“ It isn ’ t always easy to handle ” : Qualitatively Exploring the Experiences of International Student-Athletes at a Mid-Major University

Introduction: International student-athletes (ISA) face unique challenges during their transition to life on an American university campus. It is critical to understand these challenges to enhance their academic and athletic experiences. Thus, the purpose of this study was to gain an understanding of the specific challenges ISA at a mid-major, Division I university face and their perceptions of how those challenges are currently being met by their university. Methods: Focus groups were completed with 24 ISA. Participants were asked to discuss their transition experiences. Interviews were transcribed, coded, and analyzed by a four-person research team. Each team member coded independently, and then the group met to discuss the codes and determine emerging themes. Results: Three themes and subsequent subthemes were found: (1) Adjusting to university life (subthemes: Navigating the structure of the athletics program; The importance of teammates; Academic unfamiliarity; Adapting to American living); (2) Unexpected challenges (subthemes: Financial concerns; Discontent with available resources; Disconnects in communication); and (3) Recommendations for ISA transitions. Conclusions: ISA continue to face numerous challenges during their transition and many needs are currently unmet. Universities need to create programs that incorporate the voices of ISA to best serve their unique needs.

understanding of issues related to language, immigration, and travel, 3,5,13 a dedication of more resources toward recruitment, 4, [14][15][16] and the need to navigate issues regarding professionalism which are not typically a concern with SA. 5,[16][17][18] ISA, in their dual roles as international students and SA, illustrate the potential to bring to the university setting the respective benefits of both international students 15,18 and SA. 5,13,19 As such, it is in the best interest of the university, and specifically athletics, to best understand the issues facing ISA in order to "be a valuable member of [the] ISA's support system". 13 From a practical standpoint, a university should seek to "protect their investment…and must devote resources to the success and retention of ISA". 4 Protecting the investment is inherently tied to understanding transition issues specific to ISA, and working to implement a system which focuses on ISA success and retention. The retention of ISA is particularly an issue of concern, as research has found that coaches perceive it to be one of the most pressing issues when dealing with ISA, and yet coaches routinely underrepresent their own amount of ISA turnover. 16 In order to add to the body of knowledge regarding ISA transition issues, the present study focuses on ISA at a mid-major institution. While existing ISA research has been conducted at mid-major DI institutions, 13 research on migration patterns, or "pipelines" of ISA suggest that school destination choices for ISA may emphasize mid-majors. 19 Thus, the purpose of this study is two-fold: (1) to gain a richer understanding of the specific challenges ISA face during their initial transition to campus and their perceptions of how those challenges are currently being met by their university; and (2) to explore whether the resources currently in place are meeting the needs of ISA as they transition to life at a mid-major DI American university.

Conceptual Framework
Comeaux and Harrison's Conceptual Model of Academic Success for Student Athletes helped to direct the scientific method for the present study. 20 The model builds on the six elements of Tinto's Model of Institutional Departure [21][22] with additions specific to SA. Notably, it adds components of sport participation and sport commitment in order to better interpret academic success and experiences of SA. The focus on SA experiences make Comeaux and Harrison's model the ideal framework for the qualitative nature of the present study as it establishes a construct for exploring the wide range of factors involved in the transition process of ISA to a mid-major DI athletics program.

Participants
After securing IRB approval through their mid-major university in the southeastern United States, researchers solicited ISA for participation in the study. Solicitation was done via email and word-of-mouth, and participants signed voluntary consent forms prior to participation. Consent forms informed participants of their right to discontinue participation at any time, that audio recording of focus groups would occur, that pseudonyms would be used to protect their identities, and that interview data would be securely stored and protected. In all, 24 ISA participated in eight focus groups (n = 3 male, n = 21 female) between August 2019 and November 2020. The majority of ISA were on full scholarship and ranged from 19 to 21 years old. All participants were current members of their respective teams and represented the sports of: tennis, soccer, golf, track and field, and volleyball.

