To further the integration of athletic training within the public health arena, athletic trainers need to expand their professional focus from the teams and athletes they work with at their institutions to all physically active individuals, urged the National Athetic Trainers' Association at a press conference at its 2016 Clinical Symposia and AT Expo in Baltimore, Maryland and in a report on its Athletic Training and Public Health Summit published in the Journal of Athletic Training. (1)
"The most pressing health problems facing active children and adults require population-based approaches to reduce or prevent injury," says lead author Mark Hoffman, PhD, ATC, vice provost for international programs, Oregon State University. "We held a summit that included three symposiums in August 2015 to address this topic and explore opportunities for athletic trainers and others to partner with public health professionals and identify clear steps for change."
The Centers for Disease Control and Prevention Foundation defines public health as the "science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases." Public health approaches emphasize prevention over treatment, populations over individuals, and engagement at multiple levels.
The objectives of the summit were to: 1) describe the benefits of using a population-based approach to address concerns; 2) identify specific skill sets and potential partnerships that would be beneficial for maximizing the prevention of injuries and illnesses; and 3) identify and develop potential solutions to challenges that arise in the development, translation, adoption and assessment of preventive policies, guidelines and practices.
Participants followed a process commonly used to address health problems:
The summit focused on three types of prevention:
"It is critical for athletic trainers and others to understand the impact they can have on public health and identify specific areas of clinical practice. Similarly, policy development and assessment are two fundamental aspects of public health that are highly applicable to a wide variety of health care professions as they pertain to injury prevention and safety in the workplace or on the athletic field," says Hoffman.
The summit focused on three important areas of sports injury prevention:
1. Sudden Cardiac Death and Development and Implementation of Policies and Guidelines for Injury Prevention
Sudden cardiac arrest is the most common cause of death in high school and college athletes:
Speakers addressed challenges of screenings in different sports settings and the need to engage stakeholders and establish polices. They recognized that a "one-size-fits-all" approach to cardiac screenings may not be appropriate for all athletic populations, and highlighted the existing challenges and controversies associated with implementing cardiac screening in settings ranging from the National Football
League to high school basketball.
2. Sport-Related Concussion and Program and Policy Evaluation
Sports-related concussions are a serious public health concern, with some suggesting that the numbers have reached epidemic proportions. Studies show that:
Since the first concussion law went into effect in May 2009, all 50 states have adopted so-called Lystedt Laws. The effect of such legislation has not been widely studied, but a 2014 study by researchers at the University of Michigan (2) designed to evaluate the impact of the new concussion laws found a 92 percent increase in children seeking medical assistance in states with such legislation in place compared to a 75 percent increase in states without concussion laws.
While recognizing that the increase in the incidence of concussion may be due to increased awareness, the speakers nevertheless encouraged rigorous evaluation of policies to fill safety gaps (many non-school-sponsored activities are not covered by state law) and too many schools still do not have an athletic trainer on staff.
3. Osteoarthritis and Translation to Practice
Acute traumatic knee joint injuries are common in young athletic populations, which significantly increase the risk for posttraumatic osteoarthritis. Guidelines exist, note the authors, but need to be disseminated and implemented.
1. Hoffman M, Bovbjerg V, Hannigan K, Hootman JM, Johnson STG, Kucera KL, Norcross MN. Athletic Training and Public Health Summit. J Athl Tr. 2016;51(7):000-000 doi: 10.4085/1062-6050-51.6.01 (e-pub ahead of print, June 23, 2016)
2. Gibson TB, Herring SA, Kutcher JS, Broglio SP. Analyzing the effect of state legislation on health care utilization for children with concussion. JAMA Pediatr. 2015;169(2):163-168. doi:10.1001/jamapediatrics.2014.2320.
Posted June 23, 2016
Links:
[1] https://mail.momsteam.com/under-5/rise-in-emergency-department-visits-concussions-result-increased-awareness-says-Centers-Disease-Control
[2] https://mail.momsteam.com/health-safety/mandatory-screening-athletes-heart-conditions-with-ECG-echocardiograms-subject-of-debate
[3] https://mail.momsteam.com/health-safety/acl-reconstruction-surgery-puts-at-greater-risk-osteoarthritis-later-in-life-say-reseachers-at-AOSSM-2014
[4] https://mail.momsteam.com/health-safety/hcm-sudden-cardiac-death-in-young-athletes
[5] https://mail.momsteam.com/health-safety/neuromuscular-training-reduces-acl-injury-risk-by-half-study