Low SES

& it’s role in Athletic Training

By Kemi Adeleke
 A little background:
- ATs in high school
- Kechia Rowles
- Range from low SES to high SES

https://www.youtube.com/
watch?v=pK7Xzbh3dbk
 - Low SES schools

Objectives - The Dilemma

- Understanding the Athlete
Low SES Schools
University of Wisconsin (study on high schools in Wisconsin)

- Indicators:
- high percentage of free or reduced lunch & low county median household income
- Less access with an onsite AT
- Limited access to quality healthcare
- Personal experience
- 70% of high schools in the US have access to an AT
- Increase over the past decade
The Dilemma
Journal of Athletic Training

- “Despite the recommendation [of all high schools to have a certified AT on staff],
many high schools lack the medical services of an AT” (from)
- 20 public high school athletic directors
- Various regions of the US
- Telephone interviews (~20 min)
- Results: 3 themes
- Lack of power
- Budget concerns
- Nonbudget concerns
- In addition: misconceptions about the role of an AT & community interference
The Dilemma...
Limitations

- Sample size
- Type of high school
- Perspective
- Future research: larger scale; online data collection; private vs public

Conclusion:
“Although continuing research is needed, we hope
that identifying these barriers will lead to the
development of strategies to overcome them”
Understanding the Athlete
The unique circumstances faced by people from various SES backgrounds may
influence the coping styles they use in response to injury.

Methods:

- Family Affluence Scale (FAS 2)

- 3 groups: low, middle, and high SES
- Semi-structured interviews
- NCAA D1 athletes (Western United States)
- Within a year of IRB approval; , lasted/expected to last 4 weeks until RTP
- 2 Phases: phase 1 (34 participants), phase 2 (11 participants)
Understanding the Athlete...
Results

- Analysis of the data produced 73 raw data themes

- 16 high order themes; categorized into 5 general dimensions
- The 5:
- Cognitive appraisals
- Emotional reactions
- Problem-focused coping
- Emotion-focused coping
- Avoidance coping
- Focused on coping
Understanding the Athlete...
Problem-focused coping

● Comparison to past experiences

“He compared his injury to his past life experiences beyond his sport. For instance, he
noted that having to deal with his family’s house catching on fire or the gang activity
at his high school presented a lot more challenges than his present injury; thus, he was
prepared to manage this setback”

● Commitment to rehab

“Tony credited this determination and work ethic to his father, who worked long
hours to support his family. Growing up, he was accustomed to his father getting up
early in the morning to go to work and coming home late in the evening without
complaining”
Understanding the Athlete...
- SES was not isolated as an independent variable
- Avoidance coping strategies most often occur in the early stages of injury
- Family background + religion
- Positive reframing and perseverance (more common in participants’ accounts)

“For instance, Ian credited his perseverance to his mother, who dealt with adversity
when he was younger. For Michael, he simply did not want to return to his old life,
which influenced him to be perseverant. In other words, he viewed sport as a way out
of an undesirable living situation. Additionally, Sam expressed his motivation to not
give up in order to make his mother, who was recovering from a serious illness, proud”
Understanding the Athlete...
Limitations

- Various stages of rehab; retrospective

- How low is low SES?
- Severe gender imbalance

In conclusion:

We can all be “more

conscious of SES and other elements of one’s
identity when collaborating with an injured athlete”
QUESTIONS?
References
1. Brown M, Hetzel S, Lutes B, McGuine TA, Torres C. Low Socioeconomic Status
Limits High School Athletes’ Access to Quality Athletic Training Services. UW
Health-University of Wisconsin Sports Medicine; April 2017.
2. Mazerolle S, Raso S, Pagnotta K, Stearns R, Casa D. Athletic Directors' Barriers to
Hiring Athletic Trainers in High Schools. Journal Of Athletic Training (Allen
Press) [serial online]. October 2015;50(10):1059-1068. Available from:
SPORTDiscus with Full Text, Ipswich, MA.
3. Bejar M, Butryn T. Experiences of Coping with Injury in NCAA Division I
Athletes from Low-to-Middle Socioeconomic Status Backgrounds. Journal Of
Sport Behavior [serial online]. December 2016;39(4):345-371. Available from:
SPORTDiscus with Full Text, Ipswich, MA.