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Mind, Body and Sport: Interpersonal violence and the student-athlete population

An excerpt from the Sport Science Institute’s guide to understanding and supporting student-athlete mental wellness

By Lydia Bell and Mary Wilfert

Sexual assault, harassment, bullying and hazing – these serious interpersonal injuries to an individual’s sense of safety and well-being find their way into athletics departments from the culture at large, tainting the experience of student-athletes.  

When an event unfolds on campus, it can cast a shadow on a university’s reputation as a safe place for emerging adults to explore who they will become and how they will contribute to society. As educators, we have an understanding of some of the underlying factors that may increase the risk of interpersonal violence for students-athletes and students at large.

The challenge before us is to examine components of the athletics culture, including issues around masculinity, encouraging aggression, group-think, bystander effect, homophobia and gender discrimination, that may contribute to violence, and to identify ways to mitigate the impacts of these factors on behavior.

As we consider education and prevention, it’s important to note that many aspects of the student-athlete experience provide opportunities to reinforce positive behaviors and outcomes, including the influence of coach as mentor, the support found in being part of a team, and leadership roles and skill development integrated in competitive play.

We do not have the data to indicate whether student-athletes experience more violence than their non-athlete peers, nor if the athletics culture by nature increases the risk of interpersonal violence. However, violence precursors, such as aggression and control, are part of the athletics culture, and “group-think,” which is embedded in team play, may allow some behaviors to go unchallenged.

Though most men on campus and on athletics teams are not involved in perpetrating violence, most interpersonal violence is perpetrated by men, and occurs more often within the context of group behaviors, and these can include fraternities and athletics teams. It is imperative that we take a critical look at these precursors and assess in what manner and to what extent they need to be tempered to reduce the potential they may exacerbate the behaviors of those with a predisposition to become violent.   

Our data sources include the 2012 NCAA Social Environments Study and the 2008-12 iterations of the National College Health Assessment*. The Social Environments Study features a representative sample of more than 20,000 male and female student-athletes across Divisions I, II and III. The survey included items assessing campus environment, entitlement and aggression, social relationships and help-seeking behaviors, and character education and intervention.

The National College Health Assessment, a comprehensive survey covering issues including substance use, sexual behavior, physical health, weight, personal

safety, violence, and mental health and well-being, is offered through the American College Health Association and administered in either the spring or fall term. Varsity student-athletes were identified upon indicating that they had participated in organized, varsity, college athletics within the last 12 months. All other participants constituted the non-athlete comparison group.

Aggression in athletics

In his 2010 book “Anger Management in Sport,” sport psychologist Mitch Abrams identified two forms of aggression, which he termed as instrumental and reactive. Instrumental aggression is behavior defined by actively, forcefully pursuing one’s goal, where harm to others may be a potential result of the action, but would never be a primary goal.

Reactive aggression or hostile aggression is related to anger, and is behavior that has harming another as a primary goal. Abrams also notes that anger, in and of itself, if not necessarily negative, is an emotion like any other, and does not have to lead to violence.  

In some cases, anger may enhance athletics performance as it prompts a physiological response of increased muscle strength. However, slower cognitive processing, and decreased fine motor skills are also part of that physiological response, which could hamper athletes, depending on the sport.

It is important to keep these differences in mind when viewing the data regarding aggression both on and off the field for student-athletes, as not all aggressive behavior is linked to interpersonal violence.

The 2012 NCAA Social Environments Study examined both athletics aggression and general aggression. Responses indicated that more than a third of males and a quarter of females have been trained to be aggressive in competition and believe that aggression is key to being a good athlete (see the table at the top of the following page).

Additionally, 45 percent of men and 29 percent of women are willing to do whatever it takes to win, and more than a fifth of men indicate that winning is more important than good sportsmanship. It is important to note that these numbers are nearly identical across divisions, with the exception that Division I males agree that they would do whatever it takes to win at slightly higher rates than those in Divisions II and III.

Athletics aggression among NCAA student-athletes

% Agree/Strongly Agree that… Men Women
I’ve been trained to compete with aggression. 42% 25%
Being fiercely aggressive during competition is a key to being a good athlete. 40% 23%
During a competition I would do whatever it takes to win. 45% 29%
Winning is more important to me than good sportsmanship. 21% 5%
I perform better in competition if angry. 26% 14%
If an athlete is fouled hard, he/she is justified in retaliating physically. 15% 5%

The data also reveal that being athletically aggressive may be entwined with unethical decision-making. In determining whether an athlete is justified in retaliating physically when fouled hard, we find that when a student-athlete indicates that he or she has been trained to compete with aggression, he or she is three to four times more likely to agree that the retaliation is justified.

