Context:

Female athletic trainers (ATs) tend to depart the profession of athletic training after the age of 30. Factors influencing departure are theoretical. Professional demands, particularly at the collegiate level, have also been at the forefront of anecdotal discussion on departure factors.

Objective:

To understand the career and family intentions of female ATs employed in the collegiate setting.

Design:

Qualitative study.

Setting:

National Collegiate Athletic Association Division I.

Patients or Other Participants:

Twenty-seven female ATs (single = 14, married with no children = 6, married with children = 7) employed in the National Collegiate Athletic Association Division I setting.

Data Collection and Analysis:

All female ATs responded to a series of open-ended questions via reflective journaling. Data were analyzed via a general inductive approach. Trustworthiness was established by peer review, member interpretive review, and multiple-analyst triangulation.

Results:

Our participants indicated a strong desire to focus on family or to start a family as part of their personal aspirations. Professionally, many female ATs were unsure of their longevity within the Division I collegiate setting or even the profession itself, with 2 main themes emerging as factors influencing decisions to depart: family planning persistence and family planning departure. Six female ATs planned to depart the profession entirely because of conflicts with motherhood and the role of the AT. Only 3 female ATs indicated a professional goal of persisting at the Division I setting regardless of their family or marital status, citing their ability to maintain work-life balance because of support networks. The remaining 17 female ATs planned to make a setting change to balance the roles of motherhood and AT because the Division I setting was not conducive to parenting.

Conclusions:

Our results substantiate those of previous researchers, which indicate the Division I setting can be problematic for female ATs and stimulate departure from the setting and even the profession.

Key Points
  • Female athletic trainers decided to depart the Division I setting because the required hours of the job limited the time available for parenting.

  • Female athletic trainers working in the Division I setting who were able to persist after having a family credit strong support networks and the development of effective work-life balance strategies.

Traditionally, working women endure more challenges balancing career demands and family responsibilities than working men, often because of their mothering philosophies and traditional gender stereotypes.1  Surprisingly, gender differences have not been found in the occurrence of conflicts between work and life in the athletic training profession.2,3  This finding is perplexing because female athletic trainers (ATs) continue to depart from the profession.4  Hypothetically, the decline in the number of female ATs in the profession has been linked to the desire to strike a balance among work responsibilities, personal interests, and family obligations.13,5 

Concerns about work-life balance (WLB) and time for parenting have been found to influence decisions to persist within the collegiate levels, as the job responsibilities often include long hours (>40 h/wk) and travel, which can limit time spent at home with family.13,5  It is an unfortunate reality that female ATs make up only approximately 28% of the full-time collegiate staff.5  This is especially concerning when the National Athletic Trainers' Association indicates that more than 50% of its members are female.6  A relationship appears to exist between balancing professional responsibilities with parenthood and retention factors, especially for those who leave the collegiate clinical setting to work in clinical settings more favorable to family life.

Female ATs in the National Collegiate Athletic Association Division I setting experience great challenges in maintaining WLB because of the demands of the setting.1  In a recent study,1  the primary reasons female ATs continued in the Division I setting were enjoyment of the job and atmosphere, increased autonomy, positive athlete dynamics, and the social support network. It is important for female ATs to have support at work and home to persist in the collegiate or athletic training clinical setting. However, long work hours and the inability to find WLB can stress this support network. Mazerolle and colleagues2,3  first proposed that motherhood plausibly could lead to departure from the profession as the result of a myriad of factors but mostly because of a lack of time and control over work schedules. Further investigations have supported this theory and also have found that other reasons for leaving the profession are WLB concerns, supervisory and coach conflicts, caring for children, and role overload.1,4,5 

Fulfillment of WLB is an important retention factor for female coaches within the collegiate setting,7  thus providing some supporting evidence to the suppositions that motherhood can be a mediating factor in the retention of female ATs in the collegiate setting. Additional support can be garnered from Mazerolle et al,2  who found that only 22 female ATs with children were employed at the collegiate setting, a statistic supported by Kahanov et al,5  who reported that only about a quarter of all full-time ATs at the collegiate setting were female.

