Baltimore, June 23, 2016 – At NATA’s 67th Clinical Symposia and AT Expo in Baltimore today, leading health care professionals addressed the topic of “Reducing Your Risk in Work, Life and Sport: An Educational Public Health Initiative” during a national press conference at the Hilton Baltimore.
The paper, “Athletic Training and Public Health Summit,” which will appear in the July 2016 issue of the Journal of Athletic Training, was advance released during the event and offers a clear approach to injury and illness prevention.
“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: 1) describe the magnitude of the problem (incidence and burden); 2) identify risk factors and mechanisms; 3) develop interventions for the risk factors identified; 4) assess the efficacy and effectiveness of the intervention to reduce incidence; 5) describe the intervention context to understand what can actually be implemented in real-world settings; and 6) implement and evaluate the effectiveness of interventions.
Primary prevention focuses on interventions before the injury or illness has happened (e.g., neuromuscular programs to prevent knee injuries); secondary prevention focuses on intervention immediately after injury or illness has happened (early treatment, slowing of disease); and tertiary prevention focuses on improving outcomes for those with long-term injuries or illnesses (e.g., knee or ankle osteoarthritis).
“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.
Summit topics included:
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.
- 2,000 children in the U.S. die every year from sudden cardiac arrest.
- Sudden cardiac arrest (SCA) is the leading cause of death in exercising young athletes.
- Approximately one in 300 young athletes has a heart disorder that may increase his or her risk of sudden cardiac arrest.
Sport-Related Concussion and Program and Policy Evaluation
Since the first concussion law went into effect in 2009, all 50 states have adopted legislation; however the effect of that legislation remains unknown. Speakers addressed the increase in the incidence of concussion. Although this may be due to improved awareness, they encouraged rigorous evaluation of policies – particularly if there are gaps with non-school-sponsored activities or understaffing of schools by health care professionals.
- There are three times as many catastrophic head injuries in football among high school athletes than college athletes, and 39 percent of the athletes were playing while still having symptoms from a prior head injury.
- In 2012, there were 163,670 young athletes seen in the emergency department for a concussion, which is more than 8 percent of the 1.35 million youth sports-related injuries reported to the emergency room, meaning every three minutes a child is seen in an ER for a sports-related concussion.
- Among high school athletes, concussion rates have risen 200 percent in the past decade.
Osteoarthritis and Translation to Practice
Acute traumatic knee joint injuries are common in young athletic populations and these injuries significantly increase the risk for posttraumatic osteoarthritis. Guidelines exist, note the authors, but need to be disseminated and implemented.
- According to the CDC, osteoarthritis affects 13.9 percent of adults in the United States aged 25 years and older and 33.6 percent (12.4 million) of those 65 and older: a total estimated 26.9 million U.S. adults.
The summit focused on questions to be asked as health care experts create a roadmap for change:
- Who needs to be involved in the discussions moving forward?
- What skills, knowledge and abilities do athletic trainers or others need in order to see their work through a public health lens?
- What educational opportunities and activities will promote the integration of athletic training and public health?
- In what areas are athletic trainers (and other health care professionals) already taking the lead in public health-related initiatives and in what other potential areas may athletic trainer expertise and public health- related initiatives overlap?
“As we look toward a public health model to address injury prevention, treatment and behavior modification, it is vital to incorporate a wide range of health care disciplines and to establish the policies and measures that ensure reduction of risk of injury in work, life and sport,” says Hoffman. “Policies and practices that positively impact large groups will ultimately result in better health, safety and well-being of physically active individuals.”