Game Situation Four Total
Aid Training
Yes No

Count 28 33 61
Yes

Expected Count 27.7 33.3 61

Count 47 57 104
No

Expected Count 47.3 56.7 104

Count 75 90 165
Total

Expected Count 75 90 165

 

 

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

 

 

American Red
Cross First Game Situation Five Total
Aid Training
Yes No

Count 17 44 61
Yes

Expected Count 15.9 45.1 61

Count 26 78 104
No

Expected Count 27.1 76.9 104

Count 43 122 165
Total

Expected Count 43 122 165
Backup Player in a Clearly Winning Situation
American Red
Cross First Game Situation Six Total
Aid Training

Yes No

Count 10 51 61
Yes

Expected Count 8.5 52.5 61

Count 13 91 104
No

Expected Count 14.5 89.5 104

Count 23 142 165
Total

Expected Count 23 142 165

 

231

 

 

 

 

Starter in a Clearly Losing Situation

 

 

 

 

 

American Red
Cross First Game Situation Seven Total
Aid Training
Yes No

Count 8 53 61
Yes

Expected Count 8.1 52.9 61

Count 14 90 104
No

Expected Count 13.9 90.1 104

Count 22 143 165
Total

Expected Count 22 143 165
Backup Player in a Close Winning Situation
American Red
Cross First Game Situation Eight Total
Aid Training

Yes No

Count 27 19 46
Yes

Expected Count 22 24 46

Count 36 50 86
No

Expected Count 41 45 86

Count 63 69 132
Total

Expected Count 63 69 132

 

l\)
OJ
Ix)

 

 

H.111: .-

 

Bench Player in 8 Clearly Losing Situation

 

 

 

American Red
Cross First Game Situation Nine Total
Aid Training
Yes No
Count 20 26 46
Yes
Expected Count 15.7 30.3 46
Count 25 61 86
No
Expected Count 29.3 56.7 86
Count 45 87 132
Total
Expected Count 45 87 132
233

 

 

 

mg,

APPENDIX Q

Chi-Square Analysis of Game Situation Data Sheet by CPR Training

 

 

 

234 I

First off the Bench in a Clearly Losing Competition Situation

 

 

 

 

 

 

CPR Training Game Situation One Total
Yes No
Count 7 71 78
Yes
Expected Count 6.6 71.4 78
Count 7 80 87
No
Expected Count 7.4 79.6 87
Count 14 151 165
Total
Expected Count 14 151 165
Starter in a Clearly Winning Competition Situation
CPR Training Game Situation Two Total
Yes No
Count 20 58 78
Yes
Expected Count 23.6 54.4 78
Count 30 57 87
No
Expected Count 26.4 60.6 87
Count 50 1 15 165
Total
Expected Count 50 115 165
235

Bench Player in a Clearly Winning Situation

 

 

 

 

 

CPR Training Game Situation Three Total
Yes No

Count 13 65 78
Yes

Expected Count 12.3 65.7 78

Count 13 74 87
No

Expected Count 13.7 73.3 87

Count 26 139 165
Total

Expected Count 26 139 165
Starter in a Game that the Team is Down by 5 Points
CPR Training Game Situation Four Total

Yes No

Count 39 39 78
Yes

Expected Count 35.5 42.5 78

Count 36 51 87
No

Expected Count 39.5 47.5 87

Count 75 90 165
Total

Expected Count 75 90 165

 

236

1

Bench Player in a Game that the Team is Down by 4 Points

 

CPR Training Game Situation Five Total
Yes No

Count 23 55 78
Yes

Expected Count 20.3 57.7 78

Count 20 67 87
No

Expected Count 22.7 64.3 87

Count 43 122 165
Total

Expected Count 43 122 165

 

 

Backup Player in a Clearly Winning Situation

 

 

CPR Training Game Situation Six Total
Yes No

Count 11 67 1 78
Yes

Expected Count 10.9 67.1 78

Count 12 75 87
No

Expected Count 12.1 74.9 87

Count 23 142 165
Total

Expected Count 23 142 165

 

[Q
'4’.)
\l
A — ' —'ll

Starter in a Clearly Losing Situation

 

 

 

 

 

CPR Training Game Situation Seven Total
Yes No

Count 9 69 78
Yes

Expected Count 10.4 67.6 78

Count 13 74 87
No

Expected Count 1 1.6 75.4 87

Count 22 143 165
Total

Expected Count 22 143 165
Bench Player in a Clearly Losing Situation
CPR Training Game Situation Nine Total

