Department of Kinesiology, Sam Houston State University, Huntsville, TX.
Department of Kinesiology, University of Wisconsin-Madison.
J Athl Train. 2024 Apr 1;59(4):388-393. doi: 10.4085/1062-6050-0445.22.
Evidence suggests that lower socioeconomic status (SES) and negative social determinants of health (SDOH) contribute to health care disparities. Due to their accessibility in the high school setting, secondary school athletic trainers (SSATs) may encounter patients who are historically underserved in health care, such as patients with low SES. However, a significant gap in knowledge exists regarding how SDOH and SES may influence SSATs' clinical management decisions.
To describe SSATs' perceptions of how patient SDOH and SES influence clinical management decisions and to identify barriers to athletic health care.
Cross-sectional study.
Online survey.
National Athletic Trainers' Association SSATs (6.7% response rate).
MAIN OUTCOME MEASURE(S): Secondary school athletic trainers were asked about their perceptions of patient SDOH and SES (content validity index = 0.83 for relevancy). The levels of relevance and agreement were answered on a 4-point Likert scale. Data were summarized using means and SDs, frequencies and proportions (%), and median scores.
A total of 380 SSATs participated (mean years of experience = 14.9 ± 11.7 years). When providing care, most (71.3%) SSATs believed their patients' health or health care access to be the most relevant of the 5 SDOH, whereas the other 4 SDOH were less than 60% relevant. Most SSATs agreed or strongly agreed that patient SES affected both referral (67.4%) and the reliance on conservative treatment before referral (71.2%). Secondary school athletic trainers identified patient or guardian compliance (70.2%) and type of health insurance (61.5%) as barriers to providing care to patients with low SES.
Secondary school athletic trainers perceived health or health care access as the most relevant social determinant when providing care to patients with low SES. When SSATs further considered the SES of patients, they identified all SDOH as barriers that they were ill equipped to navigate as they delivered care and engaged in patient referral.
有证据表明，较低的社会经济地位（SES）和负面的健康社会决定因素（SDOH）导致了医疗保健方面的差距。由于中学体育训练师（SSAT）在高中环境中易于接触到，他们可能会遇到在医疗保健方面服务不足的患者，例如 SES 较低的患者。然而，对于 SDOH 和 SES 如何影响 SSAT 的临床管理决策，知识上存在很大的差距。
描述 SSAT 对患者 SDOH 和 SES 如何影响临床管理决策的看法，并确定体育保健服务的障碍。
横断面研究。
在线调查。
国家运动训练员协会的 SSAT（6.7%的回应率）。
中学体育训练师被问及他们对患者 SDOH 和 SES 的看法（内容有效性指数为 0.83）。相关性和一致性的水平是通过 4 点李克特量表来回答的。数据用平均值和标准差、频率和比例（%）以及中位数得分来总结。
共有 380 名 SSAT 参与（平均工作年限=14.9±11.7 年）。在提供护理时，大多数（71.3%）SSAT 认为他们患者的健康或医疗保健获取是 5 个 SDOH 中最相关的，而其他 4 个 SDOH 的相关性低于 60%。大多数 SSAT 同意或强烈同意患者 SES 既影响转诊（67.4%），也影响转诊前保守治疗的依赖程度（71.2%）。中学体育训练师认为患者或监护人的依从性（70.2%）和健康保险类型（61.5%）是为 SES 较低的患者提供护理的障碍。
中学体育训练师在为 SES 较低的患者提供护理时，将健康或医疗保健获取视为最相关的社会决定因素。当 SSAT 进一步考虑患者的 SES 时，他们认为所有的 SDOH 都是他们在提供护理和进行患者转诊时难以应对的障碍。
