University of Kentucky UKnowledge Theses and Dissertations--Kinesiology and Health Promotion Kinesiology and Health Promotion 2021 Helping the Have-Nots: Examining the Relationship Between Rehabilitation Adherence and Self-Efficacy Beliefs inCL A Reconstructed NAIA and NCAA DII and DIII Female Athletes Myles Tutin Englis University of Kentucky, [email protected] Author ORCID Identifier: https://orcid.org/0000-0002-7009-9275 Digital Object Identifier: https://doi.org/10.13023/etd.2021.243 Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Englis, Myles Tutin, "Helping the Have-Nots: Examining the Relationship Between Rehabilitation Adherence and Self-Efficacy Beliefs in ACL Reconstructed NAIA and NCAA DII and DIII Female Athletes" (2021). 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Myles Tutin Englis, Student Dr. Marc L. Cormier, Major Professor Dr. Melinda Ickes, Director of Graduate Studies HELPING THE HAVE-NOTS: EXAMINING THE RELATIONSHIP BETWEEN REHABILITATION ADHERENCE AND SELF-EFFICACY BELIEFS IN ACL RECONSTRUCTED NAIA AND NCAA DII AND DIII FEMALE ATHLETES ________________________________________ THESIS ________________________________________ A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in the College of Education at the University of Kentucky By Myles Tutin Englis Lexington, Kentucky Director: Dr. Marc Louis Cormier, Associate Professor of Kinesiology and Health Promotion Lexington, Kentucky 2021 Copyright © Myles Tutin Englis 2021 https://orcid.org/0000-0002-7009-9275 ABSTRACT OF THESIS Helping the Have-Nots: Examining the Relationship Between Rehabilitation Adherence and Self-Efficacy Beliefs in ACL Reconstructed NAIA and NCAA DII and III Female Athletes Anterior cruciate ligament injuries are among the most common and traumatic sport-related injuries, and often negatively impact one’s quality of life during and post- rehabilitation. For many NCAA Division I and professional female athletes, rehabilitation is streamlined with a multidisciplinary team, including sport psychology. For others (e.g., NAIA, NCAA Division II, III athletes) this may not always be the case, as many of these athletic programs may not have the resources to meet the various needs of injured and rehabilitating female student-athletes. In these instances, rehabilitation motivation, adherence, and success may be more dependent on the athletes’ individual resources and personalities, as compared to their Division I and professional counterparts. With so many more women athletes competing at this level across the U.S., a better understanding of ACL injury rehabilitation and return to sport with limited resources is warranted. Thus, the purpose of this study was to examine what factors related to motivation and self- efficacy contribute to a successful rehabilitation for NAIA and NCAA Division II and III female athletes following ACL reconstruction. Qualitative interviews were used to investigate personal factors, as well as cultural and social elements that impact adherence to rehabilitation protocols and ultimately, recovery. KEYWORDS: [Sport Psychology, Injury Rehabilitation, Self-efficacy, Rehabilitation Adherence, ACL Reconstruction, Women’s Sports] Myles Tutin Englis 7/12/2021 Helping the Have-Nots: Examining the Relationship Between Rehabilitation Adherence and Self-Efficacy Beliefs in ACL Reconstructed NAIA and NCAA DII and DIII Female Athletes By Myles Tutin Englis Dr. Marc Cormier, PhD Director of Thesis Dr. Melinda Ickes, PhD Director of Graduate Studies 7/12/2021 Date DEDICATION To the athletes who shared their stories with me. ACKNOWLEDGEMENTS In appreciation for their support and guidance throughout the work represented by this thesis as well as throughout my master’s training, I thank the members of my committee, Dr. Marc Cormier, Dr. Shelby Baez, and Dr. Heather Erwin. I am incredibly thankful for their patience and thoughtful advice throughout this process. I will look back on my time at the University of Kentucky as a student with fond memories. For their assistance in letting me talk about this project and give me suggestions where needed, I’d also like to thank Rena Curvey, Shannon White, and Travis Scheadler. I am very thankful for the expertise they shared with me. Without the love and support of Dani Pulgini, this thesis would have been far more difficult. Dani always believed in my writing abilities and most importantly, she was always there to share my joy and my sorrow. Finally, a big thank you to my parents Judy Tutin and Basil and Paula Englis. I love them all dearly. They are always valuable sources of instruction and would always put my writing challenges into perspective with a comment like, “Imagine doing a project like this in 1983 like me.” I love you all. iii TABLE OF CONTENTS TITLE .................................................................................................................................. 1 ABSTRACT OF THESIS ..................................................................................................... 2 ACKNOWLEDGEMENTS ................................................................................................. iii TABLE OF CONTENTS ..................................................................................................... iv LIST OF TABLES ............................................................................................................... vi CHAPTER 1. Introduction and Research Purpose ....................................................... 1 1.1 Purpose Statement ............................................................................................... 6 1.1.1 Research Questions ......................................................................................... 6 1.1.2 Hypothesis....................................................................................................... 6 CHAPTER 2. Review of Literature ................................................................................ 7 2.1 Theoretical Framework ....................................................................................... 7 2.1.1 Self-Efficacy Theory ....................................................................................... 7 2.1.2 Self-Determination Theory ............................................................................. 8 2.1.3 Biopsychosocial Model ................................................................................. 10 CHAPTER 3. Method .................................................................................................. 12 3.1 Participants and Recruitment ............................................................................ 12 3.2 Research Type and Data Analysis .................................................................... 13 3.3 Measures ........................................................................................................... 14 3.3.1 Interviews ...................................................................................................... 14 3.3.2 General Rehabilitation Adherence Scale (GRAS) ........................................ 14 3.4 Procedure .......................................................................................................... 15 3.4.1 Bias, Trustworthiness, and Validity .............................................................. 17 CHAPTER 4. Results ................................................................................................... 19 4.1 Nature of the Data ............................................................................................