Context: Work-family conflict (WFC) involves discord that arises when the demands of work interfere with the demands of family or home life. Long work hours, minimal control over work schedules, and time spent away from home are antecedents to WFC. To date, few authors have examined work-family conflict within the athletic training profession.Objective: To investigate the occurrence of WFC in certified athletic trainers (ATs) and to identify roots and factors leading to quality-of-life issues for ATs working in the National Collegiate Athletic Association Division I-A setting.Design: Survey questionnaire and follow-up, in-depth, inperson interviews.Setting: Division I-A universities sponsoring football. Patients or Other Participants: A total of 587 ATs (324 men, 263 women) responded to the questionnaire. Twelve ATs (6 men, 6 women) participated in the qualitative portion: 2 head ATs, 4 assistant ATs, 4 graduate assistant ATs, and 2 AT program directors.Data Collection and Analysis: Multiple regression analysis was performed to determine whether workload and travel predicted levels of WFC. Analyses of variance were calculated to investigate differences among the factors of sex, marital status, and family status. Interviews were transcribed verbatim and then analyzed using computer software as well as member checks and peer debriefing. The triangulation of the data collection and multiple sources of qualitative analysis were utilized to limit potential researcher prejudices.Results: Regression analyses revealed that long work hours and travel directly contributed to WFC. In addition to long hours and travel, inflexible work schedules and staffing patterns were discussed by the interview participants as antecedents to WFC. Regardless of sex (P 5 .142), marital status (P 5 .687), family status (P 5 .055), or age of children (P 5 .633), WFC affected Division I-A ATs.Conclusions: No matter their marital or family status, ATs employed at the Division I-A level experienced difficulties balancing their work and home lives. Sources of conflict primarily stemmed from the consuming nature of the profession, travel, inflexible work schedules, and lack of full-time staff members.Key Words: work load, job responsibilities, quality of life Key PointsN Factors contributing to the work-family conflict experienced by Division I-A athletic trainers included long working hours, required travel, inadequate staffing, and lack of control over work schedules.N Regardless of sex or marital or family status, athletic trainers struggled to find sufficient time for themselves and their nonwork obligations.

Context: Certified athletic trainers (ATs) working at the National Collegiate Athletic Association Division I level experience challenges balancing their professional and personal lives. However, an understanding of the strategies ATs use to promote a balance between their professional and personal lives is lacking.Objective: To identify the strategies ATs employed in the Division I setting use to establish a balance between their professional and personal lives.Design: Qualitative investigation using inductive content analysis.Setting: Athletic trainers employed at Division I schools from 5 National Athletic Trainers' Association districts.Patients or Other Participants: A total of 28 (15 women, 13 men) ATs aged 35 6 9 years volunteered for the study.Data Collection and Analysis: Asynchronous electronic interviews with follow-up phone interviews. Data were analyzed using inductive content analysis. Peer review, member checking, and datasource triangulation were conducted to establish trustworthiness.Results: Three higher-order themes emerged from the analysis. The initial theme, antecedents of work-family conflict, focused on the demands of the profession, flexibility of work schedules, and staffing patterns as contributing to work-life conflict for this group of ATs. The other 2 emergent higher-order themes, professional factors and personal factors, describe the components of a balanced lifestyle. The second-order theme of constructing the professional factors included both organizational policies and individual strategies, whereas the secondorder theme of personal factors was separation of work and life and a supportive personal network.Conclusions: Long work hours, lack of control over work schedules, and unbalanced athlete-to-AT ratios can facilitate conflicts. However, as demonstrated by our results, several organizational and personal strategies can be helpful in creating a balanced lifestyle.Key Words: work-family conflict, organizational support, professional satisfaction Key Points N Although professional demands, inflexible work schedules, and inadequate staffing patterns can cause conflicts, work-life balance is achievable for athletic trainers at the Division I level.N To promote work-life balance, administrators should encourage teamwork, and athletic trainers can set boundaries and priorities.N A strong support system, both at work and at home, is the critical link that allows athletic trainers to balance their professional and personal lives.

