Abstract
Development of written policies and procedures (P&P) may enhance adequate preparation and management of spinal cord injuries (SCI). PURPOSE: To evaluate the current adoption of SCI P&P in the secondary school setting as reported by athletic trainers (ATs). METHODS: Using a cross-sectional design, ATs employed in a secondary school (n=3315) were emailed invitations to participate in an online questionnaire about sport safety best practices, which included three questions related to SCI P&P (Table 1). The questions were framed using the Precaution-Adoption Process Model (PAPM), which is a health behavior model aimed at identifying an individual’s readiness to act with answers including unaware, unengaged, undecided, decided not to act, decided to act, acting and to maintaining a SCI P&P. Additional questions related to the management of SCI were also asked. Frequencies were tabulated and prevalence ratios with 95% confidence intervals (CI) are presented. RESULTS: Of the 389 ATs who responded (response rate = 8.5%)(male= 52.1%, age=41±10 years), a majority reported “maintaining” for all questions (Q1 (Comprehensive SCI plan)= 82.8%, Q2 (Equipment Removal)=79.1%, Q3 (Healthcare professional practice)=64.8%, Table 1). The proportion of ATs reporting being “unaware” was higher in Q2 compared to Q1 (7.2% vs 4.8%; (PR=1.78, 95% CI= 1.11, 2.87)). Further, the ATs reporting “acting” or “maintaining” in Q2 was higher than Q3 (80.6% vs 65.8%; PR=1.22, 95% CI=1.12, 1.33). Approximately half (56.6%) reported they coordinate SCI policy with emergency medical services (EMS). A majority reported they do not document practicing equipment removal (62.2%). CONCLUSION: Overall, the PAPM appears to be able to classify ATs readiness to act for the adoption of a SCI P&P, though there was a low proportion in many of the stages. Interventions may be needed to improve the practicing and documentation of equipment removal skills along with collaborative efforts between ATs and EMS.
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