Date of Award

Spring 2018

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Services Research

Committee Director

Denise M. Claiborne

Committee Director

Bonnie L. Van Lunen

Committee Member

Cailee E. Welch Bacon

Committee Member

Cailee E. Welch Bacon


Many secondary school athletes are lacking appropriate medical care during sport participation. Athletic trainers (ATs) are qualified healthcare professionals that can fill this need. Barriers to hiring ATs within this setting have been identified, however important information from administrators is lacking on why secondary schools choose to utilize ATs. Understanding this decision making process has the potential to guide future strategies to increase the number of secondary schools that employ ATs and improve retention of athletic training positions within the secondary school setting.

Our objective was to explore athletic directors’ perceptions of the roles and services provided by ATs working in the secondary school setting and to understand the needs of the athletic program and school in terms of the utilization of athletic training services. Utilizing a qualitative methodology, ten high school athletic directors employed by schools that utilize the services of full-time ATs completed a telephone interview facilitated by a semi-structured interview guide. All interviews were recorded and transcribed verbatim. Data was analyzed following the consensual qualitative research approach (CQR). Data credibility was established through peer review, field notes, member checking, and multiple analyst triangulation. Five themes emerged. Justification pertained to reasons athletic directors would use to defend or justify why they utilize ATs within their schools. Athletic trainer roles and responsibilities represented the observed services provided by ATs. Recognition of worth referred to the evaluation of and appreciation for the AT’s position within the school. Challenges represented the concerns and struggles athletic directors faced regarding the use of ATs within their athletic programs. Influencing factors consisted of aspects related to the decision to utilize ATs within athletic programs. The findings demonstrate that athletic directors have an appreciation for and overall understanding of the services provided by ATs in the secondary school setting. The value of secondary school ATs is predominantly supported by anecdotal evidence rather than formalized assessment methods or the use of data driven materials. Despite the athletic director’s administrative role, school board members hold the ultimate authority in the decision making process to utilize ATs in this setting.