Yes No

Count 23 37 60
Yes

Expected Count 20.5 39.5 60

Count 22 50 72
No

Expected Count 24.5 47.5 72

Count 45 87 132
Total

Expected Count 45 87 132

 

238

 

l

APPENDIX R

Chi-Square Analysis of Game Situation Data Sheet by Current First Aid Certification

239

 

 

 

 

Starter in a Clearly Winning Competition Situation

 

Current First

 

 

 

 

Aid Game Situation Two Total
Certification
Yes No

Count 7 14 21
Yes

Expected Count 6.4 14.6 21

Count 43 101 144
No

Expected Count 43.6 100.4 144

Count 50 1 15 165
Total

Expected Count 50 115 165
Bench Player in a Clearly Winning Situation
Current First
Aid Game Situation Three Total
Certification

Yes No

Yes Count 5 16 21

Expected Count 3.3 17.7 21

Count 21 123 144
No

Expected Count 22.7 121.3 144
Total Count 26 139 165

Expected Count 26 139 165

 

 

 

 

 

 

Starter in a Game that the Team is Down by 5 Points

 

Current First

 

 

 

 

 

Aid Game Situation Four Total
Certification
Yes No

Count 12 9 21
Yes

Expected Count 9.5 11.5 21

Count 63 81 144
No

Expected Count 65.5 78.5 144

Count 75 90 165
Total

Expected Count 75 90 165
Bench Player in a Game that the Team is Down by 4 Points
Current First
Aid Game Situation Five Total
Certification

Yes No

Count 7 14 21
Yes

Expected Count 5.5 15.5 21

Count 36 108 144
No

Expected Count 37.5 106.5 144

Count 43 122 165
Total

Expected Count 43 122 165

241

 

 

 

 

Backup Player in a Clearly Winning Situation

 

Current First

 

 

 

 

 

Aid Game Situation Six Total
Certification
Yes No
Count 4 17 21
Yes
Expected Count 2.9 18.1 21
Count 19 125 144
No
Expected Count 20.1 123.9 144
Count 23 142 165
Total
Expected Count 23 142 165
Starter in a Clearly Losing Situation
Current First
Aid Game Situation Seven Total
Certification
Yes No
Yes Count 2 19 21
Expected Count 2.8 18.2 21
Count 20 124 144
No
Expected Count 19.2 124.8 144
Count 22 143 165
Total
Expected Count 22 143 165
242

 

 

 

 

Backup Player in a Close Winning Situation

 

Current First

 

 

 

 

 

Aid Game Situation Eight Total
Certification
Yes No
Count 8 8 16
Yes _
Expected Count 7.6 8.4 16
Count 55 61 1 16
No
Expected Count 55.4 60.6 116
Count 63 69 132
Total
Expected Count 63 69 132
Bench Player in a Clearly Losing Situation by Age
Current First
Aid Game Situation Nine Total
Certification
Yes No
Yes Count 5 1 1 16
Expected Count 5.5 10.5 16
Count 40 76 1 16
No
Expected Count 39.5 76.5 1 16
Count 45 87 132
Total
Expected Count 45 87 132
243

 

11

 

 

Appendix S

Chi-Square Analysis of Game Situation Data Sheet by Current CPR Certification

 

244 ! -

First off the Bench in a Clearly Losing Competition Situation

 

 

 

 

 

Current CPR . .
Certification Game Situation One Total
Yes No
Count 5 25 30
Yes
Expected Count 2.5 27.5 30
Count 9 126 135
No
Expected Count 11.5 123.5 135
Count 14 151 165
Total
Expected Count 14 151 165
Starter in a Clearly Winning Competition Situation
Current CPR . .
Certification Game Situation Two Total
Yes No
Count 10 20 30
Yes
Expected Count 9.1 20.9 30
Count 40 95 135
No
Expected Count 40.9 94.1 135
Count 50 1 15 165
Total
Expected Count 50 115 165

 

 

 

 

Bench Player in a Clearly Winning Situation

 

 

 

 

 

 

Current CPR Game Situation Three Total
Certification
Yes No

Count 7 23 30
Yes

Expected Count 4.7 25.3 30

Count 19 116 135
No

Expected Count 21.3 113.7 135
Total Count 26 139 165

Expected Count 26 139 165
Starter in a Game that the Team is Down by 5 Points
Current CPR . .
Certification Game Situation Four Total

