Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study

J Athl Train. 2015 Dec;50(12):1310-8. doi: 10.4085/1062-6050-51.1.08. Epub 2015 Dec 17.


Context: Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting.

Objective: To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports.

Design: Descriptive epidemiology study.

Setting: Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states.

Patients or other participants: High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011-2012 through 2013-2014 academic years.

Main outcome measure(s): The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non-time-loss (NTL) injuries.

Results: Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001).

Conclusions: These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.

Keywords: NATION; injury surveillance; medical coverage; sports.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletic Injuries / epidemiology
  • Athletic Injuries / therapy*
  • Female
  • Humans
  • Male
  • Physical Education and Training*
  • School Health Services
  • Schools* / statistics & numerical data
  • United States / epidemiology