Use of discretionary protective equipment in high school athletes: Prevalence and determinants

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.