For example, only 2 percent of women not trained to be athletically aggressive agreed that retaliation was acceptable, as compared with 11 percent of the women who were trained to be aggressive. Among men, 7 percent of those not trained to be athletically aggressive agreed that retaliation was acceptable, as compared with a quarter of the men trained to be aggressive.

In examining aggressive behavior off the field, males indicated higher levels of physical aggression than females, which is consistent with existing research on aggression. In most cases, men agreed to these items at twice the rate of women, with the exception of the question asking if they exhibited irritation when frustrated, with nearly one in five men and women agreeing to the item. Additionally, some of these items specifically ask about violent behavior resulting from anger, indicative of reactive aggression.

Aggrssion measures for NCAA student-athletes

% Agree/Strongly Agree that… Men Women
I have trouble controlling my temper. 13% 7%
Some of my friends think I get angry easily. 13% 7%
When frustrated, I let my irritation show. 17% 18%
Given enough provocation, I may hit another person. 19% 6%
I have become so mad that I have broken things. 19% 8%

While these data do not allow us to determine whether general aggression predicts aggression on the field, a relationship between the two scales is clear. Males prone to general aggressive behavior were far more likely to agree that winning was more important than good sportsmanship (64 percent vs. 20 percent), and aggressive females were six times more likely to agree (30 percent vs. 5 percent) that winning was more important than good sportsmanship.

Additionally, as we do not have a nationally representative sample of non-athletes responding to these questions, we do not know if the rates of off-field aggression for student-athletes is any higher or lower than their non-athlete peers.

The influence of alcohol

The role alcohol plays as a factor in violence and sexual assault has been well documented. At least 50 percent of college student sexual assaults are associated with alcohol use.

The NCHA survey data provided insight on negative behaviors attributed to alcohol consumption, which include engaging in regrettable actions, memory loss, police encounters, unprotected sex, physical injury to self or others, and suicidal thoughts.

Behaviors as a consequence of alcohol consumption (Figure 5A)

  Males Females
As a consequence of drinking, have you… Athlete Non-athlete Athlete Non-athlete
Done something you later regretted 33% 27% 33% 28%
Forgot where you were/what you did 32% 27% 30% 24%
Got in trouble with the police 6% 5% 3% 3%
Had sex without giving consent 2% 1% 2% 2%
Had sex without getting consent 1% 1% 0% 0%
Had unprotected sex 19% 13% 14% 12%
Physically injured self 16% 15% 14% 13%
Physically injured another person 5% 3% 2% 1%
Seriously considered suicide 1% 2% 1% 1%

Percentages represent the percent of respondents in each group that answered “yes” to each survey item. The other choices were “No” and “N/A, I don’t drink.” Approximately 20 percent of male and female student-athletes reported not drinking, so if one was to compare only the behaviors of those who drink, the respondents who say “yes” to experiencing these consequences are higher in number. For example, of the nearly 5,500 male student-athletes who reported that they consume alcohol, 24 percent reported that they had had unprotected sex as a consequence of drinking.

As the table indicates, male and female student-athletes report higher rates of alcohol-related regrettable actions and memory loss than their non-athlete peers. The high-profile nature of the student-athlete role, coupled with the pressure to serve as role models, may in part explain this higher rate of regrettable actions.

However, the higher rates of memory loss may indicate higher rates of excessive drinking among the student-athlete population.

The other statistic that bears further consideration is that more than one in 10 students overall reported engaging in unprotected sex related to alcohol consumption, and that this number jumped to nearly one in five among male student-athletes.

Additionally, student-athletes and non-athletes attributed alcohol consumption to incidences of physical violence and sex without consent, reinforcing the role alcohol can play in interpersonal violence.  

Sexual violence

The NCHA survey also gathered data about experiences of sexual violence within the past year. The accompanying table contrasts rates of sexual violence by sex and compares student-athletes with non-athlete populations.

