Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget

Abstract Context: Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. Objective: To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Design: Cross-sectional study. Setting: Mailed and e-mailed survey. Patients or Other Participants: One hundred sixty-six South Carolina high schools. Intervention(s): The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. Main Outcome Measure(s): The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Results: Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R2 = 0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget. Conclusions: The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.

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Indiana Secondary School Athletic Directors Perceptions of Athletic Training Services and Influences on Hiring Athletic Trainers

Journal of Sports Medicine and Allied Health Sciences Official Journal of the Ohio Athletic Trainers Association ◽

10.25035/jsmahs.06.03.02 ◽

2021 ◽

Vol 6 (3) ◽

Author(s):

Thomas Greffly ◽

Matthew Rivera ◽

Lindsey Eberman

Keyword(s):

Secondary School ◽

Athletic Training ◽

Employment Status ◽

Online Survey ◽

School Setting ◽

Health Concern ◽

Full Time ◽

Factors Influencing ◽

Part Time ◽

Training Services

Purpose: The purpose of this investigation was to examine ADs perceptions on satisfaction of current care provided, factors influencing the hiring of ATs, and the roles and responsibilities of ATs. Methods: We used a mixed methods design with an online survey (Qualtrics®, Provo, UT), which we distributed to Indiana secondary school ADs (n = 410) with publicly available emails. The survey remained open for 5 weeks with reminder emails sent weekly. We used a panel (n=2) with experience in survey research and/or the secondary school setting. The survey included both quantitative (7 items) and qualitative (8 items) data. Participants were asked to share their perceptions on the roles/responsibilities of ATs as well as experiences with the challenges, barriers, and benefits of hiring ATs in open-ended questions. We used Kruskal-Wallis one-way ANOVAs to compare employment status, type of employer, and school size on satisfaction. We coded the open-ended responses using inductive coding with multi-analyst triangulation and auditing to establish trustworthiness. Results: We identified significant differences relative to employment status of the AT on satisfaction with overall care, whereby those with full-time athletic training services were more satisfied with care than those with per-diem, part-time services (p=0.010). When participants were asked about factors influencing the decision to provide services ADs reported liability, cost, and workload as major considerations. Conclusions: Consistent with previous research, financial challenges continue to play a role in the hiring of ATs in the secondary school setting, participants also identified the benefits of ATs in promoting safety, reducing liability, as well as the increased workload and cost. Access to qualified athletic healthcare continues to be a public health concern in America and all stakeholders should reconsider how to offer both a comprehensive athletics program and the healthcare needed to ensure safety in that participation.

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Athletic Administrators Report of Emergency Action Plan Adoption in Secondary School Athletics: The Influence of Athletic Training Services

Journal of Applied Sport Management ◽

10.18666/jasm-2019-v11-i3-9240 ◽

2019 ◽

Vol 11 (3) ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Samantha E. Scarneo-Miller ◽

Lindsay J. DiStefano ◽

Johna K. Register-Mihalik ◽

Rebecca L. Stearns ◽

Craig R. Denegar ◽

...

Keyword(s):

Secondary School ◽

Athletic Training ◽

Action Plan ◽

Athletic Administrators ◽

Training Services

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Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer

Journal of Athletic Training ◽

10.4085/1062-6050-51.3.03 ◽

2016 ◽

Vol 51 (2) ◽

pp. 175-183 ◽

Cited By ~ 3

Author(s):

Stephanie M. Mazerolle ◽

Christianne M. Eason ◽

Ashley Goodman

Keyword(s):

Medical Care ◽

Athletic Training ◽

National Collegiate Athletic Association ◽

Athletic Trainers ◽

Negative Influence ◽

Division I ◽

Athletic Trainer ◽

Full Time ◽

Frequency Distributions ◽

Training Services

Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided.Context: To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer.Objective: Mixed-methods qualitative and quantitative study.Design: The NCAA Division I.Setting: Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26−52 years), with 12 ± 7 years (range, 3−29 years) of athletic training experience.Patients or Other Participants: All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility.Data Collection and Analysis: Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and opportunities for rejuvenation. For many, the summer season mimicked the hours, workload, and expectations of the nontraditional season.Results: The NCAA rule changes and medical care expectations affected the summer workload of athletic trainers, but job sharing seemed to help them manage conflict associated with providing summer athletic training services.Conclusions:

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Deficiency of Athletic Trainers in California Secondary Schools

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2018-0106 ◽

2019 ◽

Vol 24 (4) ◽

pp. 169-173

Author(s):

Riana R. Pryor ◽

Summer Runestad ◽

Bethany A. Chong Gum ◽

Nathan J. Fuller ◽

Moon Kang ◽

...

