Athletic Trainer-Reported Prevalence of Mental Health, Substance Use, and Barriers to Health in Secondary Schools

Abstract

ABSTRACT Context: Where a person lives can have a significant impact on health. Limited access to health care, food insecurity, lack of affordable housing, and violence increases a person's likelihood for poor health. Athletic trainers can have an impact on identifying and improving the determinants of health that affect student-athletes. Objective: To understand 1) What are the current perceptions athletic trainers have about the health behaviors (specifically mental health and substance use) of high school student-athletes? 2) What are the barriers that athletic trainers experience when providing health services to high school student-athletes? 3) How does the developed environment effect the health behaviors and barriers that athletic trainers observe? Design: Survey Setting: Online Participants: Certified National Athletic Training Association Members employed in the secondary school setting Main Outcome Measure(s): Demographics of athletic trainers, athletic trainers' perceptions on the health of student-athletes across developed environments, prevalence of mental health issues, tobacco and substance use, barriers to health care services, and housing and food insecurities among student-athletes. Descriptive statistics for the outcome measures are reported. Results: 7,600 electronic surveys were distributed to athletic trainers, with 910 respondents. Respondents were 61% female; average age was 36 years old; and an average of 12.5 years of experience. 82% of athletic trainers identified their school setting as public, 43.7% of respondents identified their school as suburban, 30.1% rural, and 26.2% urban. Athletic trainers perceived a high average prevalence of mental health issues (32%), e-cigarette use (31.7%), and marijuana use (26.9%) in student athletes. There were significant perceived barriers to health including access to transportation, poverty, housing and food insecurities. Conclusions: This study highlights health disparities and barriers athletic trainers observe when addressing health care needs of student-athletes. Understanding determinants of health to identify causes of health disparities may better prepare athletic trainers to manage the health needs of underserved student-athletes.