Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ.
Department of Athletic Training, A.T. Still University, Mesa, AZ.
J Athl Train. 2024 Apr 1;59(4):394-402. doi: 10.4085/1062-6050-0327.23.
Addressing social determinants of health (SDOH) in all populations improves patient outcomes, leading to better patient-centered care. Despite known influences of SDOH, little is known about the ability of athletic trainers (ATs) to observe SDOH in practice.
To explore ATs' observations of SDOH and describe actions taken at the point of care in collegiate and university settings.
Descriptive via an observational card study.
Athletic training facilities.
Collegiate and university ATs (23 participants across 20 institutions).
The ATs used a modified observation card to document observations of SDOH during patient encounters in the collegiate or university setting. The cards contained instructions for completion and a table with 4 columns: (1) a list of 19 predetermined SDOH, (2) a checkbox for observed SDOH, (3) a checkbox for the perceived negative influence of observed SDOH on patient health, and (4) an open box to write in what actions, if any, were taken to address the observed SDOH.
Overall, 424 cards were collected. Of 725 observed SDOH, access to social media (153/725, 21.1%), academic stressors (131/725, 18.1%), and behavioral health issues (71/725, 9.8%) were the most commonly observed. Nearly 39% (281/725) had a perceived negative influence. Of those, academic stressors (49/281, 17.4%), behavioral health issues (46/281, 16.4%), and transportation issues (32/281, 11.4%) were most common. For the 23.0% (166/725) of SDOH acted upon, ATs used counseling and education (73/166), provided additional resources (60/166), referred to others (29/166), or communicated with others (4/166).
Because ATs are positioned to accurately assess SDOH, they can promote better patient-centered care and improve patient outcomes. Our results suggest that many SDOH observed by ATs in the collegiate or university setting have a negative influence on patient health. Better support for patients with academic stressors and behavioral health issues is important because of these SDOH.
解决所有人群的健康社会决定因素（SDOH）可改善患者预后，从而实现以患者为中心的更好的医疗护理。尽管 SDOH 的影响众所周知，但对于运动训练师（ATs）在实践中观察 SDOH 的能力却知之甚少。
探讨 ATs 对 SDOH 的观察，并描述在学院和大学环境中护理点所采取的措施。
通过观察卡研究进行描述性研究。
运动训练设施。
学院和大学的 ATs（20 个机构中的 23 名参与者）。
ATs 使用改良观察卡记录在学院或大学环境中患者就诊时观察到的 SDOH。卡片上包含填写说明和一个包含 4 列的表格：（1）19 项预定 SDOH 的清单，（2）观察到的 SDOH 的复选框，（3）观察到的 SDOH 对患者健康负面影响的复选框，（4）一个可填写任何已采取的行动的开放框，以解决观察到的 SDOH。
共收集了 424 张卡片。在 725 项观察到的 SDOH 中，社交媒体的可及性（153/725，21.1%）、学业压力（131/725，18.1%）和行为健康问题（71/725，9.8%）最常见。近 39%（281/725）认为存在负面影响。其中，学业压力（49/281，17.4%）、行为健康问题（46/281，16.4%）和交通问题（32/281，11.4%）最为常见。对于 23.0%（166/725）采取行动的 SDOH，ATs 采用了咨询和教育（73/166）、提供了额外资源（60/166）、转介给他人（29/166）或与他人沟通（4/166）。
由于 ATs 能够准确评估 SDOH，因此他们可以促进更好的以患者为中心的医疗护理并改善患者预后。我们的结果表明，ATs 在学院或大学环境中观察到的许多 SDOH 对患者健康有负面影响。由于这些 SDOH，更好地支持有学业压力和行为健康问题的患者很重要。