Keyword(s):

Physical Activity ◽

Secondary Schools ◽

Medical Care ◽

Athletic Training ◽

Athletic Trainers ◽

Emergency Medical Technician ◽

Athletic Director ◽

Emergency Medical ◽

Training Services ◽

Medical Technician

Athletic trainers (ATs) prevent and treat sport-related and catastrophic injuries due to physical activity. However, not all secondary schools hire ATs to provide medical care. The purpose of this study was to determine athletic training services available in California secondary schools. Approximately half (51%, 143/278) of California secondary schools reported hiring an AT, however, only 35% (87/251) of schools hired a certified AT. Schools without an AT most commonly hired a paramedic, emergency medical technician, coach, or athletic director to provide medical care. Nearly two-thirds of California secondary schools lack an AT, dramatically fewer schools than the nationwide average of 70% of public and 58% of private secondary schools with a certified AT.

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Athletic Training Services During Daily Patient Encounters: A Report From the Athletic Training Practice-Based Research Network

Journal of Athletic Training ◽

10.4085/1062-6050-51.8.03 ◽

2016 ◽

Vol 51 (6) ◽

pp. 435-441 ◽

Cited By ~ 13

Author(s):

Kenneth C. Lam ◽

Alison R. Snyder Valier ◽

Barton E. Anderson ◽

Tamara C. Valovich McLeod

Keyword(s):

Health Care ◽

Secondary School ◽

Athletic Training ◽

Clinical Data ◽

Preventive Services ◽

Research Network ◽

Practice Based Research ◽

Training Services ◽

Hot Pack ◽

Training Practice

Context: Athletic training services such as taping, wrapping, and stretching are common during routine care but rarely captured in traditional patient documentation. These clinical data are vital when determining appropriate medical coverage and demonstrating the value and worth of athletic trainers (ATs). Objective: To analyze clinical data from daily encounter forms within the Athletic Training Practice-Based Research Network (AT-PBRN). Design: Descriptive study. Setting: Secondary school athletic training clinics. Patients or Other Participants: Adolescent patients (n = 4888; age = 16.3 ± 1.4 years) seeking care from ATs. Main Outcome Measure(s): We used Web-based electronic medical records from December 1, 2009, to July 1, 2015, to obtain patient characteristics via deidentified data. Descriptive data regarding practice characteristics from patient encounter forms were analyzed and reported as percentages and frequencies. Results: A total of 36 245 patient encounters (mean = 7.5 ± 11.6 encounters per patient) were recorded. Football, basketball, soccer, track, and volleyball accounted for 85.1% of all encounters. Most encounters were for preventive services (48.8%, n = 22 329), followed by care for a current injury (37.2%, n = 17 027) and care for a new injury (13.9%, n = 6368). Of the preventive encounters, taping (52.7%) was the most common service provided, followed by ice- or hot-pack application (25.4%) and treatment (9.6%). Taping (28.7%) was also the most common service for current injuries, followed by treatment (26.7%) and ice- or hot-pack application (26.2%). Conclusions: Our findings highlight the unique role of ATs as health care providers who provide substantial preventive services to their patients. Further, these results represent one of the first attempts to describe athletic training services related to nontime-loss injuries, emphasizing the significant role that ATs play in the health care of secondary school athletes. These findings should help clinicians and administrators make more informed decisions regarding appropriate medical coverage.

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The National Sports Safety in Secondary Schools Benchmark (N4SB) Study: Defining Athletic Training Practice Characteristics

Journal of Athletic Training ◽

10.4085/1062-6050-48.4.04 ◽

2013 ◽

Vol 48 (4) ◽

pp. 483-492 ◽

Cited By ~ 17

Author(s):

Tamara C. Valovich McLeod ◽

Kellie C. Huxel Bliven ◽

Kenneth C. Lam ◽

R. Curtis Bay ◽

Alison R. Snyder Valier ◽

...

