Table.
Examples of the Socioecological Framework Within Individual Factors Associated With Sport-Related Death
| Intrapersonal |
Interpersonal |
Organizational |
Environmental |
Policy |
|
| Sudden cardiac arrest (SCA) | Cardiovascular screening allowed for knowledge of athlete status and potential for SCA13 | Approximately 59% of states required cardiopulmonary resuscitation/first-aid training of all coaches14 | School-based automated external defibrillator programs resulted in high survival rate for SCAs on campus15 | Access to and application of automated external defibrillator within 3 minutes demonstrated survival rates of up to 90%16 | 71% of states did not require schools to have an emergency action plan14 |
| Exertional heat stroke (EHS) | Low physical fitness level, sleep deprivation, body weight, dehydration, inadequate water intake increased risk for EHS17 | Coaches lacked knowledge on general EHS; fewer than 20% of athletic trainers obtained body temperature to diagnose EHS18 | a | Rate of exertional heat illness increased when the environmental conditions measured by wet- bulb globe temperature > 82°F19 | 35% of states mandated comprehensive heat-acclimatization protocol14 |
| Traumatic head injuries | Head contact, high sticking, elbowing, athlete knowledge associated with disclosure20 | Team, coach-athlete, parent-athlete interactions affected concussion reporting21 | Despite 100% of states mandating a concussion policy, school district compliance was 30%–100%22 | Properly fitted equipment23,24 | 100% of states required some form of a concussion policy; however, a majority of states did not require a comprehensive concussion policy14 |
| Exertional collapse associated with sickle cell trait | Despite mandatory screening and disclosure of sickle cell trait at birth, 52% of young African-American adults were uncertain about their status25 | a | a | a | a |
| Spinal cord injuries | Athlete knowledge of proper tackling technique26 | a | a | a | a |
| Asthma | Known history of asthma status allowed preventive measures to reduce triggers27 | a | a | a | Limited policy adoption at federal, state, or local level27 |
| Anaphylaxis | Known history of allergies allowed for access to quick-acting epinephrine28 | a | a | a | a |
| Traumatic internal injuries | a | a | a | a | |
| Lightning | a | a | “When thunder roars, go indoors!”29 | a | |
| Diabetes | Lack of adherence to diabetes management plan30 | a | a | a | a |
a
Indicates a gap in the literature.