Experiences with sexual violence (Figure 5B)

  Males Females
Within the past 12 months… Athlete Non-athlete Athlete Non-athlete
Sexually touched without consent 4.6%* 3.5% 9.1% 8.5%
Sexual penetration attempted without consent 1.2%* 0.9% 4.0% 3.6%
Sexually penetrated without consent 0.9%* 0.6% 2.1% 2.1%
Sexually abusive relationship 1.0% 0.9% 2.0% 2.1%

As indicated in the table, the percent of student-athletes and non-athletes in self-reported sexually abusive relationships was not significantly different. However, male student-athletes experienced some form of sexual assault at rates significantly (p<.01) higher than their non-athlete peers, and female students overall experienced sexual violence at rates twice that of men, across all categories.   

The data also revealed that lesbian, gay, bisexual and transgender (LGBT) students, independent of sex or athlete status, experienced significantly higher rates of sexual assault within the past 12 months than those who did not identify as LGBT. Such data serve as a reminder that sexual assault prevention training is applicable to both male and female student-athletes, and bring our attention to the need for additional focus on this topic among those athletes who identify as LGBT.

Mental health implications of sexual violence

NCHA survey participants were asked a series of questions about their mental health status within the past 30 days. To understand the mental health implications of sexual assault, the mental health responses of participants who indicated experiencing any sort of sexual assault (touched, attempted penetration, penetrated without consent) within the past 12 months were compared with those who had not experienced any of these conditions.  

The data revealed that for both athletes and non-athletes, males and females who self-reported experiences of sexual assault were significantly more likely to experience hopelessness, mental exhaustion, depression or suicidal thoughts; struggle academically; find it hard to handle intimate relationships; and experience sleep issues.  

However, student-athletes – both those who have experienced sexual assault and those who have not – appear to experience each of these conditions, with the exception of academic struggles, at lower rates than non-athletes. It is important to note that among both male and female student-athletes, those who indicated experiences of sexual assault within the past 12 months were three times more likely to have had recent suicidal thoughts than those who did not (13 percent vs. 4 percent for women, and 12 percent vs. 4 percent for men). (See Figures 5C and 5D)

Hazing and bullying

Hazing has been a topic of discussion for many years, and research has shown that the student-athlete population may be particularly vulnerable when first joining their teams.

The 1999 Alfred University hazing study of college athletics shed light on this topic when it revealed that upon joining their team, more than two-thirds of college student-athletes had experienced humiliating hazing, and half were required to participate in alcohol-related hazing.  

Male responses to mental health items (Figure 5C)

  Male Non-athletes Male Athletes
  No sexual abuse Sex abuse in past 12 mo. No sexual abuse Sex abuse in past 12 mo.
Felt hopeless within last 30 days 22% 33%* 17% 32%*
Felt exhausted (not from activity) within last 30 days 57% 66%* 47% 61%*
Felt so depressed it was hard to function within last 30 days 13% 24%* 10% 23%*
Seriously considered suicide within last 12 months 6% 14%* 4% 12%*
Diagnosed with depression within last 12 months 12% 20%* 8% 12%*
Difficult to handle academics within last 12 months 19% 32%* 35% 51%*
Hard to handle intimate relationships within last 12 months 28% 48%* 27% 48%*
Sleep issues within last 12 months 22% 35%* 18% 32%*

Female responses to mental health items (Figure 5D)

  Female Non-athletes Female Athletes
  No sexual abuse Sex abuse in past 12 mo. No sexual abuse Sex abuse in past 12 mo.
Felt hopeless within last 30 days 27% 40%* 23% 36%*
Felt exhausted (not from activity) within last 30 days 71% 81%* 65% 74%*
Felt so depressed it was hard to function within last 30 days 16% 29%* 12% 22%*
Seriously considered suicide within last 12 months 6% 16%* 4% 13%*
Diagnosed with depression within last 12 months 18% 29%* 13% 19%*
Difficult to handle academics within last 12 months 48% 62%* 43% 59%*
Hard to handle intimate relationships within last 12 months 33% 59%* 31% 55%*
Sleep issues within last 12 months 25% 41%* 20% 34%*

The prevalence of hazing in sport – despite harsher penalties and intensive prevention efforts – has been attributed in part to group-think and masculinity in sport. Athletics teams are like a family and become extremely close, allowing for forgiveness or ignorance of negative situations.

Student-athletes are especially vulnerable to group-think when they are isolated from outside opinions, when they are in homogenous groups, when they are expected to be obedient to “superiors,” and when there are no clear rules for decision-making.