Keyword(s):

Secondary School ◽

Secondary Schools ◽

Medical Care ◽

Athletic Training ◽

Athletic Trainers ◽

School Setting ◽

Practice Setting ◽

Web Based ◽

Practice Characteristics ◽

Training Practice

Context: Increased rates of sport participation and sport-related injury have led to greater emphasis on and attention to medical care of student-athletes in the secondary school setting. Access to athletic training services is seen as a critical factor for delivering adequate injury prevention and medical care to student-athletes. However, few data are available regarding practice characteristics of athletic trainers (ATs) in this setting. Objective: To characterize the practices of secondary school athletic trainers (ATs). Design: Descriptive study. Setting: Web-based survey. Patients or Other Participants: A total of 17 558 ATs with current National Athletic Trainers' Association membership were identified for survey distribution. Of these, 4232 ATs indicated that they practiced in the secondary school setting, and 4045 completed some part of the survey. Main Outcome Measure(s): A Web-based survey was used to obtain demographic information about ATs and their secondary schools and characteristics of athletic training practice. Descriptive data regarding the athletic trainer's personal characteristics, secondary school characteristics, and practice patterns are reported as percentages and frequencies. Results: Most respondents were in the early stages of their careers and relatively new to the secondary school practice setting. Nearly two-thirds (62.4%; n = 2522) of respondents had 10 or fewer years of experience as secondary school ATs, 52% (n = 2132) had been certified for 10 or fewer years, and 53.4% (n = 2164) had 10 or fewer years of experience in any practice setting. The majority of respondents (85%) worked in public schools with enrollment of 1000 to 1999 (35.5%) and with football (95.5%). More than half of respondents were employed directly by their school. Most respondents (50.6%) reported an athletic training budget of less than $4000. The majority of ATs performed evaluations (87.5%) on-site all of the time, with a smaller percentage providing treatments (73.3%) or rehabilitation (47.4%) services all of the time. Conclusions: This is the first study to describe secondary school athletic training that reflects national practice trends. To improve the quality of athletic training care and to support and improve current working conditions, the profession must examine how its members practice on a day-to-day basis.

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Athletic Trainers' Effect on Population Health: Improving Access to and Quality of Care

Journal of Athletic Training ◽

10.4085/1062-6050-219-17 ◽

2019 ◽

Vol 54 (2) ◽

pp. 124-132 ◽

Cited By ~ 2

Author(s):

Ellen Shanley ◽

Charles A. Thigpen ◽

Cole G. Chapman ◽

John Thorpe ◽

Robert G. Gilliland ◽

...

Keyword(s):

Health Care ◽

South Carolina ◽

Athletic Training ◽

Sports Medicine ◽

Absolute Risk ◽

Clinical Care ◽

Risk Difference ◽

Athletic Injuries ◽

Early Results ◽

Before And After

Context The scope of athletic training practice combined with the magnitude of scholastic athletic injuries means that the scholastic athletic trainer (AT) is uniquely positioned to positively affect the overall health care of this population. The AT is equipped to serve in the prevention and primary management of injuries and return to activity of scholastic athletes. However, to optimize the musculoskeletal health of all athletes within a given setting, the gaps in clinical care must be continuously evaluated. Quality improvement (QI) approaches are often used to establish a framework for delivering care that promotes the best health status of the targeted population. Objective To describe the creation, implementation, and early results of a QI initiative aimed at advancing the health of the scholastic athletes served in the Greenville County, South Carolina, school district. Design Cohort study. Patients or Other Participants A total of 49 793 athletes. Main Outcome Measure(s) The QI framework consisted of a process that documented the magnitude of athletic injuries, established risk factors for injury, defined intervention steps for at-risk athletes, and evaluated the QI process before and after implementation. The results were regularly reported to participating stakeholders, including ATs, athletic directors, coaches, parents, and athletes. Results After the QI process, injury rates decreased (absolute risk difference between the 2011–2012 and 2016–2017 academic years = 22%) and resources were more strategically allocated, which resulted in a decrease in health care costs of more than 50%. Conclusions Collectively, the QI framework as described provides a systematic process for empowering the AT as the foundation of the scholastic sports medicine team.

