ABSTRACT
Collegiate student-athletes experience an increasing number of mental health concerns. To help address these concerns and provide high quality healthcare for student-athletes, institutions of higher education are being encouraged to create interprofessional healthcare teams that are specifically dedicated to managing mental health. We interviewed three interprofessional healthcare teams who collaborate to manage routine and emergency mental health conditions in collegiate student-athletes. Teams were representative across all three National Collegiate Athletics Association (NCAA) divisions and included athletic trainers, clinical psychologists, psychiatrists, dieticians and nutritionists, social workers, nurses, and physician assistants (associates). The interprofessional teams indicated the existing NCAA recommendations helped to solidify members and roles of the mental healthcare team; however they all indicated their teams would benefit from more counselors and psychiatrists. Teams shared different mechanisms for referral and accessing mental health resources on their campuses, which may make on-the-job training for new members of the team an organizational necessity.
ABSTRACT
Purpose: Legislation was created for NCAA Divisions I, II, and III to guarantee an independent medical care administrative structure designed to give "unchallengeable autonomous authority" regarding diagnosis, management, and return to play decisions to primary athletics health care providers (physicians and athletic trainers). The purpose of this project was to 1) explore the structure of athletic health care in NCAA athletic institutions as it relates to independent medical care, and 2) describe changes in those structures that have occurred as a result of the COVID-19 pandemic. Methods: We used a cross-Sectional Study. Setting: College/University. In 2017, 162 supervising athletic trainers responded to our survey. Variables collected included health care delivery model, AHCA selection, decision making and injury reporting structure, confidence in independent medical care, COVID-19 response involvement, changes due to COVID-19. Results: The overall demographic characteristics indicated that most supervising athletic trainers were male (117/162, 72.2%), 48 +/- 10 y old, and have been at the institution for a significant tenure 15 +/- 11y. In 2020, responses from 174 supervising athletic trainers were recorded in the survey. The majority of respondents were male (108/174, 62.1%). Average age of the population was 45 +/- 11y with 22 +/- 10y of experience and 15 +/- 10y of experience at their current institution The athletics health care model is most common across all NCAA Divisions (n=163 80.7%). Average confidence was rated 4.54 +/- 0.67. Results indicate a significant increase in confidence from 2017 to 2020 that patient care decisions are independent of influence. The majority of supervising athletic trainers indicated that they were involved in COVID-19 response (n=190, 94.1%) Conclusions: More NCAA Institutions should transition to a medical model of health care delivery to ensure independent medical care. Athletic trainers were used in the policy creation and implementation of COVID-19 protocols for their institutions and athletics programs.
ABSTRACT
Purpose: Hand hygiene (HH) is a cost-effective public health intervention to prevent infectious disease transmission, including COVID-19. Health care professionals have shown poor adherence to HH best practices, and little is known about athletic trainer (AT) HH. ATs typically work in dynamic, unpredictable environments, creating barriers to HH compliance. The purpose of this study was to understand the self reported behaviors and challenges with adherence to HH of secondary school ATs, particularly related to mitigating infection transmission during the COVID-19 pandemic. Methods: In this qualitative study, we conducted 11 semi-structured interviews with secondary school ATs actively engaged in direct patient care (age=31 +/- 9 years;experience=9 +/- 8 years). A 2-person data analysis team used a multi-phase inductive coding process to identify emerging domains and themes to create a codebook. Trustworthiness and credibility were established with member checking, multi-researcher analysis, and internal auditing. Results: We identified four themes: 1) best practices awareness, 2) impact of COVID-19, 3) resources, and 4) community-based prevention. Participants indicated HH training was included during on-boarding, but lacked contextual knowledge for HH in clinical practice, despite identifying ATs as health care providers. Participants expressed increased HH frequency due to the COVID-19 pandemic and concern for transmission. Participants noted an overall positive perception of access to physical resources, like hand sanitizer, sinks, and soap, as well as financial support to provide those resources. Participants noted decreased perceived risk and lack of formal policy or enforcement of HH expectations for facility users. Conclusion: ATs have general knowledge and resources but lack contextual knowledge and behaviors to employ HH best practices. The COVID-19 pandemic increased awareness, but HH by athletic training facility users remains poor. ATs should engage in HH based on best practice recommendations consistent with a traditional healthcare facility. Policies should be developed and enforced to limit disease transmission.