Athletic Trainers' Familiarity, Comfort, Knowledge, and Recognition of Social Determinants of Health

Abstract

Context Social determinants of health (SDH)—education, transportation, housing, employment, health systems and services, economic status, and physical and social environments—influence patient outcomes; therefore, athletic trainers (ATs) need to be able to understand and address these factors. However, little is known about how ATs perceive SDH or how knowledgeable they are about social factors that contribute to patient health and well-being. Objective To evaluate ATs' familiarity and comfort with SDH and their perceived knowledge and recognition of SDH. Design Cross-sectional. Setting Online survey. Patients or Other Participants Our survey was distributed to 17 000 ATs; 1829 accessed it (access rate=10.8%), and 1694 completed it (completion rate=92.6%, AT experience=15.2±10.6 years, age=36.6±10.8 years). Main Outcome Measures The survey included multipart questions that evaluated ATs' perceptions of their familiarity, comfort, and knowledge about SDH. Data were summarized using descriptive statistics. Results Few respondents (4.1%, 70/1691) reported they were extremely familiar with SDH. Most reported being moderately familiar (45.0%, 761/1691), minimally familiar (34.7%, 587/1691), or not familiar at all (16.1%, 273/1691). For questions about comfort, few reported being extremely comfortable (3.5%, 59/1691) with SDH, and most reported being moderately comfortable (35.4%, 598/1691), minimally comfortable (41.1%, 695/1691), or not comfortable at all (18.6%, 314/1691). For questions about knowledge, few reported being extremely knowledgeable (2.7%, 46/1686) about SDH, and the majority reported being moderately (38.9%, 622/1686), minimally (41.8%, 704/1686) or not knowledgeable at all (18.6%, 314/1686). Over half of ATs accurately categorized 8 of the 9 SDH listed in the survey, and 22% endorsed more correct than incorrect items. Conclusions A majority of ATs perceived their familiarity, comfort, and knowledge about SDH to be moderate-to-low, which may reflect the relatively recent emphasis on SDH in athletic healthcare. Because SDH can have a major impact on patient health and well-being, strategies should be developed for educating ATs about SDH. Developing strategies to increase comfort with the SDH in patient care is critical to ensure that those factors that can be addressed at the patient level are identified and managed.