Concerns about retention, particularly of female ATs, have become an increasingly popular topic within the athletic training literature, with attention focused on the collegiate clinical setting. This setting not only is one of the largest employment settings for the AT6  but is recognized as a time-intensive, demanding work environment.2,3,8,9  Moreover, data suggest women are leaving this particular clinical setting to find a more family-friendly work environment, which may or may not be in the profession of athletic training.10,11  Additionally, 2 recent studies10,11  suggest that female athletic training students intend to pursue careers in athletic training, but as highlighted by Kahanov and Eberman,4  women are rapidly departing the profession for a variety of reasons. The emigration of female ATs from the profession has been theoretically associated with the desire to attain balance among family commitments, personal time, and work responsibilities.1,2  Difficulties maintaining WLB and sufficient time for parenting shape decisions to continue at the collegiate level.1,2 

Because of the concerning trend of female AT attrition, the purpose of our study was to understand the perspectives of female ATs, regardless of marital status, and to evaluate career and family intentions. Our objective was to gain a more thorough understanding of female ATs' professional goals as they may be influenced by family planning. Our research questions included, “What factors influence the career intentions of female ATs regarding career longevity?” and “Do female ATs have intentions to remain in the NCAA Division I setting?”

Participants and Research Design

A total of 27 female ATs employed in the Division I collegiate setting volunteered for our research study.

Our qualitative study used online, asynchronous in-depth interviewing, with journaling as the primary method for collecting data. Asynchronous interviewing is described as interviewing that does not require the interviewee and interviewer to be online at the same time. The concept centers on “different time–different place,” allowing the inclusion of individuals who may not live near the researchers but are viable participants. The advantages of the asynchronous interview include cost effectiveness, efficiency in scheduling interviews, and confidentiality, which were the primary reasons for selecting this data-collection procedure.8,10,12  Additionally, this medium allowed our participants the flexibility to complete the interview questions at their leisure, an important option for a population whose time is limited. Though lacking in participant and researcher interactions, online communication can still produce rich, insightful data because of the participants' sense of confidentiality and time to reflect upon the questions as opposed to the immediate responses required in one-on-one interviews.10 

Instrumentation and Data Collection

Data collection was conducted online using QuestionPro (QuestionPro Inc, Seattle, WA), a secure data-tracking Web site designed specifically for research purposes. Before data collection, we completed a peer review and content analysis. Initially, the interview guide was reviewed by an athletic training researcher with knowledge of the topic of WLB and 2 female ATs employed in the Division I setting to validate survey content. Upon completion of the review, we made grammatical edits, reworded a few questions, and expanded questions. Before data collection, the interview guide was piloted by a panel of experts (n = 3) for clarity to decrease the chances of misinterpretation or miscommunication of the material. The panel consisted of female ATs employed in the collegiate clinical setting who represented the 3 categories of marital and motherhood status: single, married without children, and married with children. No changes were made to the interview guide upon completion of pilot testing. We developed the interview guide for a larger qualitative study that was concerned with the experiences of the female AT in the Division I setting. The interview guide was designed to answer questions related to the experiences of female ATs related to WLB, career intentions, and family planning.

After institutional review board approval had been secured, we purposefully recruited participants using a convenience- and snowball-sampling procedure.13  Female ATs employed in the Division I clinical setting were recruited, as the overall aim of our study was to gain a holistic picture of issues facing female ATs employed in the collegiate setting regarding WLB. Each female AT was e-mailed a detailed description of our study and a direct link to the survey. Consent was implied upon completion of the online questionnaire. Female ATs were asked to provide information regarding basic demographic information (ie, age, marital status, years in the profession, children) and then were asked to respond to a series of open-ended questions via journaling. The Appendix provides a sampling of questions sent to participants. We borrowed the questions from previously published work in athletic training regarding WLB,2,3,8,14  retention in the workplace,1  and motherhood in athletic training.5  Participants who had not completed the survey were sent 1 reminder e-mail 2 weeks after the initial e-mail to ensure study completion. Data were transferred from the online survey database to a Word document (version 2013; Microsoft Inc, Redmond, WA) for data analysis.

