Abstract
CONTEXT: Socioeconomic status (SES) is a significant predictor of morbidity and mortality across health outcomes. Limited information exists on how school SES affects athletic training practice when a certified athletic trainer (AT) is present at secondary schools. OBJECTIVE: To describe contact frequencies and service rates provided by ATs for injuries among secondary school student-athletes and how these differ by school SES. DESIGN: Cross-sectional study. SETTING: The number of athletic training facility (ATF) visit days and AT services were collected from 77 secondary schools. Schools were separated into 3 school SES groups: affluent (n = 31), average (n = 29), and disadvantaged (n = 17). PATIENTS OR OTHER PARTICIPANTS: Secondary school student-athletes who participated in ≥1 of 12 boys' or 11 girls' sports, visited the ATF during the 2014-2015 through 2018-2019 academic years, and received athletic or nonathletic injury care. MAIN OUTCOME MEASURE(S): Contact frequencies were expressed as ATF visit days per injury, AT services per injury, and AT services per ATF visit day. Rates for service type used were expressed as the total count over reported athlete-exposures. RESULTS: The ATs documented 1191 services. Affluent and average SES school communities provided more contact frequencies for injury-related care than did disadvantaged school communities, particularly in AT services per injury (7.10 ± 13.08 versus average: 9.30 ± 11.60 and affluent: 9.40 ± 12.20; P = .020). Affluent school communities supplied greater rates of services in 5 of the 11 service groups reported. No differences were observed among school SES groups in therapeutic exercise. CONCLUSIONS: Our findings reflect that AT practice characteristics may have differed by school SES, but these differences did not appear to result in less medical care. Given the complexity and widespread effects of SES, future investigators should use a complex method to determine SES and aim to identify how SES may affect secondary school student-athletes in ways other than AT practice characteristics.