Protocol
Focus groups were conducted with ISA in order to provide them the opportunity to describe their lived experiences. Researchers utilized a semi-structured question guide which allowed for unprompted interjections from participants. Per recommendation, while using the same guide provided structure between different focus groups, 23 the semistructured nature gave participants the chance to expand on their own circumstances and give meaning to their own, unique, transition experiences. Interviewers occasionally deviated from the guide when they deemed it necessary for an additional probing inquest. This setting follows recommendations for collecting detail-rich data by centering on open-ended questions with broad guidelines in a qualitative, phenomenological approach. 24 Each focus group interview began with a reminder to participants of their voluntary participation and subsequently followed procedures set forth by Marshall and Rossman for ethical management of data through proper recording, uploading, and storage procedures. 25 Following recording, uploading, and storing, each recording was de-identified and transcribed through a reliable service. Interviews were transcribed verbatim to ensure that participant responses would be accurately represented during data analysis. To add an additional level of trustworthiness and precision, researchers then read transcriptions while listening to original recordings to identify and rectify transcription errors. In all, researchers adhered to Lincoln and Guba's guidelines for data trustworthiness. 26 Credibility was upheld through triangulation and member checking. Transferability was demonstrated through the use of a comprehensive description of all participants to detail the observed phenomena. Dependability was established through the previously detailed steps of ethical data management. Finally, confirmability was confronted by researchers addressing and documenting potential bias concerns prior to the coding process. Most notably, three of the four researchers were former studentathletes themselves, thus, the fourth member of the research team served as a critical friend to assess potential research bias during the data analysis phase.

Statistical Analysis
Each researcher began the analysis process by independently coding the transcriptions using NVivo software. The process involved creating initial codes and then further categorizing data to perform a thematic analysis. 27 The researchers coded each individual statement from participants. Some statements contained one code, such as "dissatisfied with food options" while other statements contained multiple codes to reflect more than one idea being presented by the participant. For example, the following quote contained the codes of "miscommunication", "teammates as family", "advice from others in advance", and "initial transition challenges": "And once you get there he's completely different. I think getting that perspective from the student athletes and how their coaches are, because at the end they're your family here and those are the ones that make a difference for you here. To me it would have been better or to get that advice to talk a lot to girls from the team." NVivo was used to group and categorize the codes so that researchers could better understand the commonalities present. After coding, the researchers documented similarities and patterns within the data, which ultimately led to the formation of themes. Following the independent analysis, the four-person research team convened to share their independent findings. Codes were discussed within the research team until consensus was met. Upon consensus, codes were categorized into specific themes and subthemes. [28][29][30] This process, called thematic analysis, is typically utilized during phenomenological and exploratory qualitative studies and involves the researchers theming the data to identify what each code means and how to best interpret it based on the participant experience. 31 Through conducting the coding independently and then discussing the codes and proposed themes together, the researchers added additional rigor to the study, accounting for researcher bias and allowing for a more thorough analysis. The code groupings were explored and the researchers examined how to best create overarching themes to represent the numerous codes, and further, develop a means to connect the emergent themes to tell the full story of the participants' unique experiences. 31 Specific quotes and excerpts were identified and included in the results to represent each theme and to ensure adequate substance for each theme.

Results
Results from the focus groups revealed three themes with subsequent subthemes: (1) Adjusting to university life (subthemes: Navigating the structure of the athletics program; The importance of teammates; Academic unfamiliarity; Adapting to American living); (2) Unexpected challenges (subthemes: Financial concerns; Discontent with available resources; Disconnects in communication); and (3) Recommendations for ISA transitions.
Adjusting to university life All participants discussed the challenges they faced upon arriving to campus and needing to make immediate adjustments to their typical lifestyles. Not only were participants unfamiliar with the campus itself, but having to adjust to American culture, specifically Southern American culture, created a stressful transition experience. Focus group discussions centered on navigating the structure of the athletics program, the importance of having a bond with teammates, unfamiliarity with academics, and adjusting to American living as a whole.
Navigating the structure of the athletics program Many participants voiced that they had to make a major adjustment upon starting a DI sports program, as they learned to work with a new team, coach, and climate. Lauren stated: "I had no idea what it takes to like be part of a college team." For her, she was not used to having equipment, an athletic trainer, hitting partners, and a facility available to her at all times. Moving from being an independent athlete to a team member was a welcome change, but an adjustment nonetheless. Participants also shared how the intensity of the program was higher than expected, and many were not prepared to practice so intensely in the heat. Amy shared: "We practice in the afternoon from 2:30 to 4:30[pm] and it's so hot. And it's just, it's a high level we practice here and it's already intense. But then with the climate, it's even more intense and you sweat so much." She further explained that combining the intensity of the program with a new team, new drills, and the hot climate, "it isn't always easy to handle." Further commentary on this topic included trying to find an appropriate athletic-academic balance, especially regarding travel for away games and moving from having no practice schedule to a structured practice schedule that was dictated by the coach. Kristin explained: "…I got to pick when I went to golf, what tournament…And then you come to a university and you have to do it this time, this time, this time. Oh and you've got this, and this, and this, too." Her teammate further expounded on this, saying that the university decides everything for the athletes and for all the events they "have to go as a team," which resulted in change of pace for many ISA athletes.
The importance of teammates Participants voiced that their teammates played a large role in their successful transition to campus, referencing the strong bonds they built with both their American and International teammates. John shared that "nine of ten times" he would go to his teammates for help regarding academic, financial, and personal matters. His teammates were his first source of information, as opposed to asking for help from the coach, athletics, or university administration. Teammates helped newcomers on the team learn about campus life, American culture, and how to navigate academic life. Participants also mentioned that it was nice to build relationships with American teammates because during breaks, the dorms would close and many ISA were stuck on campus. Often times, American teammates would invite ISA home during breaks so they would not be left alone. Regarding her first Thanksgiving experience, Maya shared, "It was kind of cool to experience another culture, another holiday. That helps to understand America better." Teammates served multiple roles on the team, and were ultimately instrumental as a source of social support.