Data Analysis

We used a general inductive process described by Creswell15  and Thomas16  to analyze the textual data. This systematic process is a common method used in health and social science research and was chosen to help uncover the most dominant themes from the data as they related to the specific aims of our study. Using the research questions to guide the analysis process, we focused on the discussions from our participants related to the questions linked to career intentions, family planning, and experiences in the profession. Initially, we read the transcripts in their entirety to gain a sense of the data; this holistic evaluation of the data is the foundation to the general inductive process. Read-throughs continued multiple times, and during the second and third read-throughs, data were assigned categories (eg, labels). These labels were descriptors of the main thoughts and findings of the transcripts. Once categories had been assigned to the data, they were organized into more specific dominant themes to reduce the redundancy of the categories.

Establishing Trustworthiness of the Data

Data credibility was established by using member checks, peer review, and multiple-analyst triangulation. One woman from each subgroup (single, married without children, married with children) was contacted for a brief follow-up interview. The purpose of our member check, or stakeholder verification,16  was to present the initial findings from the data analysis to the participants for their confirmation. We selected this method of member checking because of the online data-collection procedures, which limit interactions between researchers and participants, especially if follow-up becomes necessary based on a participant's response to a question.12  The peer review was completed by an athletic training scholar with experience in qualitative methods and strong knowledge in the areas of WLB and retention of ATs. The peer helped to establish credibility by reviewing all data-collection procedures and final themes. Two researchers independently completed the data-collection procedures as outlined above to establish multiple-analyst triangulation.

Descriptive statistics calculated for the demographic data illustrated that the female ATs who were married with children were slightly older and possessed more Division I work experience (Table 1) than the single female ATs and those who were married without children. Only 26% (n = 7) of female ATs at the Division I setting who participated in our study had children, and of those, 4 women had more than 1 child (1 ± 1). Most participants had attained a master's degree (89%, n = 24) and were currently employed as assistant ATs at their respective institutions (78%, n = 21). Those not employed as assistant ATs classified their position as associate AT (n = 3), director of sports medicine (n = 1), head AT (n = 1), or graduate assistant AT (n = 1). Primary sport-coverage responsibility was women's basketball (n = 9), followed by women's soccer (n = 7), football (n = 3), volleyball (n = 3), women's ice hockey (n = 2), track and field (n = 2), and women's gymnastics (n = 1). Additional background information on our participants is provided in Table 2. The majority of female ATs were contracted for 12 months and worked 58 ± 19 hours a week. Their average workweek responsibilities are shown in Table 3. All participants were given pseudonyms to protect their identity.

Table 1.

Participants' Ages and Experience

Participants' Ages and Experience
Participants' Ages and Experience
Table 2.

Participants' Demographic Data

Participants' Demographic Data
Participants' Demographic Data
Table 3.

Work Schedules

Work Schedules
Work Schedules

Two major themes emerged regarding the career planning of female ATs in the Division I setting and are articulated in Figures 1 and 2. The first theme, family-planning departure, refers to the female ATs who plan to leave the profession or, at a minimum, make a setting change to balance their responsibilities as a mother and an AT. The second theme, family-planning persistence, recognizes that some female ATs plan to remain in their positions as female ATs in the Division I setting, whereas others contemplate leaving the profession entirely, regardless of their marital or family status (Table 4).

Figure 1.

Family planning—reasons to depart the National Collegiate Athletic Association Division I setting.

Figure 1.

Family planning—reasons to depart the National Collegiate Athletic Association Division I setting.

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Figure 2.

Family planning—reasons to persist in the National Collegiate Athletic Association Division I setting.

Figure 2.

Family planning—reasons to persist in the National Collegiate Athletic Association Division I setting.

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Table 4.

Participants' Career Intentions

Participants' Career Intentions
Participants' Career Intentions

Family-Planning Departure

For this group of female ATs, the Division I setting was viewed as demanding and not conducive to success as a female AT and a mother. Two causes emerged as driving forces for our female ATs to realize that they would eventually make career changes (Figure 1). Analysis also indicated that no formal policies were in place to help female ATs balance their roles as both mother and collegiate AT, which were complicated by the long work hours and salaries earned by the female ATs.

Hours Worked

Samantha, a married female AT without children, highlighted concerns about hours and the nature of the Division I setting:

I may need to change the setting that I work in to be able to balance work and family so that I have time to actually be a parent. My husband and I are already making plans for this. In several months, I will be leaving the Division I-A athletics setting. I'm looking into jobs as a physician extender, personal training, or per diem work. I am at peace with it and am ready for new challenges that allow me to have weekends, no travel, and be able to take vacation when I want. I have had a good 10-year career and have climbed the ladder as high as I feel I can go short of being a head athletic trainer. I'm ready to start a new chapter that allows for both career and personal goals to be attained.

