For Lexi Kier, sport has always been more than competition — it’s an intersection of joy and loss, community and pressure, and resilience and vulnerability. As a doctoral student in public health education at UNC Greensboro, she is building a research agenda that challenges how institutions understand athletes, particularly Black athletes.
“I come from an athletic background,” Kier says. “And I’ve seen these challenges firsthand.”
Now, Kier has been named a Robert Wood Johnson Foundation Health Policy Research Scholar, a prestigious national leadership distinction for doctoral students whose research has the potential to shape health policy across the United States.
Kier grew up in Winchester, Va., in a family deeply rooted in athletics. She played competitive basketball in high school and dreamed of continuing at the collegiate level until her two knee surgeries—one a total reconstruction — ended her playing career.
At the same time, she watched her brothers navigate the intense demands of elite sport.
One brother played football at the University of Virginia. There, he experienced a concussion that, Kier says, changed his demeanor and mental health. Another rose from walk-on status at Marshall University to the NFL, where he now plays for the Kansas City Chiefs, bringing both extraordinary success and ongoing injury-related challenges.
“Seeing athletes, especially Black athletes, go through what they go through, and not being able to do anything about it, really motivated me,” says Kier, who also worked with the Virginia Tech women’s basketball team for several years. “I couldn’t just keep watching.”
That motivation led her first to a master’s in kinesiology at UNCG, concentrating in sport and exercise psychology, and eventually to a Ph.D. in public health education. There she found a disciplinary home that allowed her to examine not just behavior, but the broader systems shaping athlete health.
Broadening the definition of athlete health
Since beginning her doctorate, Kier’s research portfolio has expanded rapidly. Recent work examines multiple dimensions of athlete health and transitions.
One recently accepted commentary in the Journal of Physical Activity and Health, critiques what Kier and her mentors, Drs. DeAnne Brooks and Erin Reifsteck, describe as the “miseducation” of athletes. The paper argues that sport culture prioritizes winning at the expense of long-term physical and mental health, leaving athletes unprepared for life after sport.
“There’s this sport ethic of ‘win at all costs,’ even over your body and your health,” Kier says. “Then when athletes transition out, they don’t know how to sustain physical activity, and mental health often declines.”
In another article in Journal of Clinical Sport Psychology, Kier, Reifsteck, and Kier’s doctoral advisor Dr. Jeff Milroy examine how pain intensity and pain interference affect symptoms of depression and anxiety in athletes across different sport types.
Their findings suggest that even when athletes can still perform daily activities, pain alone can significantly impact mental health. This insight carries important implications for injury management and psychological support.
Kier is also interested in the research tools used to study athlete health. During her master’s work at UNCG, she initially planned to examine concussions using electroencephalography (EEG) but encountered racial limitations embedded in the technology related to Black hair types and styles.
With support from an internal grant, she evaluated how open Black athletes are to participating in research with current EEG caps. The resulting publication in the International Journal of Kinesiology in Higher Education reinforced a principle that continues to guide her work: inclusion must be built into research from the start, not added later.
Research in community, research with purpose
Kier currently serves as a mental-skills trainer for Karenni youth soccer players in Winston-Salem. Her work with the community originally from Myanmar is part of a randomized controlled study focused on emotional regulation, cognitive restructuring, problem-solving, and teamwork.
Working with a refugee community required humility and adaptability, Kier says. “Black culture and Southeast Asian cultures are very different. I had to learn how to build trust, how to listen, and what leadership looks like in that context.”
The experience reflects her evolving interest in blending sport psychology, public health, and community engagement — an approach that aligns closely with her work as a Robert Wood Johnson Health Policy Research Scholar.
The prestigious program is designed for researchers whose work has clear policy relevance, even if they do not come from traditional policy backgrounds. The highly competitive program provides $124,000 in funding.
Kier was encouraged to apply to the program by mentors — including faculty members Drs. Michelle Martin Romero, Amanda Tanner and Tamar Goldenburg — who recognized the implications of her work before she herself fully did.
“I was like, ‘Policy? I didn’t do any policy,’” she said. But she discovered the program is intentionally designed for scholars whose research already intersects with policy questions, even if they have not been formally trained in policy analysis.
“I don’t want to be a policymaker,” she said. “But I want to know what to say, how to say it, and when to say it when I’m in the room with policymakers.”
As a scholar, Kier is learning how to frame athlete-health research in ways that resonate beyond academia, translating evidence into conversations that can influence systems, institutions, and decision-making.
“I’m learning how to communicate my work in ways that matter beyond academia,” Kier said. “It’s about making sure research reaches the people and systems that can change things.”
Looking ahead
Kier credits much of her growth at UNCG to strong mentorship, including from Milroy.
“He’s incredibly supportive,” she said. “He reminds us that we’re doing well, even when it feels overwhelming.”
As she continues her doctoral work, Kier remains open to where her research will ultimately land, whether that be in sport psychology, public health policy, or a space that bridges both.
What remains constant is her commitment to athlete health, equity, and accountability.
“I just want to get this figured out,” she said. “Because athletes deserve better.”
by Sierra Collins, Division of Research and Engagement
photography by Sean Norona, University Communications