Secondary School Athletic Trainers’ Navigation of Patient Socioeconomic Status Challenges in Care: A Qualitative Study

Abstract

Secondary school ATs (SSATs) are uniquely positioned healthcare providers at an optimal public health intersection where they can provide equitable healthcare to low socioeconomic status (SES) adolescents. SSATs face similar challenges to physicians in treating low SES patients, but their strategies may be different compared to other medical professions. However, the consequences of low SES population healthcare delivery by SSATs have not been explored. SSATs were asked to share what challenges, if any, they encounter with providing care for their low SES patients and what strategies they find most effective to overcome these challenges. Data were collected via semi-structured interviews and reflective field notes and analyzed using a four-step, interpretative phenomenological analysis (IPA) guided theme development. Data saturation was met, and the sample size aligned with other IPA studies. Trustworthiness was established with research triangulation and Yardley’s four principles. Three interrelated themes emerged: (a) mechanisms for identifying SES, (b) the impact of SES on care, and (c) navigating SES challenges. SSATs described many strategies that were gained through their clinical experiences to overcome healthcare barriers. SSATs have the potential to decrease health disparities through their role as a liaison and advocates for their low SES patients.

Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers

“…Research in athletic training has highlighted that athletic trainers can have a positive outcome in reducing negative social determinants of health experiences [ 50 ]. A qualitative research study by Hernandez et al examined secondary school athletic trainers’ experiences with providing healthcare to low socioeconomic status patient populations [ 51 ]. Results were consistent with participant comments from our study, which both suggested athletic trainers are in a good position to support and advocate for low socioeconomic populations.…”

The Role of Title 1 Secondary School Athletic Trainers in the Primary and Patient-Centered Care of Low Socioeconomic Adolescents

“…The use of an IPA design warranted a homogenous sample of approximately 12 participants with similar lived experiences [ 10 , 11 ]. Therefore, initial recruitment began in March 2021 through invitation letters that were sent to a convenience sample of secondary school ATs.…”

The Athletic Trainer as a Public Health Foot Soldier

“…3 Socioeconomic status influences both the healthcare available to each person, and its outcome efficacy. 8 Failure to evaluate and completely understand the impact of an individual’s social determinants of health, health literacy, and socioeconomic status decreases the ability of the healthcare professional to provide the care needed to achieve holistic health and wellbeing. 3,16 Approximately 80% of health outcomes are determined by factors beyond medical care; therefore, healthcare professionals need to have a sound understanding of how various health determinants influence overall student-athlete health.…”

“…Although the SB-AT has the primary responsibility of providing healthcare to student-athletes, to improve the outcome efficacy of their translational healthcare interventions they should be better prepared to identify and manage the effects that social determinants of health and health literacy have on the groups that they serve. 3,8,24 To accomplish this mission, it is imperative that SB-ATs better understand the positive impact they can have on public health. 9,10 Many perceive that they were not adequately prepared to identify and intervene with lower socioeconomic status student-athletes 8 and are not familiar with how to develop and evaluate healthcare policies, and implement comprehensive translational clinical practice initiatives using traditional public health approaches.…”

“…3,8,24 To accomplish this mission, it is imperative that SB-ATs better understand the positive impact they can have on public health. 9,10 Many perceive that they were not adequately prepared to identify and intervene with lower socioeconomic status student-athletes 8 and are not familiar with how to develop and evaluate healthcare policies, and implement comprehensive translational clinical practice initiatives using traditional public health approaches. 9,10 Developing improved educational opportunities to better prepare SB-ATs to identify population or community-based healthcare concerns that consider social determinants of health and health literacy is critical.…”