Yes No

Count 18 12 30
Yes

Expected Count 13.6 16.4 30

Count 57 78 135
No

Expected Count 61.4 73.6 135

Count 75 90 165
Total

Expected Count 75 90 165

 

 

71

Bench Player in a Game that the Team is Down by 4 Points

 

 

 

 

 

Current CPR . . .
Certification Game Situation F ive Total
Yes No
Count 9 21 30
Yes
Expected Count 7.8 22.2 30
Count 34 101 135
No
Expected Count 35.2 99.8 135
Count 43 122 165
Total
Expected Count 43 122 165
Backup Player in a Clearly Winning Situation
Current CPR . . .
Certification Game Situation Six Total
Yes No
Count 5 25 30
Yes
Expected Count 4.2 25.8 30
Count 18 117 135
No
Expected Count 18.8 116.2 135
Count 23 142 165
Total
Expected Count 23 142 165

 

 

 

Starter in a Clearly Losing Situation

 

 

 

 

 

 

€11”.th CPR Game Situation Seven Total
Certification
Yes No
Count 4 26 30
Yes
Expected Count 4 26 30
Count 18 117 135
No
Expected Count 18 117 135
Count 22 143 165
Total
Expected Count 22 143 165
Backup Player in a Close Winning Situation
Current CPR . . .
Certification Game Situation Eight Total
Yes No
Count 12 11 23
Yes
Expected Count 11 12 23
Count 51 58 109
No
Expected Count 52 57 109
Count 63 69 132
Total
Expected Count 63 69 132
248

 

 

Bench Player in a Clearly Losing Situation by Age

 

 

Current CPR . . .
Certification Game Situation Nine Total
Yes No
Count 8 15 23
Yes
Expected Count 7.8 15.2 23
Count 37 72 109
No
Expected Count 37.2 71.8 109
Count 45 87 ' 132
Total
Expected Count 45 87 132

 

 

REFERENCES

250

 

American Academy of Pediatrics. (1981). Policy statement: Recommendations for
participation in competitive sports. Pediatrics, 67, 737-739.

American Academy of Pediatrics. (1983). Sports medicine: health care for young
athletes. Evanston, IL: American Academy of Pediatrics.

 

American Red Cross (2001, April 10). Overview of Courses. [On-line]. Available:
http://www.redcross.org/tn/midsouth/courses.htni.

Antich, T. J., & Brewster, C. E. (1985). Osgood-Schlatter disease: Review of literature A
and physical therapy management. Journal of Orthopedic and Sports Physical
Therapy, 7(1), 5-10.

Bernhardt, D. T., & Landry, G. L. (1995). Sport injuries in young athletes. Advances in
Pediatrics, 42, 465-499.

 

Bijur, P. E., Trumble, A., Harvel, Y., Overpeck, M. D., Jones, D., & Scheidt, P. C. J
(1995). Sports and recreation injuries in US children and adolescents. Archives of
Pediatrics & Adolescent Medicine, 19, 333-342.

Brown, E. W., Clark, M. A., Ewing, M. E., & Malina, R. M. (1998). Participation in
youth sports: Benefits and risks. Spotlight on Youth Sports, 21(2), 1-3.

Brown, B. R., & Butterfield, SA. (1992). Coaches: A missing link in the health care
system. American Journal of Diseases of Children, 146, 211-217.

Chambers, R. B. (1979). Orthopedic injuries in athletes (ages 6 to 17); Comparison of
injuries occurring in six sports. American Journal of Sports Medicine, 7(3), 195-
197. ‘

Cheng, L. T., Fields, B. C., Brenner, A. R., et a1. (2000). Sports Injuries: An important
cause of morbidity in urban youth. Pediatrics, 105, E5.

Congeni, J. (1994). Treating and preventing little league elbow. Physician and
Sportsmedicine, 22(3), 54-64.

Curwin, S., & Stanish, W. D. (1984). Tendonitis: its etiology and treatment. _Collamore
Press, Lexington, MA.

DeHaven, K. E., & Linter, D. M. (1986). Athletic injuries: Comparison by age, sport and
gender. American Journal of Sports Medicine, 14(3), 218-224.

Dickson, T. B., and Kickline, P. D. (1987). Functional management of stress fractures in

female athletes using a pneumatic leg brace. American Journal of Sports
Afetlicine, 15(1), 86-89. '

251

DuRunt, R. H., Pendergrast, R. A., Donner, J ., Seymore, C., & Gailard, G. (1991).
Adolescent’s attrition from school-sponsored sports. American Journal of
Diseases Children, 145, 1119-1123.

