Factors Influencing Athletic Training Services in California Secondary Schools: A Five- Year Update

J Athl Train. 2024 Jun 5. doi: 10.4085/1062-6050-0187.24. Online ahead of print.


Context: California is the only state that does not regulate the athletic training profession, allowing unqualified personnel to be hired and call themselves athletic trainers. The benefits of employing a certified athletic trainer in the secondary school setting are numerous but efforts to push regulation legislation continue to fail in California.

Objective: To describe the availability of certified athletic trainers in California secondary schools and explore factors influencing athletic trainer employment.

Design: Cross-Sectional Study.

Setting: Online survey.

Patients or other participants: Participants from 1538 California Secondary Schools.

Main outcome measures: Officials from member schools completed the 2022-2023 California Interscholastic Federation Participation Census. Participants provided information specific to enrollment, sport participation, access to AEDs, and whether the school had athletic trainers on staff. The athletic trainer's certification status was independently verified. Enrollment data specific to ethnicity, race, and percentage of students eligible for free meals was obtained through the California Department of Education Statistics.

Results: More than half (51.6%) of California secondary schools did not employ a certified athletic trainer and 8.3% employed unqualified personnel as athletic trainers. Nearly half (43%) of student athlete participants were enrolled at schools with no certified athletic trainer. Schools that employed certified athletic trainers had a lower proportion of students eligible to receive free and reduced-price meals. The average percentage of Hispanic or Latino students was greater in schools with no certified athletic trainer and schools that employed unqualified personnel as athletic trainers than schools that employed certified athletic trainers.

Conclusions: Data indicates that in a five-year period, access to athletic training services in California secondary schools has not improved. There are large gaps in access to athletic training services and there are clear socioeconomic and racial and ethnic disparities. Efforts to educate stakeholders on the importance of athletic training regulation in California should continue.

Keywords: access to health care; health disparity; socioeconomic status.