Picha Kelsey J, Welch Bacon Cailee E, Lewis Joy H, Snyder Valier Alison R
A.T. Still University, Mesa, AZ.
Department of Athletic Training, School of Osteopathic Medicine in Arizona, Research Support, A.T. Still University, Mesa.
J Athl Train. 2025 Apr 1;60(4):308-315. doi: 10.4085/1062-6050-0193.24.
Athletic trainers (ATs) are in a unique position to mitigate the negative influences of social determinants of health (SDH) in their patients. In the secondary school setting, understanding common SDH may inform strategies that reduce these influences. However, little is known about the types of SDH that ATs observe in patients in this setting.
To investigate SDH observed by ATs at the point of care in the secondary school setting.
Descriptive, observational card study.
Secondary schools.
Twenty-seven ATs (average age = 29.9 ± 5.6 years, 23 [85.2%] female).
MAIN OUTCOME MEASURE(S): Athletic trainers recorded SDH on a standardized observation card during patient interactions. Cards provided instructions for completion and had a 4-column table with a list of 19 predetermined SDH, a checkbox for observed SDH, a checkbox for perceived negative influence of observed SDH on patient health, and an open box to write in actions taken to address the observed SDH.
Overall, 676 cards with 748 observed SDH were collected from 27 secondary schools. Of those, 46.9% (351/748) were perceived to have a negative influence on patient health. The top 3 observed SDH were academic stressors (14.2%, 106/748), access to social media (12.6%, 94/748), and lack of health literacy (11.4%, 85/748). The ATs reported acting on 37.7% of negatively perceived SDH through counseling and education (48.6%, 137/282), additional resources (20.6%, 58/282), referral to others (17.4%, 49/282), and communication with others (13.5%, 38/282).
Our results indicated ATs in the secondary school setting were observing and acting to mitigate the negative influence of SDH. However, these ATs should be prepared to provide resources for patients negatively influenced by academic stressors, social media, and lack of health literacy. Resources, referrals, and additional education for patients may support a healthier community and positively influence athlete health and well-being.
运动训练师（ATs）处于减轻患者健康的社会决定因素（SDH）负面影响的独特位置。在中学环境中，了解常见的SDH可能有助于制定减少这些影响的策略。然而，对于ATs在这种环境下观察到的患者SDH类型知之甚少。
调查中学环境中运动训练师在护理点观察到的SDH。
描述性观察性卡片研究。
中学。
27名运动训练师（平均年龄=29.9±5.6岁，23名[85.2%]为女性）。
运动训练师在与患者互动期间，在标准化观察卡片上记录SDH。卡片提供了填写说明，并有一个4列的表格，列出了19个预先确定的SDH、观察到的SDH的复选框、观察到的SDH对患者健康的感知负面影响的复选框，以及一个用于填写为解决观察到的SDH而采取的行动的空白框。
总体而言，从27所中学收集了676张卡片，共观察到748个SDH。其中，46.9%（351/748）被认为对患者健康有负面影响。观察到的前3个SDH是学业压力源（14.2%，106/748）、使用社交媒体（12.6%，94/748）和缺乏健康素养（11.4%，85/748）。运动训练师报告称，通过咨询和教育（48.6%，137/282）、提供额外资源（20.6%，58/282）、转介给他人（17.4%，49/282）以及与他人沟通（13.5%，38/282），对37.7%被负面感知的SDH采取了行动。
我们的结果表明，中学环境中的运动训练师正在观察并采取行动减轻SDH的负面影响。然而，这些运动训练师应准备好为受到学业压力源、社交媒体和缺乏健康素养负面影响的患者提供资源。为患者提供资源、转介和额外教育可能有助于建立更健康的社区，并对运动员的健康和福祉产生积极影响。