Engh, F. (1981). Medicine man for the ailing youth sports scene. Parks and Recreation,
58(2), 27-31.

Flint, F .A, & Weiss, MR. (1992). Returning injured athletes to competition: A role and
ethical dilemma. Canadian Journal of Sport Science, 17, 34-40.

Gallagher, S. S., Guer, B., Kotechuch, M., Bass, J., Lovejoy, F ..H, Mechoughlan, E., &
Mehta, K. (1982). Massachusetts Department of Public Health. A strategy for
the reduction of childhood injuries in Massachusetts: SCIPP. New England
Journal ofMedicine, 307, 1015-1019.

Gallagher, S. S., Finson, K., Guyer, B., & Goodenough, S. (1984). The incidence of
injuries among 87,00 Massachusetts’s children and adolescents: Results of the
1980—81 statewide childhood injury prevention program surveillance system.
American Journal of Public Health, 74, 1340-1347.

Garrick, J. G., & Requa, R. H. (1978). Injuries in high school sports. Pediatrics, 61, 465-
469.

Godshall, R. W. (1975). Junior league football; risk versus benefits. American Journal of
Sports Medicine, 3, 139.

Goldberg, B. (1989). Injury patterns in youth sports. Physician and Sportsmedicine, 17
(3), 175-184.

Halpern, 8., Thompson, N., & Curl, W. W. (1987). High school football injuries:
Identifying the risk factors. American Journal of Sports Medicine, 15, 316-320.

Hoff, G. L., & Martin, T. A. (1986). Outdoor and indoor soccer: Injuries among youth
players. American Journal for Sports Medicine, 14(3), 231-233.

Hootman, J. M. (2000). Utilization of ambulatory medical services among youths with

activity related injuries, United States 1997._Journal of Athletic Training, 35(2),
816.

Jackson D. W., Jarrett, H., Bailey, D, Kausek, J., & Swanson, J. (1978). Injury prediction

in the young athlete: A preliminary report. American Journal of Sports Medicine,
6 (1), 6-14.

Janda, D. H., Wojtys, E. M., Hankin, F. M., & Benedict, M. E. (1988). Softball sliding
injuries: A prospective study comparing standard and modified bases. Journal of
the American ll/Iedical Association, 259(12), 1848-1850.

ix)
U1
1 \)

 

 

 

Keller, C. S., Noyes, F. R., & Buncher, CR. (1987). The medical aspects of soccer injury
epidemiology. American Journal of Sports Medicine, 15, 230-237.

Kreipe, R. E, & Gewanter, H. L. (1985). Physical maturity screening for participation in
sports. Pediatrics, 75, 1076-1080.

Kujala, U. M., Kvist, M. and Heinonen, O. (1985). Osgood-Schlatter’s disease in
adolescent athletes. American Journal of Sports Medicine, 13(4), 23 6-241.

Lubell, A. (1987). Insurance, liability and the American way of sport. Physician and
Sportsmedicine, 15(9), 192-200.

Luschen,G. & Moore, W. (1987). Knowledge helps prevent sports-injury lawsuits.
Spotlight on Youth Sports, 10(2), 3.

Malina, R. M. (2001). Injuries in Organized Sports for Children and Adolescent. In J. L.

Frost (Ed), Children & Injuries (pp. 199-248). Tucson, AZ: Lawyers & Judges
Publishing Company.

Malina, R. M., Bouchard, C., & Bar-Or, O. (2004). Growth, Maturation, and Physical
Activity (2nd Edition ed.). Champaign: Human Kinetics. .

Martin, R. K., Yesalis, C. E., & Foster, D. (1987). Sports injuries at the 1985 Junior

Olympics-an epidemiological analysis. American Journal of Sports Medicine, 15,
603-608.

Micheli, L. J. (1983). Overuse injuries in children’s sports: The growth factor.
Orthopedic Clinics ofNorth America, 14(2), 337-360.

Mueller, F., & Blyth, C. (1982). Epidemiology of sport injuries in children. Clinical
Sports Medicine, 1, 343.

National Youth Sports Safety Foundation. (2000, November 21). Coaching Education.
[On-line]. Available: 1111pEl/WWW.IILSSfCI‘Q/COZIChIng.1111111.

National Youth Sports Safety Foundation. (2000, November 21). Did you know. [On-
line]. Available: http://tw-wnvssforg/didhtml.