Several other female ATs spoke of making a setting change; 11 of 27 female ATs interviewed were considering a change in clinical setting. Nancy, a married female AT without children, wrote, “I will likely have to change settings to ensure that I can be around for my children as much as I want to be.” Kristen commented,

I love my job and love working with athletes at this level, but with the hours required and the lack of support from administration with understanding the need for more staff, I'm not sure I can sustain this level of work and be a good mom.

Many of the single female ATs were also planning a setting change to balance motherhood and the professional responsibilities associated with athletic training. Jaime shared, “Yes [I hope to remain], but [I] may change the setting I am employed [in] if I decide having a family is too difficult to balance.” Jamie's response was focused primarily on the long work days she endured, especially during the in-season schedule of her team. Mary, a single female AT, discussed taking a position outside the Division I setting in order to be an active parent, as modeled in her childhood. She observed,

[In college athletics, there are] more sacrifices personally, less family time with children. [Especially] for their sports [as they] grow up and that [sports] was a huge part of my family life. [I was] coached by my parents. I may take a high school job or a part-time job to spend more time with my family.

Katie stated, “I will not want to travel as much and feel like I am missing my own children's life to raise someone else's.” Travel, as discussed by Katie, requires time away from family and is often on top of an already long workweek.

Departure from the profession was also described by several of the female ATs as necessary in order to succeed in their role as a mother. Molly, a single female AT, recognized that one day, when she has a family, it may be necessary to change careers. She noted, “I may have to change careers if I decide I want to have children.” Julie shared, “I believe that once we [my husband and I] have a family, that I will end up giving up my professional career as an AT to pursue a ‘normal' 9-to-5 job to better support my family.” Regardless of marital or family status, the roles of mother and AT can be demanding of time and resources, which often affect one another. As a result, female ATs recognize the need to sacrifice role (often the role of collegiate AT) for the other. Julie and Molly both addressed the need to change settings or careers because a more traditional workday can benefit WLB, as compared with the unstructured workday of the AT, especially when employed in the collegiate setting.

Financial Rewards

Based on our participants' responses, it appears that the current salaries of female ATs in the Division I setting do not seem to fairly compensate them for the actual amount of time spent working. Long hours and high-demand jobs without sufficient compensation were concerns for our female ATs when considering their ability and desire to remain in the Division I setting. Although hours worked was a distinguishing factor for departure, as previously presented, so that they could provide emotionally and physically for their families, our participants also illustrated the importance of financial support for their families. Hannah commented,

This [Division I] setting has influenced my professional commitment in a negative way. It has made me not want to do this profession anymore because of the constant demand and lack of financial compensation for that demand.

A single female AT, Molly, highlighted, “I don't think that women in this profession get paid enough to make this a lifelong career.” The current economic environment was described as problematic for an AT because the lack of adequate compensation affects family resources. Yolanda discussed the specific challenges for female ATs who have a family: “It might be hard to stay working in the college setting because of the child care situation and money situation.” Our female ATs appeared to consider their salaries influential factors, and they did not feel their salaries allowed them to support their families or to offset the demands of their jobs. This negative appraisal made them reconsider whether they wanted to continue working in the NCAA Division I setting or even in the profession. Statements from our participants suggested that women were not paid enough to persist.

Regardless of the marital status of our participants or their intentions to have a family in the future, the perceived financial shortcomings appeared to be an independent factor affecting their desire to persist at the Division I setting or to leave the profession entirely.

Family-Planning Persistence

The female ATs who planned to remain in the collegiate work setting based that decision on the fulfillment of WLB because of support networks and the ability to prioritize family needs over work-related obligations (Figure 2). Yolanda, who was married with 2 children, wrote, “I think my work has more support systems than anywhere else. That's why I think I can stay here and work.” Support from coworkers is necessary in athletic training8 ; however, in addition to peer support, this group of female ATs discussed the importance of support from the coach and coaching staff of family and in balancing the demands of college athletics and parenting. Claire, a mother of 1 child, noted, “Having a coaching staff with young children helps because they understand the importance of time with family as well, so they prioritize the same way.” Beth illustrated the role of the coach in a female AT's ability to successfully balance both roles:

One of the head coaches I work with wants a family of her own, so she is trying to find balance in her own life, which helps me. The other coach is my age with no kids and no life outside of coaching. She has no concept of balanced lifestyle.

