Secondary School Athletic Trainers' Clinical Management Decisions of Low Socioeconomic Status Patients

Author:

Hernandez MI1,Miller EC2,Biese KM3,Columna L2,Andreae S2,McGuine TA2,Snedden TR2,Eberman LE4,Bell DR2

Affiliation:

1. *Sam Houston State University

2. †University of Wisconsin Madison

3. ‡University of Wisconsin-Oshkosh

4. §Indiana State University

Abstract

Context Evidence suggests that negative social determinants of health (SDOH) and lower socioeconomic status (SES) contribute to health care disparities. Due to their accessibility in the high school setting, secondary school athletic trainers (SSATs) may encounter patients that are historically underserved in health care such as low SES patients. However, there is a significant gap in knowledge regarding how SES and SDOH may influence SSATs' clinical management decisions. Objective The purpose of this study was to describe SSATs' perceptions of how patient SDOH and SES influence clinical management decisions and to identify barriers to athletic healthcare. Design Cross-sectional study. Setting Online survey. Participants NATA SSATs (6.7% response rate). Main Outcome Measure(s) SSATs were asked about their perceptions of patient SES and the SDOH (CVI = 0.83 for relevancy). Questions were ranked on a 4-point Liker scale on level of relevance and agreement. Data were summarized by means and standard deviations (SD), frequencies and proportions (%), and median scores. Results A total of 380 SSATs participated (years of experience mean=14.9±11.7 years). When providing care, most (71.3%) SSATs believed that their patient's health/health care access SDOH to be the most relevant of the 5 SDOH whereas the other 4 SDOH were less than 60% relevant. Most SSATs agreed/strongly agreed that patient SES impacts referral (67.4%) and the reliance on conservative treatment before referral (71.2%). SSATs identified patient/guardian compliance (70.2%) and type of health insurance (61.5%) as barriers to providing care to low SES patients. Conclusions SSATs perceived health/health care access as the most relevant SDOH when providing care to low SES patients. When SSATs further considered the SES of patients, they identified all SDOHs as barriers to providing health care they were ill equipped to navigate as they delivered care and engaged in patient referral.

Publisher

Journal of Athletic Training/NATA

Subject

Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine,General Medicine

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