Masculinity can also play a role in hazing, as the definition of being a “real man” can encourage hazing as a practice to prove that one can be physically and emotionally tough.  

Despite increased attention on this topic and stricter enforcement of anti-bullying codes of conduct, the University of Maine’s National Hazing Study (2008) found that more than 55 percent of college students involved in clubs, teams or Greek organizations have been subject to hazing, and more than 25 percent of club advisers or coaches were aware that this behavior was occurring.

Such discouraging data reinforce the need for continued anti-hazing programming for student-athletes, in addition to programming tailored specifically for coaches who may be able to prevent such actions at the outset.

The Maine Collaborative is currently conducting pilot programs on a number of NCAA campuses, engaging multi-departmental cross campus working groups, to test effective comprehensive prevention programs. As a supporter of this effort, the NCAA will receive and share findings to the membership on how best to decrease the risk of hazing.


An Indiana State University study in 2011 defined cyberbullying as using technology, such as social networking, text messaging or instant messaging, to harass others with harmful text or images or intentionally isolate another from a social group. The study found that almost 22 percent of college students reported being cyberbullied, 38 percent of students knew someone who had been cyberbullied, and almost 9 percent reported cyberbullying someone else.

Prevalence of cyberbullying

% Agree/Strongly Agree with the following Men Women
White Black Latino Other White Black Latina Other
I sometimes receive negative or threatening messages from fans via social networking sites. 9 17 12 11 3 6 3 4


The rise in cyberbullying is not limited to college students, and has received increased attention and in some cases local and state-level law adoption designed to mitigate this behavior among the K-12 population.

Among the student-athlete population, concerns about cyberbullying are not limited to peer-to-peer interactions. The 2012 NCAA Social Environments Study revealed that coaches have begun to encourage student-athletes to interact with fans via social media. While many reported positive interactions, some also noted receiving negative or threatening messages. (See Figure 5E)  

Of particular concern is black student-athletes who reported receiving negative or threatening messages at twice the rate of white student-athletes. Although approximately 80 percent of student-athletes noted that their coaches or others in athletics talk to them about responsible use of social media, departments may also want to consider how to help student-athletes address negative or threatening messages from fans.

Hazing and bullying, both in traditional forms and online, exist in the absence of strong leadership and direction, when groups are allowed to operate in secrecy and without supervision. These groups are more likely to deviate from social norms of conduct when coaches and administrators take a “hands-off” position, and when there are not clear policies or they are not consistently enforced.  

The NCAA Hazing Prevention Handbook recommends actions that administrators, coaches, team captains and athletes can take to ensure an athletics environment that speaks clearly to discourage hazing and that provides positive opportunities to enhance team building and bonding.

The NCAA Social Environments Study revealed that when faced with concerns over hazing and bullying, nearly 30 percent of student-athletes turn first to their parents for advice, support or assistance. While many would turn to teammates or coaches, parents were the most consistent first choice across the sample.

This was particularly true for freshmen, as nearly 40 percent indicated a desire to turn to parents first. As such, athletics departments may consider sharing information about hazing and bullying prevention and campus resources with parents so they can assist their children if approached about this topic.

Various efforts have recognized that effective hazing prevention requires collaboration across campus to assure clear and consistent hazing policies, and targeted educational programming to address the unique cultural elements for various student groups. The NCAA published the Hazing Prevention Handbook (, which provides examples of hazing prevention policy and education, and specific guidance for athletics administrators, coaches and student-athletes.  

Athletics departments can join the broader campus effort to address hazing through, which sponsors the annual Hazing Prevention Week ( the third week of September, providing resources that support hazing prevention at the campus level.  

Participation with campus colleagues working to decrease hazing in student groups will facilitate the athletics effort to assure team environments are free of hazing activities.  

Additionally, best-practice models in effective hazing prevention are under development through the National Collaborative for Hazing Research and Prevention (, a multiyear pilot project to build an evidence base to better understand how to change the campus culture in order to reduce the risk of hazing for any one student.  

Intervention and character education

The 2012 NCAA Social Environments Study included items regarding participants’ willingness to intervene in a range of situations that could lead to aggressive or violent behavior. As the accompanying table reveals, the rates of intervention vary widely depending on the situation, and men and women appear willing to intervene at significantly different rates depending on context.