Like Claire and Beth, Paula, who was married with 1 child, stressed the importance of the coach in the fulfillment of WLB, which allowed the female AT to persist in the collegiate setting. “I guess the fact that 1/2 of them [coaches] have children is helpful and the fact that the others work closely with other people who have children makes them all more understanding.” Support networks was 1 aspect of persistence for the female AT but also important was the need to prioritize family demands at times. Claire observed, “Professionally I'm going to have to acknowledge that there are times that I'm going to have to miss work and depend on my coworkers in order to do what is needed for my family.” Claire had no intentions of leaving collegiate athletics because of motherhood. In fact, her career goals included “remaining at the college setting” and her personal goals included “to have healthy children and be able to spend quality time with them.”

Work-life balance is difficult for most to imagine, but do view it as attainable. However, achieving this balance is particularly challenging for female ATs.1,5  Previous researchers5  found that women were increasingly departing the collegiate athletic training setting after the age of 30. Concerns related to WLB and parenting were documented as reasons to leave the Division I setting or the profession entirely.1,5  Our data suggest that, as speculated by other authors,5  family planning can play a role in career longevity for the female AT. Financial compensation, a common complaint or factor cited as a dissatisfying element of being an AT,17,18  was linked to career longevity for the female AT—a unique finding based upon gender, not the profession. Our findings also continue to support the early work of Capel,17  who cited hours worked and salary as 2 major contributors to departure for the AT.

Many of our single female ATs indicated the increased possibility of changing their job setting or leaving the profession once they decide to start a family. Our female ATs' priorities became realigned to raise their children, and they were uncertain that a proper WLB could be achieved by staying in the Division I setting. Our results agree with those of prior investigators1,4  who concluded that female ATs leave the profession or change job settings because of the conflicting time required for parenting expectations and athletic training obligations. Recently, Bowman and Dodge19  stated that even ATs who demonstrated professional commitment by pursuing postprofessional degrees in athletic training were influenced to depart the profession because of WLB concerns, primarily driven by hours worked and low salaries.

According to previous research5,20  in related health care professions, job-setting flexibility that allows for parenting is a crucial factor in the decision to change work settings and work hours. Persistence in the collegiate setting can be significantly influenced by the fulfillment of WLB.7  Frequently, this WLB is facilitated by the ATs' support networks and prioritization of responsibilities.8  Similarly, female ATs thought they would persist in the Division I setting if they found the right family-work environment. We found that the majority of our female ATs who were married with children would remain in their particular job setting and in the profession. These female ATs believed that with the right work environment and overall support system, they were able to achieve WLB. This observation ties directly into research2123  examining the effect of job embeddedness, the collection of forces keeping an individual in the job. Although job embeddedness encompasses 2 dimensions, organizational and community embeddedness, researchers21,23  have noted that the organizational dimension better predicts employee job performance and job retention than does the community dimension. However, our single female ATs indicated that once they decided to start a family, they would leave the Division I setting or exit the profession altogether. They expected, from observing others, that the athletic training profession would require more time caring for someone else's children and less quality time available for their own children. Married female ATs with the intention of starting a family in the near future had already begun making plans to change their job settings. Most of these married female ATs acknowledged that this was their solution in order to have the capability and opportunity to be there for their children. Job embeddedness may play a role in mitigating departure for those who have committed themselves early (our participants who were married with children); however, as recently described by Eberman and Kahanov,24  the decision to not have children may be directly linked to retention in the profession. Furthermore, our findings, particularly of those female ATs who are single or married without children, support the idea that managing work and family is stressful and that more women desire to be able to spend time at home, parenting and completing domestic tasks.