Context: Previous researchers have shown that work-family conflict (WFC) affects the level of a person's job satisfaction, life satisfaction, and job burnout and intentions to leave the profession. However, WFC and its consequences have not yet been fully investigated among certified athletic trainers.Objective: To investigate the relationship between WFC and various outcome variables among certified athletic trainers working in National Collegiate Athletic Association Division I-A settings.Design: A mixed-methods design using a 53-item survey questionnaire and follow-up in-depth interviews was used to examine the prevalence of WFC.Setting: Division I-A universities sponsoring football. Patients or Other Participants: A total of 587 athletic trainers (324 men, 263 women) responded to the questionnaire, and 12 (6 men, 6 women) participated in the qualitative portion of the mixed-methods study.Data Collection and Analysis: We calculated Pearson correlations to determine the relationship between WFC and job satisfaction, life satisfaction, and job burnout. Regression analyses were run to determine whether WFC was a predictor of job satisfaction, job burnout, or intention to leave the profession. Interviews were transcribed verbatim and then analyzed using the computer program N6 as well as member checks and peer debriefing.Results: Negative relationships were found between WFC and job satisfaction (r 5 2.52, P , .001). Positive were noted between WFC and job burnout (r 5 .63, P , .001) and intention to leave the profession (r 5 .46, P , .001). Regression analyses revealed that WFC directly contributed to job satisfaction (P , .001), job burnout (P , .001), and intention to leave the profession (P , .001).Conclusions: Overall, our findings concur with those of previous researchers on WFC and its negative relationships to job satisfaction and life satisfaction and positive relationship to job burnout and intention to leave an organization. Sources of WFC, such as time, inflexible work schedules, and inadequate staffing, were also related to job burnout and job dissatisfaction in this population.Key Words: burnout, attrition Key PointsN In these Division I-A athletic trainers, work-family conflict was inversely related to job satisfaction. Positive correlations were noted between work-family conflict and job burnout and work-family conflict and intention to leave the profession.N Our findings are similar to those of other researchers studying work-family conflict in a variety of populations. N Future investigators should focus on identifying successful strategies for mitigating the occurrence of work-family conflict and its negative consequences.

Context: Career opportunities for athletic training students (ATSs) have increased substantially over the past few years. However, ATSs commonly appear to be opting for a more diversified professional experience after graduation. With the diversity in available options, an understanding of career decision is imperative.Objective: To use the theoretical framework of socialization to investigate the influential factors behind the postgraduation decisions of senior ATSs.Design: Qualitative study. Setting: Web-based management system and telephone interviews.Patients or Other Participants: Twenty-two ATSs (16 females, 6 males; age ¼ 22 6 2 years) who graduated in May 2010 from 13 different programs accredited by the Commission on Accreditation of Athletic Training Education.Data Collection and Analysis: All interviews were transcribed verbatim, and the data were analyzed inductively. Data analysis required independent coding by 2 athletic trainers for specific themes. Credibility of the results was confirmed via peer review, methodologic triangulation, and multiple analyst triangulation.Results: Two higher-order themes emerged from the data analysis: persistence in athletic training (AT) and decision to leave AT. Faculty and clinical instructor support, marketability, and professional growth were supporting themes describing persistence in AT. Shift of interest away from AT, lack of respect for the AT profession, compensation, time commitment, and AT as a stepping stone were themes sustaining the reasons that ATSs leave AT. The aforementioned reasons to leave often were discussed collectively, generating a collective undesirable outlook on the AT profession.Conclusions: Our results highlight the importance of faculty support, professional growth, and early socialization into AT. Socialization of pre-AT students could alter retention rates by providing in-depth information about the profession before students commit in their undergraduate education and by helping reduce attrition before entrance into the workforce.