Likelihood of intervention

% Likely/Extremely Likely to do the following Men Women
Step in to stop a fight if someone threatens a teammate 82% 74%
Walk away from a confrontation 58% 74%
Get in a fight if the situation calls for it 50% 19%
Confront a teammate if he/she is treating a partner inappropriately 59% 47%
Intervene in a situation if it could lead to inappropriate sexual behavior 63% 71%

Understanding the considerations students weigh when deciding whether to intervene is useful when designing future training or having relevant discussions about intervention behavior.  

Participants’ responses reveal that there is a range of incentives and drawbacks to intervention that come into play when deciding whether to act. Overall, a large majority of student-athletes felt that they had a duty, at least in some cases, to act in a way that kept others safe. Additionally, many, especially females, agreed that they liked to think of themselves as helpers.

When considering drawbacks, fears of physical harm, angering teammates, and being perceived as over-reacting, often play a role in deciding whether to step in. Perhaps most concerning is that for 37 percent of males and 29 percent of females, intervening is at times perceived as just too much trouble.

Considerations regarding intervention

% who Agree/Strongly Agree with the following statement about deciding whether to help someone in trouble.
Incentives Men Women
All community members play a role in keeping people safe 78% 85%
I like thinking of myself as a helper 58% 89%
Teammates will look up to me if I intervene 59% 47%
I could get physically hurt by intervening 45% 40%
Intervening might make my teammates angry with me 43% 41%
People might think I’m overreacting to the situation 40% 37%
Sometimes it’s just too much trouble to intervene 37% 29%
I could get in trouble if I intervene 37% 32%

Character education

The Social Environments Study also included items that asked both about the types of training and character education student-athletes were receiving from their coaches, and also in what areas they would like more discussion or information.

Character education provided to and sought by student-athletes

Coach/athletics department education topic: Men Women
Discussed Want more Discussed Want more
Conducting self appropriately on campus and in community 90% 29%  (#2) 94% 31%  (#3)
Drinking/substance use 87% 25%  (#3) 93% 32%  (#2)
Diffusing/avoiding confrontations 83% 22% 79% 26%
Speaking up when you see things around you that aren’t right 80% 35%  (#1) 77% 47%  (#1)
Appropriate treatment of members of the opposite sex 80% 16% 66% 19%
Hazing/bullying 78% 16% 74% 20%
Relationship violence 67% 13% 54% 18%

More than any other topic, student-athletes want their coach or athletics department to talk about what to do when they see something around them that is not right. This is the No. 1 request across divisions, for both men and women. Student-athletes are seeking empowerment and want to build their skills in bystander intervention.

The second- and third-most requested topics were conducting one’s self appropriately on campus and in the community, and drinking and substance use. Approximately one in three men and women request more information about personal conduct, while women seek information about drinking and substance use at higher rates (32 percent) than men (25 percent). (See Figure 5H)

Coach implications for intervention

In examining character education and intervention, it is important to note some very interesting analyses a colleague at the Harvard School of Public Health has been doing with these data.

Looking specifically at predicting male student-athletes’ willingness to intervene in situations of partner mistreatment or inappropriate sexual behavior, it has been found that having a coach who talks to student-athletes about treating members of the opposite sex appropriately, relationship violence, and speaking up when things are not right, is both directly and indirectly significantly related to their willingness to intervene in both situations.

It is clear that a coach’s messages matter and can play a role in these behaviors. These analyses will be published soon and made available to NCAA members through the website.

Future directions

Interpersonal violence in the forms of sexual assault, harassment, hazing and bullying are under intense scrutiny as higher education is held accountable to provide safe environments for student life and learning. Included in this federal oversight are recommendations for education, prevention and response, identifying environmental strategies and bystander intervention training as best practices.  

A critical best practice for athletics administrators is to partner with higher education associations and experts in the field to advance our understanding of the causes and impact of interpersonal violence, and even more importantly to engage in effective prevention practices.

NASPA, the organization for Student Affairs Professionals in Higher Education, is working to identify campus practices that support healthy interpersonal relationships and that deter interpersonal violence. Athletics administrators and educators are encouraged to join in campus efforts, to meet their duties as members of the higher education community, and to address these issues in a true team effort. The NCAA is currently compiling a best-practice handbook on interpersonal violence prevention and response, to be published in the spring of 2014.

