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Reducing Competitive Anxiety Cheerleader Psychology

Primary Purpose

Sports Injury, Stress Reaction, Performance Anxiety

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Stress Inoculation Technique
Health Intervention
Sponsored by
Western University, Canada
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Sports Injury focused on measuring cheerleading, stress management, injury prevention, psychosocial factors, stress-injury, performance, coping skills, stress inoculation technique, competitive anxiety, psychological intervention

Eligibility Criteria

17 Years - undefined (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Participants must be active members of Western University's coed cheerleading team for the 2019 competitive season (August-November 2019)
  • Participants must be on Western University's coed cheerleading team during the 2019 PCA College National Championships
  • Participants must have no experience with psychological stress-management interventions aimed at reducing competitive sport anxiety, in particular, no previous experience with Stress Inoculation Technique therapy.

Exclusion Criteria:

  • Not being an active member of Western University's coed cheerleading team for the beginning of the 2019 competitive season (September 2019), whether due to injury or absence from the team.
  • Not being an active member of Western University's coed cheerleading team during the 2019 PCA College National Championships
  • Previous experience with psychological stress-management interventions aimed at reducing competitive sport anxiety in a cheerleading context, in particular, previous experience with Stress Inoculation Technique therapy.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Psychological Intervention

    Health Intervention

    Arm Description

    Six session intervention, each session 20-25 minutes in length. Stress inoculation technique-based intervention. Participants will be taught stress coping skills and relaxation skills such as self-efficacy statements, imagery, relaxation breathing, relaxation scripts, thought stoppage, cognitive reframing, positive self-talk, goal setting, event planning, and preparing for competition

    Six session intervention, each session 20-25 minutes in length. Participants will be taught relevant health and nutrition guidelines and practice using a food diary app (MyFitnessPal). Nutrition and health content will include such topics as reading Canadian food labels, vitamins and supplements, effects of alcohol on performance and recovery, vegetarian vs. omnivore diets, and hydration & performance.

    Outcomes

    Primary Outcome Measures

    Injury Time
    The amount of cheerleading time participants must modify or miss due to injuries suffered due to cheerleading. This outcome will be self-reported by each participant throughout the time frame using an injury data sheet provided to them by the investigators.
    Incidences of Injury
    The number of cheerleading injuries sustained by the participants during the study period. This outcome will be self-reported by each participant throughout the time frame using an injury data sheet provided to them by the investigators.

    Secondary Outcome Measures

    Sport Anxiety
    The amount of anxiety and stress participants report feeling as a result of the demands of training and competing for their cheerleading team. This outcome will be measured based on each participant's score on the Sport Anxiety Scale-2 (SAS-2). Each participant's post-test score on this measure will be compared to the participant's baseline score. There are fifteen questions, with five questions per subscale: somatic symptoms, concentration disruption, and worry. Each question asks participants how often they experience worry, concentration disruption, or somatic symptoms, with a low score of 1 indicating "not at all" and a high score of 4 indicating "very much". Total score on the questionnaire ranges from 15 to 60. A low total score indicates lower sports anxiety, and a higher scores indicates intense feelings of worry, disruption of concentration, and somatic symptoms.
    Stress Coping Resources
    The amount of stress coping techniques and skills participants employ in order to deal with their sport anxiety during important sporting events. This outcome will be measured based on each participant's score on the Athletic Coping Skills Inventory-28 (ACSI-28). Each participant's post-test score on this measure will be compared to the participant's baseline score. There are 28 questions, and seven subscales: coping with adversity, coachability, concentration, confidence and achievement motivation, goal-setting and mental preparation, peaking under pressure, and freedom from worry. Scores range from a low of 0 to a high of 12 on each subscale, with higher scores indicating greater strengths on that subscale. The score for the total scale ranges from a low of 0 to a high of 84, with higher scores signifying greater strength.