Previous investigators25  identified that salary can affect the longevity of ATs. In today's economy, the costs of food, rent, and insurance continue to increase. The need to cover these expenses is only complicated by adding the economic demands of supporting a family. Although the majority of female ATs are not in athletic training for financial reward but rather for their desire to keep athletes on the playing field,14  our participants cited unsatisfactory salaries in relation to daily responsibilities and hours worked. Salary is an additional negative causative factor to leave the profession when assessing WLB. Similar studies show that female ATs starting families do not foresee enough financial reward to continue in the Division I setting or stay in the profession to support their families.15  Overall, salary is not the deciding factor for female ATs leaving the profession, but it is a significant contributing factor.

Limitations and Future Directions for Research

We recognize that our sample represents only the NCAA Division I setting and, therefore, our results may not be transferable to other settings. The NCAA Division I setting can be very challenging and demanding; consequently, we encourage future researchers to examine the other collegiate divisions, as well as other clinical settings, to gain a full understanding of the career intentions of the female AT. Also, our participants were unaware of any formal policies on WLB for the AT in the collegiate setting. Formal workplace policies are important in other work settings; thus, future authors may investigate the presence of formal workplace policies to help ATs find WLB. In addition, we present the career and family goals for only the female AT. Although gender has not been identified as a mediator for issues in WLB, more information is warranted regarding the professional and personal goals of male ATs in order to gain a holistic understanding of the demands placed upon the AT and their effect.

As previously speculated by several athletic training scholars, WLB concerns and specifically time for parenting were influential for this group of female ATs. For many of our female ATs, the time demands that are associated with full-time athletic training positions at the NCAA Division I setting appeared to be too much to allow an adequate balance of motherhood and a career. Interestingly, similarly to the findings of Mazerolle and Goodman26  in a case study spotlighting several female ATs who were married with children, several of our female ATs were firm in their goal to remain in the NCAA Division I setting while managing both roles. Their persistence may benefit future female ATs, as mentorship has been revealed as necessary to retain more female ATs in this setting.10,11  Women are still leaving the profession, and conceivably a way to deter the emigration from the profession is to expose young female ATs to more role models and mentors, as they are an essential part of career development.27 

New to the literature, however, was the idea that financial compensation is not adequate to retain a female AT. Traditionally speaking, men are often more concerned with salary and earnings, but for several women in our sample cohort, financial compensation was an influence in a lifelong career in athletic training.

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Appendix. Sample Questions Sent to Participants

Background Questionnaire

  1. 1.

    How old are you?

  2. 2.

    Average work week (hours): in-season coverage

  3. 3.

    Average work week (hours): out-of-season coverage

  4. 4.

    Average travel load (days per month): in-season coverage

  5. 5.

    Average travel load (days per month): out-of-season coverage

  6. 6.

    How would you characterize your current family situation? (children, no children, # of children)

  7. 7.

    While at work, who is the primary caregiver for your child?

Interview Questions: National Collegiate Athletic Association Division I Female Athletic Trainers

  1. 1.

    What are your professional goals?a-c

  2. 2.

    Have they changed since you started a family? If so, how?c

  3. 3.

    What are your personal goals?a-c

  4. 4.

    Based upon your goals, do you envision a lifelong career in athletic training?a-c

  5. 5.

    Discuss if working in the athletic training profession provides a suitable working environment to achieve a balanced life style.a-c

  6. 6.

    What, if any, organizational policies are in place to help you as a female athletic trainer with children to help maintain a balanced life style?c

  7. 7.

    Do you feel that since starting your family, you have had to make sacrifices personally and/or professionally? Please describe.c

  8. 8.

    Do you feel as though you will be able to persist in your current position with your current job and family responsibilities?c

  9. 9.

    What role does your gender play in your response?b,c

  10. 10.

    What role does your current marital and family status play in your response?a-c

  11. 11.

    Discuss how your work/life balance has changed from being a single professional to being a married professional to being married with children? Were the challenges different at each stage for you?c

  12. 12.

    Do you have a support system that helps you maintain a healthy balance between your personal and professional life? Please describe your support system.a-c

  13. 13.

    What role does your family play in your ability to find a balanced life style?a-c

  14. 14.

    What role does your spouse play in your ability to find a balanced life style?b

  15. 15.

    What role do your co-workers play in your ability to find a balanced life style?a-c

  16. 16.

    Do you believe, once you have a family, that you will have to make sacrifices personally and/or professionally? Please describe.a-c

  • a Single female athletic trainer.

  • b Married female athletic trainer.

  • c Married female athletic trainer with children.