Nunnally, J. C. (1978). Psychometric Theory. New York. MCGraw-Hill.
O’Connor, D. L. (1998). Preventing sports injuries in kids. Patient Care, 32(11), 60-83.

Orava, S., & Saarela, J. (1978). Exertion injuries in young athletes. American Journal of
Sports Medicine, 6,(68).

1x.)
‘JI
DJ

 

 

.7

Ostrum, G. A. (1993). Sports-related injuries in youths: Prevention is the key and
nursescan help. Pediatric Nurse, 19, 333-342.

Pettrone, F. A., & Ricciardelli, E. (1987). Gymnastic injuries: The Virginia experience
1982-1983. American Journal ofSports Medicine, 15, 59-62.

Quain, R. A. (1989). An overview of youth coaching certification programs.
Adolescence, 24(95), 541-547.

 

Ransone, J ., & Dunn-Bennett, L. R. (1999). Assessment of first-aid knowledge and

decision making of high school athletic coaches. Journal of Athletic Training,
24(3), 267-271.

Rome, E. S. (1995) Sports related injuries among adolescents: When do they occur, and
how can we prevent them. Pediatric Review, 16, 184-187.

 

Roser, L. A., & Clauson, D. (1970). Football injuries in the very young athlete. Clinical
Orthopedics, 69, 219-223.

Shroyer, G. (1982). First aid and liability. Scholastic Coach, 52, 36-37.

Rowe, P. J. & Robertson, D. M. (1986). Knowledge of car and prevention of athletic
injuries in high schools. Journal of Athletic Training, 22, 116-119.

 

Rowe, P. J. & Miller, L. K. (1991). Treating high school sports injures: are

coaches/trainers competent? Journal of Physical Education, Recreation, and
Dance, 62, 49-54.

Shroyer, G. (1982). First aid and liability. Scholastic Coach, 52, 36-37.

Silverstein, B. M. (1979). Injuries in youth league football. thsician and
Sportsmedicine, 7, 105.

 

Stanitski, C. L. (1988). Management of sport injuries in children and adolescents.
Orthopedic Clinics ofNorth America, 19(4), 689-698.

Stanitski, C. L. (1989). Common injuries in preadolescent and adolescent athletes:
recommendations for prevention. Sports Medicine, 7, 32-41.

Stanitski, C. L. (1993). Combating overuse injuries; A focus on children and adolescents.
Physician and Sportsmedicne, 21(1), 87-106.

Starkey, C., & Ryan, J. (1996). Evaluation oforthopedic and athletic injuries.
Philadelphia, PA: F. A. Davis Company.

 

254

Steele, M. K. (1996). Caring for athletes in youth Sports. Maryland Medical Journal,
45(8), 689-691.

Stephens, M. K. (1991). Safety precautions in youth sports. Scholastic Coach, 60(2), 13.
Stricevic, M. V., Patel, M. R., Okazaki, T., and Swain, B. K. (1983). Karate: historical

perspective and injuries sustained in national and international tournament
competitions. American Journal of Sports Medicine, 11(5), 320-324.

 

Sullivan, J. A., Gross, R. H., Grana, W. A., and Grarcias-Moral, C. A. (1980). Evaluation
of injuries in youth soccer. American Journal of Sports Medicine, 8, 325-327.

Tanner, J. M. (1962). Growth in adolescence, 2nd ed., Charles C. Thomas, Springfield, IL.

Thomas, C. L. (Eds). (1997). Taber 's Cyclopedic Medical Dictionary. Philadelphia: F.
A. Davis Company.

 

Wall, E. J. (1998). Osgood-Schlatter disease: Practical treatment for a self-limiting
condition. Physician and Sportsmedicine [On-line]. Available:
http://wWw.plivsportsmed.come/issues/1998/O3mar/wall.htm.

Wells, M. J ., & Bell, W. G. (1995). Concerns on little league elbow. Journal of Athletic
Training, 30(3), 245-253.

Whiteside, J. A., Andrews, J. R.,& Fleisig, G. S. (1999). Elbow injuries in young
baseball players. Physician and Sportsmedicine [On-line]. Available:
http://www.physsportsmed.come/issues/1999/06 99/whiteside.htin.

Zaricznyi, B., Shattuck, J. M., Mast, T. A., Roberton, R. V., and D’Elia, G. (1980).
Sports-related injuries in school-aged children._American Journal of Sports
Medicine, 8(5), 318-324.

 

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