    Full Information

    First Posted
    February 14, 2019
    Last Updated
    March 5, 2019
    Sponsor
    Western University, Canada
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03849170
    Brief Title
    Reducing Competitive Anxiety Cheerleader Psychology
    Official Title
    Reducing Competitive Anxiety in Cheerleaders: A Psychological Approach
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2019
    Overall Recruitment Status
    Unknown status
    Study Start Date
    August 2019 (Anticipated)
    Primary Completion Date
    November 2019 (Anticipated)
    Study Completion Date
    December 2019 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Western University, Canada

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Cheer leading is a rapidly growing international sport known for its acrobatic skills and dangerous stunts. The sport presents ample risk for physical trauma, and it is common for athletes to miss extensive time from cheer leading due to injury. The goal of this study is to the see whether the investigators can reduce injury risk among cheer leading athletes by teaching them stress-coping skills to help them relax and reduce their sport-related stress. There exists a link between high levels of stress and increased rates of injury among athletes. When individuals become stressed during athletic events such as competitions or strenuous training, symptoms including muscle tension and narrowed attention often accompany the stress response, increasing injury risk and reducing performance quality. In this study, half of Western University's coed cheer leading team will participate in a six-session stress management intervention to teach them relevant psychological stress-coping skills. Such skills include relaxation breathing techniques, visualization exercises, stoppage of negative thoughts, and development of self-efficacy statements. The other half of the team will receive a placebo "sport nutrition" program. The sessions of both the control program and the stress-management intervention will be administered over the most intensive period of the cheer leading season, from September to November of 2019. The investigators predict that the intervention group athletes will report less cheer leading time missed due to injury, report less sport-related stress, and make fewer errors at their cheer leading championship than their teammates in the placebo group. This is the first study to administer a psychological injury-prevention intervention to cheerleaders.
    Detailed Description
    Background Information: Cheer leading is a growing, highly competitive, and potentially stressful sport, with 3.5 million athletes practicing worldwide. The sport presents many risks, as it was responsible for more catastrophic injuries among female high school and college athletes than any other sport between 1982 and 2016 in the U.S. In Canada, there were 1496 cheer leading injuries requiring hospitalization from 1990 to 2010. According to the Williams and Andersen stress model, athletes with certain personality dispositions (e.g. high competitive anxiety), fewer coping resources (e.g. social support, stress management) and an extensive history of life stressors are prone to appraising athletic situations as being stressful, resulting in an exaggerated stress response. The stress response is particularly likely to manifest itself during instances in which an athlete perceives a high demand to succeed, but feels they possess inadequate resources to do so. These situations often lead to a variety of symptoms, including poorer performance quality, generalized muscle tension (physiological), and heightened distractibility (attentional), culminating in a greater likelihood of injury among athletes. Objectives: The goal of this study will be to administer a psychological-based intervention to improve the stress-coping skills of competitive cheerleaders, acting to minimize their competitive anxiety, maintain their performance quality, and reduce their risk of injury during the span of a season. Hypothesis: Cheerleaders who complete a psychological-based stress-coping intervention will report lower competitive anxiety, demonstrate superior performance, and report less time lost from cheer leading due to injury compared to a control group of teammates receiving a placebo program. Theoretical Approach: The psychological intervention will be based on the Stress Inoculation Technique (SIT), with the objective of restructuring athletes' coping skills in order to improve their management of stress (i.e. competitive anxiety). During the first phase of SIT, athletes will bring up narrative accounts of stressful athletic situations, identifying previously insufficient coping techniques as well as potential coping strengths. Self-monitoring strategies will be introduced to help athletes become more aware of the ways that they inadvertently build up stress reactions. During the second SIT phase, athletes will be taught coping skills such as muscle relaxation, use of self-efficacy (confidence) statements, cognitive re-framing of stressful situations, and emotion regulation techniques, which they will then apply to their personal cheer leading experiences. These skills will be further rehearsed through positive mental imagery and practice to ensure their effectiveness. In the final SIT stage, athletes will be encouraged to apply their new coping skills to incrementally more demanding cheer leading situations while utilizing stress management techniques. Athletes will be further reminded to take credit for their improvement, instilling a lasting sense of self-efficacy. The SIT intervention will teach athletes an array of anxiety management skills in order to help them develop effective stress-coping strategies during important cheer leading events. Participants will maintain an in-person correspondence with the researcher throughout to ensure a properly personalized and collaborative intervention experience. Methods: The intervention period will reach from September 2019 to December 2019, as this is the busiest and most competitive part of the cheer leading season. Half of Western University's 30-40 athlete co-ed cheer leading team will be randomized to complete a six session "sport nutrition" program as a control, while the other half will be randomized to complete a six session bi-weekly SIT program. Since the intervention and control groups will come from the same team, all participants will share identical practice and competition schedules, ensuring each group is exposed to the same athletic situations. As such, differences in group outcomes will most likely be due to the type of intervention they received. To measure performance quality, total scoring deductions caused by the athletes in each group during Western's two runs at the 2019 PCA college cheer leading championship will be compared. Fewer deductions indicate fewer errors (bobbles, drops, falls, etc.) and reflect superior performance. Impact: The current study will be the first to develop and implement a psychological-based intervention tailored to cheerleaders with the goal of improving these athletes' stress-coping abilities. If successful, this intervention is highly scalable and can be used by athletes where stress and injury are salient features of their sport, and where individual performance is highly scrutinized.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Sports Injury, Stress Reaction, Performance Anxiety
    Keywords
    cheerleading, stress management, injury prevention, psychosocial factors, stress-injury, performance, coping skills, stress inoculation technique, competitive anxiety, psychological intervention

