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Jingzhen Yang, PhD, MPH, J. Michael Bowling, PhD, Megan A. Lewis, PhD, Stephen W. Marshall, PhD, Carol W. Runyan, PhD, MPH and Frederick O. Mueller, PhD

At the time of the study, Jingzhen Yang, Stephen W. Marshall, J. Michael Bowling, Carol W. Runyan, and Frederick O. Mueller were with the University of North Carolina Injury Prevention Research Center, Chapel Hill. Stephen W. Marshall is also with the Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill. Jingzhen Yang, J. Michael Bowling, Carol W. Runyan, and Megan A. Lewis were with the Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill. Frederick O. Mueller is also with Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.

Correspondence: Requests for reprints should be sent to Jingzhen Yang, the Department of Community and Behavioral Health, College of Public Health, The University of Iowa, 200 Hawkins Drive, E236 GH, Iowa City, IA 52242 (e-mail: jingzhen-yang{at}uiowa.edu).

Objectives. We sought to describe the use of discretionary protective equipment among high school athletes and to examine social and behavioral determinants contributing to equipment usage.

Methods. We analyzed data from a 3-year (1996–1999), stratified, 2-stage cluster sample of athletes engaged in 12 organized sports in 100 North Carolina high schools (n=19728 athlete-seasons) (an athlete-season represents an individual student who participates in a particular sport in a particular season). We used generalized logistic regression to model the association of social and behavioral determinants and demographic variables with discretionary protective equipment use.

Results. About one third of high school athletes self-reported using lower extremity discretionary protective equipment. Girls, seniors, those who played limited-contact sports, and those who played multiple sports reported higher usage. Small school size, low player/coach ratio, high proportion of team usage, and history of previous lower extremity injury were important predictors of usage. Coaches’ experience, qualifications, and training, however, were not predictive of usage.

Conclusions. Intervention efforts to promote use of discretionary protective equipment need to target school-level factors and should consider both team requirements and the role of peers in setting and reinforcing norms.

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