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Support Received During the Transition to Practice for the Secondary School Graduate-Assistant Athletic Trainer

Journal of Athletic Training ◽

10.4085/1062-6050-51.12.10 ◽

2016 ◽

Vol 51 (10) ◽

pp. 780-788 ◽

Cited By ~ 8

Author(s):

Stephanie M. Mazerolle ◽

Stacy E. Walker ◽

Jessica L. Kirby

Keyword(s):

Secondary School ◽

Medical Care ◽

Athletic Training ◽

Clinical Education ◽

School Setting ◽

Athletic Trainer ◽

Transition To Practice ◽

Care Providers ◽

Graduate Assistant ◽

Athletic Training Faculty

Context: Transitioning into clinical practice can be stressful for the newly credentialed athletic trainer (AT). The support provided by mentors, peers, and athletic training faculty can increase confidence and enhance the transition. To create specific initiatives for a smoother transition, the perspectives of those in the secondary school setting are needed. Objective: To examine the transition to practice and mentorship of newly credentialed ATs providing medical care in the secondary school setting. Design: Qualitative study. Setting: Secondary school setting. Patients or Other Participants: A total of 14 ATs (2 men, 12 women; age = 23.0 ± 2.0 years) participated in our study. They were employed in the secondary school setting through graduate assistantships, had been credentialed for less than 1 year, and had completed professional bachelor's degree programs. Data Collection and Analysis: We completed 14 semistructured phone interviews. Interviews were recorded and transcribed verbatim. Two researchers independently following the stepwise progression of a general inductive approach completed the data analysis. Trustworthiness was established through multiple-analyst triangulation, peer review, and member checks. Results: Two major themes emerged regarding the support received by our participants: past mentors and current networks of professionals. Past mentors provided autonomous learning opportunities during clinical education and then served as resources for guidance and advice. Current networks of professionals were defined by 2 subthemes: professional medical care providers and non–medical care providers within the secondary school setting (ie, athletic directors, coaches, parents). Conclusions: Former preceptors and faculty provided resources and support to help develop the newly credentialed AT's confidence and facilitate the transition. Preceptors should allow increased independence to help their students develop as clinicians. The creation of networks within the community, that is, the secondary school itself, is also critical in the transition as it provides the AT with role legitimation.

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Appropriate Medical Care Standards for Organizations Sponsoring Athletic Activity for the Secondary School–Aged Athlete: A Summary Statement

Journal of Athletic Training ◽

10.4085/1062-6050-544-18 ◽

2019 ◽

Vol 54 (7) ◽

pp. 741-748 ◽

Cited By ~ 2

Author(s):

Larry Cooper ◽

Ronnie Harper ◽

George S. Wham ◽

Jason Cates ◽

Scott J. Chafin ◽

...

Keyword(s):

Health Care ◽

Secondary School ◽

Medical Care ◽

Athletic Training ◽

Strategic Alliance ◽

Task Force ◽

Therapeutic Interventions ◽

Education Gaps ◽

National Athletic Trainers Association ◽

Board Of Certification

Objective To present the appropriate medical care standards for organizations that sponsor athletic activities for secondary school–aged athletes. Data Sources To develop the current standards and identify current best-practices evidence, the task force used a multistep process that included reviewing the existing 2004 Appropriate Medical Care for Secondary School–Aged Athletes consensus points and cross-referencing of National Athletic Trainers' Association (NATA) statements and official documents from the strategic alliance (the NATA, NATA Foundation, Board of Certification, and Commission on Accreditation of Athletic Training Education). Gaps in the recommendations from the 2004 Appropriate Medical Care for Secondary School–Aged Athletes document were identified by the task force, and the new appropriate medical care standards were developed and refined. Conclusions and Recommendations Twelve standards, with supporting substandards, were developed that encompassed readiness to participate in activity; facilities; equipment; protective materials; environmental policies; nutrition, hydration, and dietary supplementation; wellness and long-term health; comprehensive emergency action plans; on-site immediate care; on-site therapeutic interventions; psychological concerns; and athletic health care administration. Collectively, these standards describe a comprehensive approach to providing appropriate health care to secondary school–aged athletes and should serve as a framework with which organizations can evaluate and improve the medical care supplied to adolescent athletes.

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