Academic unfamiliarity
Another discussion point from the focus groups included challenges trying to adapt the academic portion of university life, specifically: registering for classes, managing class schedules, grading scales, terminology used in class, and expectations from professors. For example, many of the participants were unfamiliar with class status labels. Kristin shared, "I didn't even know what freshman was. They were like, 'oh you're a freshman.' I'm like, okay, I don't know what that means, but okay." Her teammate Avery shared a similar experience noting, "My first ever English class, I was so confused. I didn't even know what 'due' meant." Other participants struggled with the grading scale, stating that they did not know how a letter scale (i.e., A-F) worked, as they were used to a number system. Participants also shared struggles working with their professors, stating that some professors were not as accommodating as others regarding travel schedules. Sharon shared her roommate's (also an ISA) experience, noting that "her [the roommate] professor actually told her at the beginning of the year, you're going to fail this class" due to the immense amount of traveling the team was doing that season. Participants noted feeling stressed and anxious during their initial transition as they learned their way through the academic system. While familiarity with class structure grew over their years on campus, they still continued to face substantial challenges regarding class schedules, working with academic advisors, and securing internships.

Adapting to American living
The last subtheme is not unexpected, but still worthy of noting. All participants shared their experiences trying to adjust to American living. Participants spent time discussing feelings of homesickness, frustrations of having to live in dorms with no kitchens, difficulty getting around the city, and annoyance with the food offerings on and around campus. The most notable frustration was in regards to food. For many ISA, they are used to having access to a kitchen and cooking their own food, and many of their nutrition choices are not sugar-laden or fried. Morgan made the comment, "…everything seems to be like fast food, like fried. In Australia, that's not how we do things." This not only put a limitation on her options, but created a further frustration as she felt like she lost freedom and independence to cook what she wanted, when she wanted, especially since she was used to preparing more nutritionally dense foods for herself. Participants had major issues relying on the campus's cafeteria for food, as the food is not only subpar in regards to nutritional value (especially for athletes), but the options significantly dwindle on the weekends. Andrew shared, "…especially for us athletes, we need actual food. And then you go there [the cafeteria] and it's just like, pizza…" Andrew also shared that food choices became slim come the weekend, and this can be especially difficult for ISA, as many of them do not have cars to leave campus on the weekends. Participants also noted major adjustments regarding transport, specifically not having a car and having issues navigating around campus and the city by walking and/or biking, as the area was not conducive to active transport. This forced them to make friends with other students who did have cars. While this assisted with building bonds with their teammates and other students, it also resulted in a further loss of independence.

Unexpected challenges
During the course of the focus groups, it became evident that ISA face several significant challenges during their transition period, many of which they were not aware of prior to coming to campus. Subthemes in this theme included financial concerns, discontent with current resources, and disconnects in communication.