Athletics administrators and student-athletes alike are called upon to exert leadership and to model appropriate behavior, as they wear the mantle of high-profile representatives of the university community. Recent federal actions – namely the Dear Colleague Letter of Title IX, and the Campus Sexual Violence Elimination Act or SaVE Act administered under the Clery Act – have increased the duty to achieve compliance in prevention, education, and response to any violent incident. Athletics departments are equally responsible to ensure staff and students are provided resources to intervene and respond to acts of interpersonal violence.  

Current data tell us that a large number of student-athletes have been trained to compete with aggression, and that some, particularly males, exhibit aggressive behaviors off the field as well. Additionally, both male and female student-athletes are victims of sexual assault or relationship violence while on campus. Sexual assault can pose serious threats to an individual’s mental health. Those who have experienced sexual assault are significantly more likely to experience hopelessness, mental exhaustion, depression or suicidal thoughts; to struggle academically; to find it hard to handle intimate relationships; and to experience sleep issues.  

While these data shed light on some of the mental health outcomes related to sexual assault, we also want to bring attention to sexual assault and relationship violence prevention and bystander intervention.

The promise of bystander intervention training is an exciting and welcome strategy, engaging and empowering students to intervene safely and effectively when they see a friend or teammate in distress or at risk for experiencing interpersonal violence in the form of sexual assault/harassment and hazing/bullying.  

The 2012 NCAA Social Environments Study revealed that a surprising number of student-athletes appear to be reluctant to intervene in instances of relationship violence or inappropriate sexual behavior. However, more than a third of male student-athletes and half of female

student-athletes note that they would like to talk more about speaking up when they see things that aren’t right.

Many student-athletes are seeking the means to be empowered to act, and understanding their rationale for deciding when to intervene may assist us in developing programming that can directly address the perceived drawbacks to intervention.   

Sexual assault education of student-athletes and coaches is required in the U.S. Department of Education’s Title IX Dear Colleague Letter ( Bystander intervention training is a defined strategy and expectation offered in the 2013 Campus Sexual Violence Education or SaVE Act ( administered through the Clery Act and enforced by the Department of Education, requiring campus compliance in education, prevention and response.  

The Step UP! Bystander Intervention Program (, which the NCAA supports, provides facilitator-friendly training materials to conduct training with student-athletes and other student groups to help overcome the bystander effect, addressing attitudinal impediments to timely intervention and providing real skill building to safely and effectively intervene when a friend or teammate is at risk.

Athletics departments can expect to be scrutinized and expected to step up and join the campus effort to create safe and healthy learning environments for all students. Athletics administrators are in position to influence the lives of so many, and through this guidance provide a unique opportunity to assist student-athletes to experience what it truly means to be a teammate on and off the field.

Note: The NCAA issued to member schools a new handbook that illustrates the responsibility athletics departments have in collaborating with other campus leaders to fight sexual assault and interpersonal violence. Titled “Addressing Sexual Assault and Interpersonal Violence: Athletics’ Role in Support of Healthy and Safe Campuses,” the handbook was created to help athletics departments partner to change the culture surrounding this issue. The NCAA Executive Committee also issued a statement on sexual violence. To read the statement and to view more information on the issue, visit

Lydia Bell is the associate director of research for academic performance at the NCAA. Bell assists in all aspects of development and analysis of research on current and former student-athlete academic performance and well-being. Prior to joining the NCAA, she was an assistant professor of practice and director of Project SOAR in the Center for the Study of Higher Education at the University of Arizona. She received her Ph.D. in language, reading and culture and M.A. in higher education from Arizona, and an A.B. in government and legal studies and sociology from Bowdoin College.

Mary Wilfert is an associate director in the NCAA Sport Science Institute. Since 1999, she has administered the NCAA drug-education and drug-testing programs and worked to promote policies and develop resources for student-athlete healthy life choices. She serves as primary liaison to the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, the governing body charged with providing leadership on health and safety recommendations to the NCAA membership. Wilfert has worked in the health education field for more than 30 years to empower individuals to make informed choices for lifelong health and success.

*American College Health Association. American College Health Association-National College Health Assessment, Fall 2008, Spring 2009, Fall 2009, Spring 2010, Fall 2010, Spring 2011, Fall 2011, Fall 2012 ACHA-NCHA II, ACHA-NCHA llb]. Hanover, MD: American College Health Association; (2013-10-31).