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Model Description
    Independent, randomized groups, longitudinal study
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    35 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Psychological Intervention
    Arm Type
    Experimental
    Arm Description
    Six session intervention, each session 20-25 minutes in length. Stress inoculation technique-based intervention. Participants will be taught stress coping skills and relaxation skills such as self-efficacy statements, imagery, relaxation breathing, relaxation scripts, thought stoppage, cognitive reframing, positive self-talk, goal setting, event planning, and preparing for competition
    Arm Title
    Health Intervention
    Arm Type
    Placebo Comparator
    Arm Description
    Six session intervention, each session 20-25 minutes in length. Participants will be taught relevant health and nutrition guidelines and practice using a food diary app (MyFitnessPal). Nutrition and health content will include such topics as reading Canadian food labels, vitamins and supplements, effects of alcohol on performance and recovery, vegetarian vs. omnivore diets, and hydration & performance.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Stress Inoculation Technique
    Intervention Description
    Teaches athletes to use cognitive-behavioral techniques to reduce their stress response during sporting events.
    Intervention Type
    Other
    Intervention Name(s)
    Health Intervention
    Intervention Description
    Will provide basic dietary and lifestyle guidelines that athletes should follow in their daily lives to maintain their health
    Primary Outcome Measure Information:
    Title
    Injury Time
    Description
    The amount of cheerleading time participants must modify or miss due to injuries suffered due to cheerleading. This outcome will be self-reported by each participant throughout the time frame using an injury data sheet provided to them by the investigators.
    Time Frame
    14 weeks
    Title
    Incidences of Injury
    Description
    The number of cheerleading injuries sustained by the participants during the study period. This outcome will be self-reported by each participant throughout the time frame using an injury data sheet provided to them by the investigators.
    Time Frame
    14 weeks
    Secondary Outcome Measure Information:
    Title
    Sport Anxiety
    Description
    The amount of anxiety and stress participants report feeling as a result of the demands of training and competing for their cheerleading team. This outcome will be measured based on each participant's score on the Sport Anxiety Scale-2 (SAS-2). Each participant's post-test score on this measure will be compared to the participant's baseline score. There are fifteen questions, with five questions per subscale: somatic symptoms, concentration disruption, and worry. Each question asks participants how often they experience worry, concentration disruption, or somatic symptoms, with a low score of 1 indicating "not at all" and a high score of 4 indicating "very much". Total score on the questionnaire ranges from 15 to 60. A low total score indicates lower sports anxiety, and a higher scores indicates intense feelings of worry, disruption of concentration, and somatic symptoms.
    Time Frame
    First at baseline, then again 14 weeks later.
    Title
    Stress Coping Resources
    Description
    The amount of stress coping techniques and skills participants employ in order to deal with their sport anxiety during important sporting events. This outcome will be measured based on each participant's score on the Athletic Coping Skills Inventory-28 (ACSI-28). Each participant's post-test score on this measure will be compared to the participant's baseline score. There are 28 questions, and seven subscales: coping with adversity, coachability, concentration, confidence and achievement motivation, goal-setting and mental preparation, peaking under pressure, and freedom from worry. Scores range from a low of 0 to a high of 12 on each subscale, with higher scores indicating greater strengths on that subscale. The score for the total scale ranges from a low of 0 to a high of 84, with higher scores signifying greater strength.