Financial concerns
An unexpected finding from these interviews was the amount of issues ISA face regarding their finances once on American soil. Participants shared the numerous negative experiences they had working with university and athletics personnel regarding their taxes and scholarships. One participant, Elizabeth, shared that ISA have to "pay tax without even knowing." She discussed that seemingly out of nowhere she was instructed to "see a tax person" and she had no idea why, or who to see, and no one from athletics offered to help. John shared that prior to coming to campus, he was not made aware of how school tuition worked, and while his tuition was partially covered with his scholarship, he still had to pay out-of-pocket and then was instructed that "you get this amount, and you can spend it towards this. And if you don't, you get this, and there's taxes." He said he spent hours of his own time researching how tuition payments were structured and how taxes in America worked. He was constantly worried about "How much money will I get? How much money will I have to pay?" further stating that "Trying to figure that whole system out was a jungle." These financial issues are frustrating for ISA, particularly when they feel unsupported and no one within athletics can assist with their questions and issues.

Discontent with available resources
While many of the participants voiced that they felt lucky to be competing at a DI university and were thankful for the many resources available to them (i.e., uniforms, equipment, training staff, etc.), they had significant discontent over resources related to academics and personal living. Specifically, participants shared concerns about student academic advising, not having enough tutors, and the office for International students not being able to accommodate the needs of ISA. Most notable in this discussion, was the significant issues ISA had with academic advising and athletic academic advising. Participants shared they often had trouble getting an appointment with their advisor. Several participants even noted that they have had issues scheduling their classes due to having a hold on their account. This hindrance was particularly frustrating as their repeated attempts to get in touch with their athletic academic advisors failed, inhibiting their ability to solve the problem in a timely (and less stressful) manner. Many participants expressed their dissatisfaction, finding advisors consistently absent from their offices, especially during their team's designated study hall time. Participants also faced frustrations with other university resources, specifically, the lack of direction regarding how to do tasks such as getting a driver's license. Often, coaches will tell ISA to ask the office responsible for International student admissions for help, but many ISA felt that the office does not have sufficient personnel to field the needs for both ISA and traditional International students. This forced them to either find answers on their own, or ask their teammates for help. While they felt that the International student department did a decent job introducing them to different activities around campus, Jessie was quick to note that "it's much different for student-athletes" and often times, many of the activities the office offered or advertised were for events they could not attend due to their travel/game/practice schedule.

Disconnects in communication
The last subtheme involved participants noting some of the miscommunications they experienced during their transition to campus. Participants suggested that prior to coming to campus, during the recruitment phase, the coach was their main, and often, only point of contact. Very rarely were they able to do a campus visit due to the cost of plane tickets, and furthermore, they were not able to speak to current team members. Tiffany shared that "coaches can talk to you and make everything sound nice…and like, when I came here I realized that our coaches are very different than what I experienced through recruiting." Alyssa said that her first day on campus she went on a campus tour with her coach and he had "no idea" about things like housing or alternative dining options. She remembers him introducing her to people in the athletics department and her advisor and she was thinking, "I didn't even know what all this means." Avery stated there was no guidance from the coach or the athletics department regarding what to pack, so it was difficult to feel fully prepared coming to campus. This was especially problematic in relation to the weather. The coaching staff shared that the climate was hot and humid, but the participants felt unprepared for what exactly that meant, and they were also unprepared for other natural elements, like hurricanes. Libby expressed the anxiety she felt during her first hurricane. She could not understand why the coaches were not prompting them to leave the area. While something like this might seem commonplace for an American from this area, it can be a scary situation when elements like this are not communicated to those not familiar with the area.
They also felt that the lack of follow-up after recruitment and upon arriving on campus from the athletics department was problematic, specifically in relation to scheduling classes and financial-related issues. Sarah said the first day she arrived on campus she was instructed to go to the International student office to fill out forms. She said the forms were tax forms and she found herself "just signing and doing things that we have no idea why we're doing." No one took the time to explain what the forms were and why they were needed. As a veteran player, Sarah now makes sure that she goes with her new teammates to complete this paperwork so they are not confused like she was. ISA also experienced communication issues with their athletic academic advisors and academic advisors, many questioning why they needed two advisors to begin with. Camila shared: I have to meet with my academic advisor in order for her not to put a hold on my account…I meet with her and we agree on the classes I'm taking. And then I go to schedule. And I see that my athletic advisor has already registered me in classes that we didn't even talk about...And then have to go back to the academic and explain to her that the athletic messed it up. And then they just get mad at each other. And I'm in the middle.
These miscommunications add unnecessary stress to already stressed ISA, and often, it seems as though the situation is completely avoidable.

