Context Interprofessional and collaborative practice (IPCP) is thought to improve comprehensive patient care but is often hindered by a lack of knowledge about the scope of training of other providers, inadequate communication, and structural barriers. The secondary school setting may pose unique challenges to IPCP. Objective To investigate the perceptions and practices of secondary school athletic trainers (SSATs) regarding IPCP. Design and Setting Cross-sectional, Web-based survey. Patients or Other Participants Secondary school athletic trainers (N = 379, age = 35 ± 11 years, experience = 12 ± 10 years). Intervention(s) We used a modified version of the Clinician Perspectives of Interprofessional Collaborative Practice Survey, a validated survey consisting of 6 sections representing 6 different constructs (48 items) and 4 open-ended response questions focused on perceived challenges, resources, drawbacks, and benefits relative to IPCP. Main Outcomes Measure(s) We calculated descriptive statistics, including a composite mean, to characterize the scores on each construct. We analyzed the open-ended, qualitative data using general inductive coding and used multiple analysts and auditing to establish trustworthiness. Results We contacted 4666 SSATs to complete the survey. We had 507 (10.9%) SSATs respond, and 379 (74.8%) completed the survey in its entirety. Secondary school athletic trainers agreed with or marked that statements were either always true or sometimes true for all constructs. Three main themes emerged from the open-ended data: (1) communication, (2) infrastructure, and (3) learning. Communication was deemed critical, and having access to shared information improved collaboration. Secondary school athletic trainers were often responsible for initiating communication. A strong infrastructure that enhanced access to other providers, incorporated parents, and improved efficiency helped support IPCP. Interprofessional and collaborative practice resulted in learning between providers, including roles and responsibilities, which yielded stronger trust and respect. Interprofessional and collaborative practice resulted in idea sharing and potentially improved patient outcomes. Conclusions Although SSATs described regular use of IPCP in practice, barriers exist that diminish IPCP including communication, infrastructure, and learning between professions.

Current social determinants of health (SDOH) tools exist to assess patient exposure; however, healthcare providers for the adolescent population are unsure of how to integrate SDOH knowledge into clinical practice. The purpose of this study was to validate a focused history script designed to facilitate SDOH conversations between clinicians and adolescents through the use of the Delphi method. Six individuals (1 clinician, 5 educators/researchers) participated as expert panelists. Panelists provided critical feedback on the script for rounds 1 and 2. For rounds 3–7, panelists received an electronic questionnaire asking them to indicate agreement on a 6-point Likert scale (1 = strongly disagree, 6 = strongly agree). We defined consensus as mean item agreement ≥ 5.0 and percent agreement ≥ 80%. In round 7, panelists rated overall script level of agreement. After seven rounds of feedback, the focused history script achieved content validity with 100% of panelists agreeing on the final 40-item script. A focused history script for the SDOH was content validated to aid conversations between healthcare providers and adolescent patients on factors that affect their life, school, and play. Addressing social determinants of health with adolescent patients will improve cultural proficiency and family-centered care delivered by school healthcare professionals.

Low back pain is a common health concern. The development of myofascial trigger points due to low back pain can cause debilitating pain and loss of functional movement in patients. Dry needling is a minimally invasive procedure that has shown to be useful in the treatment of myofascial trigger points when used with other forms of treatment. However, the literature surrounding dry needling and myofascial trigger points in patients with low back pain is lacking. The guiding systematic review and meta-analysis sought to analyze the effectiveness of dry needling for patients with low back pain. The review utilized eight databases for randomized controlled trials and selected 11 of 784 articles for analysis based on inclusion and exclusion criteria. A 6-subgroup meta-analysis was conducted on these studies, and 6 of the 11 studies were found to have high risk of bias. The included studies used both pain measurements and functional measurements including the visual analogue scale (VAS), Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ). The studies did not include objective functional measurements. Overall researchers found a clinically meaningful decrease in outcome scores in the short-term, but there were no significant differences in pain or functional outcomes through long-term follow-up. This seems to correlate with the current literature on dry needling and its inflammatory effects on the body, suggesting that dry needling alone does not provide any long-term effect on myofascial trigger points in patients with low back pain. Dry needling should be combined with other treatments and high-quality rehabilitation to provide longer-lasting results and better treatment outcomes for patients with low back pain.

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Context Developing effective interprofessional teams is vital to achieving quality care for those dealing with behavioral health concerns. Athletic trainers (ATs) play a vital role as they are often the first healthcare provider to interact with student-athletes participating in intercollegiate athletics. However, research regarding how behavioral health providers view the AT's role on interprofessional behavioral health teams is limited. Objective To explore behavioral health providers' perceived role of ATs in collaborative behavioral healthcare. Design Qualitative. Setting Individual interviews. Patients or Other Participants Nine behavioral healthcare providers (women=6, men=3; age range=30–59 years, years in clinical practice=6–25 years) from NCAA Power 5 schools were interviewed. Data Collection and Analysis Participants were contacted via publicly available contact information from their university websites. Participants engaged in an individual, audio-only interview using a commercially available teleconferencing platform. All interviews were recorded, transcribed, and returned to participants for member checking. A phenomenological approach with inductive coding and multi-analyst triangulation was performed to analyze the transcripts for common themes and sub-themes. Results Three themes emerged: (1) provider experience, (2) AT's role in behavioral health, and (3) collaboration. Provider experience included sub-themes of formal education and interaction with ATs. Sub-themes of an AT's role included care coordination, information gathering, and positive proximity. Sub-themes for collaboration included structural collaboration, cultural collaboration, collaboration concerns, and suggestions for ideal collaboration. Conclusions Collaborative care models can enhance providers' ability and maximize support of student-athlete wellness. This study demonstrates that behavioral health providers working within a collaborative care model with ATs have overall positive experiences with such collaboration, and that clear role delineation and responsibilities help to foster high-quality patient care.