Context: Authors of most field studies have not observed decrements in physiologic function and performance with increases in dehydration, although authors of well-controlled laboratory studies have consistently reported this relationship. Investigators in these field studies did not control exercise intensity, a known modulator of body core temperature.Objective: To directly examine the effect of moderate water deficit on the physiologic responses to various exercise intensities in a warm outdoor setting.Design: Semirandomized, crossover design. Setting: Field setting. Patients or Other Participants: Seventeen distance runners (9 men, 8 women; age 5 27 6 7 years, height 5 171 6 9 cm, mass 5 64.2 6 9.0 kg, body fat 5 14.6% 6 5.5%).Intervention(s): Participants completed four 12-km runs (consisting of three 4-km loops) in the heat (average wet bulb globe temperature 5 26.56C): (1) a hydrated, race trial (HYR), (2) a dehydrated, race trial (DYR), (3) a hydrated, submaximal trial (HYS), and (4) a dehydrated, submaximal trial (DYS).Main Outcome Measure(s): For DYR and DYS trials, dehydration was measured by body mass loss. In the submaximal trials, participants ran at a moderate pace that was matched by having them speed up or slow down based on pace feedback provided by researchers. Intestinal temperature was recorded using ingestible thermistors, and participants wore heart rate monitors to measure heart rate.Results: Body mass loss in relation to a 3-day baseline was greater for the DYR (24.30% 6 1.25%) and DYS trials (24.59% 6 1.32%) than for the HYR (22.05% 6 1.09%) and HYS (22.0% 6 1.24%) trials postrun (P , .001). Participants ran faster for the HYR (53.15 6 6.05 minutes) than for the DYR (55.7 6 7.45 minutes; P , .01), but speed was similar for HYS (59.57 6 5.31 minutes) and DYS (59.44 6 5.44 minutes; P . .05). Intestinal temperature immediately postrun was greater for DYR than for HYR (P , .05), the only significant difference. Intestinal temperature was greater for DYS than for HYS postloop 2, postrun, and at 10 and 20 minutes postrun (all: P , .001). Intestinal temperature and heart rate were 0.226C and 6 beats/min higher, respectively, for every additional 1% body mass loss during the DYS trial compared with the HYS trial.Conclusions: A small decrement in hydration status impaired physiologic function and performance while trail running in the heat.Key Words: environmental physiology, dehydration, rehydration, core temperature, heart rate Key Points N The physiologic and performance decrements associated with dehydration that exist in laboratory settings also exist in field settings. N Methodologic challenges in the field setting make isolating these effects difficult.

Context: Instrument validation is an important facet of survey research methods and athletic trainers must be aware of the important underlying principles. Objective: To discuss the process of survey development and validation, specifically the process of construct validation. Background: Athletic training researchers frequently employ the use of survey research for topics such as clinical instruction and supervision, burnout, and professional development; however, researchers have not always used proper procedures to ensure instrument validity and reliability for the data collection process. Description: Four major methods exist to establish the validity of an instrument: face, content, criterion related, and construct. When developing a survey to measure a previously unexplored construct (eg, an athletic trainer's attitudes toward appropriate exertional heat stroke treatment), researchers should employ a four-step process: (1) defining constructs and content domain, (2) generating and judging measurement items, (3) designing and conducting studies to develop a scale, and (4) finalizing the scale. Clinical Advantages: Establishing the validity of a survey instrument strengthens the data yielded from the data collection process, which allows for greater confidence in the interpretation of the results from the survey. Conclusions: Construct validity, although a time-intensive process, is necessary to ensure accuracy and validity of the survey instrument.

The ATs surveyed have sound knowledge of the correct means of EHS recognition and treatment. However, a significant portion of these ATs reported using temperature assessment devices that are invalid with athletes exercising in the heat. Furthermore, they reported using cooling treatment methods that have inferior cooling rates.

Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care.