Recommendations for ISA transitions
Throughout the focus groups, participants were quick to offer their suggestions for improvements to enhance the transition period for ISA. Participants thought it would be helpful for university athletic departments to create a handbook for ISA covering topics such as getting a driver's license, taxes, navigating the city, what to pack, local terminology, tuition, and campus life. John said that he could have benefitted tremendously from a resource that detailed how scholarships and credit hours worked. He found from his own research that things like this are very straightforward, they just are not told to ISA. Having step-by-step guides to cover some essential processes would likely make the transition smoother and less stressful. They suggested that ISA should be involved in the creation of this handbook, so that they can provide personal experiences, somewhat creating a "how-to" guide of examples of how previous athletes were successful in this process.
Participants also stressed the importance of teams creating peer mentorship programs. While many of these relationships happen organically, pairing an ISA with an American student-athlete has its benefits. Macy mentioned that her deepest relationships are with other ISA because they can relate to each other better, but her teammate, Melissa, stated that relationships with American teammates are also important because they are the ones to help them better understand the culture. Some of the participants interviewed were on teams with only ISA, so they mentioned it would be helpful if the athletics department formed a peer-to-peer program that allowed them to form relationships with not only other student-athletes outside of their team, but from other parts of the world as well.
Lastly, participants discussed the need for the university to create an orientation program that was separate from what is offered for all incoming student-athletes. Currently, student-athletes at this particular university must attend a life skills class during their first year on campus. While ISA enjoyed interacting with their American counterparts, they also felt like the class needed to be separated to meet the needs of the ISA in attendance. For example, an American studentathlete does not need to know how to get a driver's license, but this is crucial for an ISA. Building some of these elements into a first-year life skills class could enhance the transition experience tremendously.

Discussion
Results revealed three major themes, including adjusting to life at an American university, facing unexpected challenges as both an athlete and student, and recommendations for athletic departments and universities to assist with ISA transitions. The ISA voices in this study reflected previous findings 5, 13, 15 as they expressed difficulty in the transition in relation to adjusting to campus life (i.e., culture shock, changes in nutrition, homesickness, etc.) and adapting to new academic structure and rigor. Previous researchers 3,13 have identified the important role the university members play in assisting ISA with their initial transition onto campus. Despite awareness about their important role though, it appears that many university systems, and athletic departments within these universities, are not properly meeting the needs of ISA. In this study, ISA not only struggled in their initial transition period, but throughout their entire collegiate tenure. While the issues faced were lessened as time at the university continued, many of these participants expressed having continual issues with academic scheduling, financial aid, and advisor support. Furthermore, despite ISA voicing their concerns to their teammates and coaches, new recruits endure the same issues year after year. While there is major appeal in recruiting ISA for play at American universities, it is evident that they are not properly supported. These negative transition experiences ISA have could be problematic for future recruitment efforts, thus, it is essential that university athletic programs reflect on the needs of ISA and assess whether their resources are meeting the needs of the ISA in question. Note. Participants included an additional 5 female ISA and 1 male ISA One prominent point of discussion initiated by participants in all focus group sessions was the inadequate food options available to them while on campus. Most of the participants expressed that the main difficulty was a loss of independence as they no longer had free access to a kitchen and were typically at the mercy of what the cafeteria was offering that day. Additionally, often, the options available were fried or not nutritionally dense, which proved especially problematic for athletes training for high level competition. This was an exceptionally difficult part of the transition for many of these ISA, and something worthy to note, as this issue is one that is relatively realistic to "fix". Some universities, such as the University of Wisconsin, The Ohio State University, and Auburn University, have athlete-centered dining halls on campus, specifically in place to meet the nutrition needs of student-athletes. These centers include nutritionists on staff as well as a rotation of meals that are nutritionally-dense and designed specifically for training and competition by sport. While implementing these types of programs can be challenging due to funding concerns, if able, this could be a way to alleviate the dissatisfaction student-athletes experience with available food options. These centers could also provide platforms to teach student-athletes how to cook and prepare foods (a skill that is transferable beyond their collegiate tenure), which could serve not only as a team building exercise, but also a lesson in nourishing the body appropriately for competition. There is significant value in addressing this concern for ISA, and one that universities could benefit from addressing, as it would enhance not only physical, but mental health.
While the results were not unique, the consistency found across previous research on this topic is troubling. Findings related to academic unfamiliarity, financial concerns, and adjustment to life on American soil are not new, but what is eye-opening, is that these issues continue to be reported and yet programs specific to ISA seem to be scarce, or at some universities, non-existent. Echoing the call from Baghurst et al. 5 and Constantindides 15 , it is imperative that universities who plan to recruit and accept ISA into their programs also develop a curriculum, or a handbook, as suggested by the ISA in this study, that educates ISA on life in America and how to navigate the potential challenges they might face as an ISA. Baghurst et al. 5 provide recommendations for how coaches can play a pivotal role in this regard, while other researchers 7, 16 encourage the use of peer-led programs for ISA to help with the initial transition and continual adjustment to American culture. Participants in this study shared these same perspectives, providing suggestions for how universities can enhance the ISA experience throughout all phases of their collegiate tenure. Concerns surrounding creating a supportive, caring climate for ISA have been detailed in the literature, yet it seems like awareness regarding this issue has gone unheard. In order to alleviate the struggles and challenges many ISA face, it is essential that universities assess their current resources available to ISA and determine where breakdowns in communication may occur and how to fix those occurrences. It also seems critical to further disseminate the literature in this area, as the lived experiences of these ISA continue to go unnoticed at the university-level. ISA need to feel as though their voices are being heard by athletic and university officials, so that they continue to feel valued within this program. While Baghurst and colleagues 5 and Constantindides 15 believe that the coach can play a role in this transition period, the authors believe that too much reliance on the coach for these efforts may prove problematic, as their role becomes blurred. Creating programs that cater specifically to ISA housed within university athletic departments that are university initiated and contain peer-led components, could be a valuable resource for future ISA that will enhance their overall athletic and academic experiences.
Despite the strengths of this study, a few limitations do exist. First, the sample used was a convenience sample, and while a number of athletic teams were represented, the sample was predominantly female, and the researchers only interviewed ISA at one university. While the findings echo results from other studies, they may not be entirely generalizable to the broader population. A more diverse sample is warranted in future explorations. A second limitation includes the potential researcher and subject bias that can occur when conducting qualitative research. Three of the four members of the research team were former student-athletes, and while the fourth member of the research team served to buffer their bias, it is possible that bias existed during the interview and/or analysis process. Likewise, while participants voluntarily agreed to participate in this study, that does not mean they are exempt to answering in socially desirable ways. While it is the belief that the experiences they shared are truthful and accurate, but it is possible that they hesitated to share information with us or provided responses that were in line with what they believed we wanted to hear.

