Determinants of racial/ethnic disparities in athlete mental health
| Reference | Sample size and detail | Racial/ethnic categories | Define race, describe mechanism and name racism22 | Primary study outcome(s) | Domain, level of influence and determinants of racial disparities16 |
| Ballesteros and Tran2 | n=241 Self-identified ‘varsity’ athletes from ACHA-NCHA II dataset who also self-identified as African American, Latinx or Asian American, and were categorised as ‘in need’ of mental health services based on their responses to the ACHA-NCHA II mental health symptom questions. | Self-identification as African American, Latinx or Asian American. | Define race: no Describe mechanism: yes Name racism: no | Mental health psychotherapy utilisation, measured as a yes/no response to the question: ‘Have you ever received psychological or mental health services from your current college/university’s counselling or health service?’ | Domain: sociocultural Level of influence: individual Determinant: sociodemographic |
| Naoi et al 26 | n=271 Varsity athletes at one Division I university and one Division II university. | Self-identification as Caucasian, black, Hispanic, Asian, Native American or other; dichotomised into Caucasian and minority. | Define race: no Describe mechanism: no Name racism: no | Interest in discussing mental health concerns (depression, anxiety, eating disorder), or dealing with pressure/stress during a hypothetical sports psychology consultation (yes/no) | Domain: healthcare system Level of influence: individual Determinant: treatment preferences |
| Preference for sport psychology consultant being of same race | Domain: healthcare system Level of influence: interpersonal Determinant: patient–clinician relationship | ||||
| Sadberry and Mobley27 | n=98 Collegiate athletes from four institutions (two historically black and two predominantly white institutions). | Self-identification as: African American, black, biracial/multiracial, African, Haitian, Jamaican, Central/South American. | Define race: no Describe mechanism: race-related stress Name racism: yes ‘Perceived racism’, ‘institutional racism’ and ‘individual racism’ | Subscales of the College Adjustment Scale (anxiety, depression, self-esteem, substance abuse, interpersonal relationships, family problems and academic concerns) | Domain: sociocultural environment Level of influence: individual Determinant: response to discrimination |
| Steinfeldt and Steinfeldt25 | n=245 Male college football players at four institutions (two Division II and two Division III). | Self-identification as white, black, Hispanic, Asian, American Indian, multiracial, other. | Define race: no Describe mechanism: no Name racism: no | Attitudes towards help-seeking, measures by the Self-Stigma of Seeking Help Scale | Domain: sociocultural environment Level of influence: individual Determinant: perceived norms and stigma |
| Wilkerson et al 28 | n=9 Black male Division I football players from a highly competitive institution. | Black | Define race: no Describe mechanism: yes Name racism: yes ‘Healthcare discrimination’ and ‘interpersonal racism’ | Qualitative study exploring perceived barriers to seeking professional mental health services | Domain: sociocultural environment Level of influence: interpersonal Determinant: family norms |
Statistical significance refers to p<0.05 unless otherwise indicated.
ACHA-NCHA, American College Health Association’s National College Health Assessment.