    Time Frame
    First at baseline, then again 14 weeks later.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    17 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Participants must be active members of Western University's coed cheerleading team for the 2019 competitive season (August-November 2019) Participants must be on Western University's coed cheerleading team during the 2019 PCA College National Championships Participants must have no experience with psychological stress-management interventions aimed at reducing competitive sport anxiety, in particular, no previous experience with Stress Inoculation Technique therapy. Exclusion Criteria: Not being an active member of Western University's coed cheerleading team for the beginning of the 2019 competitive season (September 2019), whether due to injury or absence from the team. Not being an active member of Western University's coed cheerleading team during the 2019 PCA College National Championships Previous experience with psychological stress-management interventions aimed at reducing competitive sport anxiety in a cheerleading context, in particular, previous experience with Stress Inoculation Technique therapy.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Harry Prapavessis, Ph.D
    Phone
    5196612111
    Ext
    80173
    Email
    Hprapave@uwo.ca
    First Name & Middle Initial & Last Name or Official Title & Degree
    Alexander D Marchand, B.Sc
    Phone
    5196612111
    Ext
    81189
    Email
    amarcha7@uwo.ca
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Harry Prapavessis, Ph.D
    Organizational Affiliation
    Western University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    Citation
    Meichenbaum, D. H., & Deffenbacher, J. L. (1988). Stress Inoculation Training. The Counseling Psychologist, 16(1), 69-90.
    Results Reference
    background
    Citation
    Williams, J. M., & Andersen, M. B. (1998). Psychosocial Antecedents of Sport Injury: Review and Critique of the Stress and Injury Model. Journal of Applied Sport Psychology, 10, 5-25.
    Results Reference
    background
    Citation
    Smith, R. E., Schutz, R. W., Smoll, F. L., & Ptacek, J. T. (1995). Development and Validation of a Multidimensional Measure of Sport-Specific Psychological Skills: The Athletic Coping Skills Inventory-28. Journal of Sport and Exercise Psychology, 17, 379-398.
    Results Reference
    background
    Citation
    Smith, R. E., Smoll, F. L., Cumming, S. P., & Grossbard, J. R. (2006). Measurement of Multidimensional Sport Performance Anxiety in Children and Adults: The Sport Anxiety Scale-2. Journal of Sport & Exercise Psychology, 28, 479-501.
    Results Reference
    background
    PubMed Identifier
    25783366
    Citation
    Hardy I, McFaull S, Saint-Vil D. Neck and spine injuries in Canadian cheerleaders: An increasing trend. J Pediatr Surg. 2015 May;50(5):790-2. doi: 10.1016/j.jpedsurg.2015.02.039. Epub 2015 Feb 19.
    Results Reference
    background
    Citation
    Kucera, K. L., Thomas, L. C., Cantu, R. C. (2017). Catastrophic Sports Injury Research, Thirty-Fourth Annual Report, Fall 1982 - Spring 2016. Chapel Hill, NC.
    Results Reference
    background
    PubMed Identifier
    15446646
    Citation
    Kolt GS, Hume PA, Smith P, Williams MM. Effects of a stress-management program on injury and stress of competitive gymnasts. Percept Mot Skills. 2004 Aug;99(1):195-207. doi: 10.2466/pms.99.1.195-207.
    Results Reference
    result
    Citation
    Maddison, R., & Prapavessis, H. (2005). A Psychological Approach to the Prediction and Prevention of Athletic Injury. Journal of Sport and Exercise Psychology, 27, 289- 310.
    Results Reference
    result

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