The Use of Patient-Reported Outcome Measures: Secondary School Athletic Trainers' Perceptions, Practices, and Barriers

Abstract

Context Incorporating patient-reported outcomes (PROs) into daily routine is essential for patient-centered clinical practice. Secondary school athletic trainers (ATs) may encounter unique barriers that limit their willingness to use PROs. Objective To explore how secondary school ATs who were using PROs perceived their application, benefits, and problems compared with those who did not. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A total of 2984 secondary school ATs received an e-mail invitation, and 322 completed the survey (response rate = 10.8%). Respondents were 43 ± 10 years old, with most indicating at least 11 years as a Board of Certification–certified AT (n = 276, 85.7%). Main Outcome Measure(s) The ATs were invited to complete a Web-based survey regarding the uses and benefits of and problems with PROs. Those using PROs in clinical practice were asked their criteria for selecting the measures, whereas those not using PROs were asked their reasons for not using them. Dependent variables were endorsements of uses and benefits of and problems with PROs. Results The most commonly cited uses of PROs were determining treatment effectiveness (193/264, 73%) and demonstrating effectiveness to administration (174/264, 66%). Improving communication with the patient (267/296, 90%) and helping to direct the plan of care (256/297, 86%) were the most frequently endorsed benefits of PROs. Time to score and analyze (152/284, 53%) and time for patients to complete (134/284, 47%) PROs were the problems encountered most often. For ATs not using PROs (223/262, 85%), the most frequent reason was the lack of a support structure (102/219, 46%). For ATs using PROs (39/262, 15%), quick completion times (32/39, 82%) was the most common criterion used to select individual measures. Conclusions A majority of secondary school ATs recognized the benefits of PROs and yet did not use them in clinical practice due to setting-specific barriers.