Practice of and Barriers to Prevention by Secondary School Athletic Trainers

Abstract

Purpose: Prevention is a key aspect of care from athletic trainers. There is limited research on the practice strategies employed to prevent injury by secondary school athletic trainers (SSATs). The purpose of this study was to describe the prevention practice strategies and barriers faced by secondary school athletic trainers. Methods: Athletic trainers (n=3010) were recruited from secondary schools through e-mails provided by the national professional organization database. Secondary school athletic trainers were surveyed on their self-reported prevention practices and barriers using a web-based survey platform. Respondents were 28±3 years, predominantly female (n=260/359, 72.4%), with about 5 years (±2yrs) of clinical experience. The survey contained prevention strategies items with tasks from Domain 1 of the Board of Certification Role Delineation Study (6th ed.) that relates to athletic training clinical practice. Barrier items were developed from previous literature about implementing evidence-based practice strategies. Partial data (completion rate=359/473, 75.9%) was used for the analyses. Data were analyzed by using frequencies, medians with percentiles, means, and standard deviations. Results: The least frequently practiced environmental illness monitoring techniques and addressing patient-specific nutritional needs were identified. In contrast, secondary school athletic trainers most frequently practiced compliance for both equipment maintenance and maintaining a clean facility. The most common ‘always practiced’ skills align with Task 102, 103, and 104 in Domain 1 of the Board of Certification Role Delineation Study. These include pre-participation and screening, personal protective equipment, and maintaining treatment and rehabilitation areas through regulatory standards. A lack of time, workload, player compliance, available space, and coach support were the most commonly cited barriers to prevention practice. Conclusions: Overall, secondary school athletic trainers engaged in prevention strategies frequently, yet external factors were barriers to implementation. The consistent and continual practice of prevention skills are essential to risk mitigation. As a result, always practicing the skill is essential and should not be completed as an occasional duty of the athletic training. As many prevention strategies are required for all patient encounters, the frequency of task performance must improve for clinical practice.