Social cohesion and peer acceptance predict student-athletes’ attitudes toward health-risk behaviors: A within- and between-group investigation

Objectives: Collegiate student-athletes often engage in health-risk behaviors such as alcohol misuse and hazing, but the literature in this domain lacks evidence pertaining to how peers shape attitudes towards such behaviors. We investigated how peer acceptance and social cohesion relate to attitudes towards alcohol use, marijuana use, drinking and driving, playing through a concussion, performance enhancing substance use, and hazing. Design: Cross-sectional survey. Methods: Participants were 387 NCAA athletes from 23 intact teams. Multilevel modeling was used to examine the extent that health-risk attitudes clustered within teams and enabled us to disentangle individual-level and group-level effects of peer acceptance and social cohesion. Results: Intraclass correlation coefficients revealed that health-risk attitudes clustered within teams. At the individual-level, student-athletes who perceived higher levels of peer acceptance, relative to teammates, held riskier attitudes towards alcohol use, playing through a concussion, and hazing. Meanwhile, those who perceived higher levels of social cohesion relative to teammates held less risky attitudes towards playing through a concussion. At the group-level, teams with greater peer acceptance held less risky attitudes towards playing through a concussion, whereas teams with greater social cohesion held riskier attitudes toward playing through a concussion. Conclusions: These data indicated that health-risk behaviors may cluster within teams, and that peer acceptance and cohesiveness are differentially associated with attitudes toward risky behavior. Given that peer influence is a multilevel phenomenon, it is prudent that prevention efforts leverage social processes within teams, while reducing pressures to engage in risky behaviors.