Conclusions
This study further sheds light on the immediate need for action regarding the assistance universities provide to ISA. Researchers can use the lived experiences of these ISA to inform and improve the current resources offered at universities to enhance the overall experience ISA have when transitioning to, and attending, American institutions. Specifically, ISA discussed challenges with transitioning to campus life, adapting to American culture, eating and finding nutritious foods to fuel their bodies, communicating with advising, and learning to balance a more rigorous practice/competition schedule with academics. Universities should be aware of these specific challenges, and work to enhance the programs and resources offered to meet these unique needs. As suggested by the participants, it might be valuable to create a ISA handbook that details how to best handle transitions to campus from an athletic and academic standpoint. This handbook could include information about scholarships, taxes, climate changes, transportation, and structure of the academic program. Additionally, universities could assess the communication discrepancies studentathletes face when working with academic advisors and athletic-academic advisors. This might include making the process for scheduling for classes more streamlined by creating a "one stop shop" for student-athletes so that they are not having to obtain approval from two different sources. Lastly, universities could benefit from completing quarterly check-ins with their ISA to assess the current challenges they are facing and how they might be able to assist. This check-in could involve support from the department for International students, Athletics, or the advising staff. Ultimately, there are numerous ways that universities could improve their support for ISA without additional personnel or funding, but these changes need to become a priority, and not merely an idea.
While this sample was specific to a mid-major university in the Southeastern United States, the researchers expect that the results could be used to improve the experiences of many of the 20,000 1 ISA facing similar issues across the country, as the needs reported in this sample are not unique to the challenges that ISA continue to report. The broader implications of this study include encouraging a continued partnership with athletics to create a more holistic program that serves all student-athletes throughout their career at the university and beyond. It seems imperative that universities include a student-athlete voice in the creation of programs that are in place to assist student-athletes. The inclusion of a student-athlete voice may elicit a more inclusive environment that respects the diversity of students, adapts to meet their changing needs, and enhances their physical and mental health.