Poster 126: Emergency Action Planning in United States High Schools
Authors: Ayres Jack , Messamore William , Tarakemeh Armin , Baker Jordan , Salazar Luis , Vopat Bryan , Darche JP , Hedberg Riley 
Published: July 2022

Objectives: Current evidence shows a variable rate of emergency action plan (EAP) implementation and a low rate of compliance to EAP guidelines in United States secondary schools. There is limited data on emergency preparedness of schools without access to an athletic trainer (AT). The purpose of this study was to identify the emergency preparedness of public high school athletics in the United States. Methods: A web-based questionnaire was developed to perform a cross-sectional analysis of the emergency preparedness of high schools. The questionnaire included 24 questions focused on demographics of the study population, EAP adoption, compliance to national EAP guidelines, access to certified medical personnel, and training received by athletics personnel. The questionnaire was delivered electronically through email by each State High School Athletics Association (SHSAA) to athletic trainers, athletic directors, and coaches of recipient schools. Results: Schools with a larger number of students enrolled were significantly associated with greater proportions of having an EAP (p<.0001), having an AT on staff (p<.0001), requiring additional training for coaches (p = .0003), and having an AED on-site for all events (p = .0021). Urban districts (OR=3.514, 95% CI=[2.242, 5.507], p <.0001) and suburban districts (OR=4.950, 95% CI=[3.287, 7.454], p <.0001) were more likely than rural districts to have an athletic trainer on staff. Rural districts were more likely than suburban districts to report financial barriers (OR=1.867, 95% CI=[1.051, 3.318], p=.0321). Rural districts were more likely than both urban (OR=1.901, 95% CI=[1.104, 3.268], p=.0192) and suburban (OR= 2.825, 95% CI=[1.770, 4.505], p<.0001) to report that additional funding would help meet NATA EAP best practice standards. High poverty districts (96 urban, 69 suburban and 157 rural) were less likely to have an AED for all athletic venues (OR=.660, 95% CI=[.452, .964], p=.0311) and less likely to have an EAP (OR=.511, 95% CI=[.306, .853], p=.0092). Among districts that were impoverished, rural districts were less likely than urban (OR=.268, 95% CI=[.153, .469], p<.0001) and suburban (OR=.121, 95% CI=[.056, .260], p <.0001) to have an AT on staff, more likely than suburban districts to report financial barriers (OR=1.867, 95% CI=[1.051, 3.318], p=.0321), and more likely to report barriers related to access to medical providers than urban (OR=3.403, 95% CI=[1.666, 6.949], p=.0005) and suburban (OR=3.900, 95% CI=[1.664, 9.144], p=.0010). Conclusions: The results of this study suggest that lower enrollment, high poverty and rural schools are less prepared for athletic emergencies than their higher enrollment, low poverty and suburban counterparts given the fact that these schools are generally less likely to have an AT on staff, less AEDs available at sporting events, lor to have EAPs implemented and less likely to provide additional training. Among these classifications, rural status may be the most important indicator, given that a comparison of impoverished schools demonstrates that rural schools were less likely to have ATs on staff and more likely to report financial barriers and barriers related to access to medical providers compared to poor urban and suburban schools. Financial barriers likely underly many of the findings in this study, as well as barriers related to access to medical professionals. Future improvement strategies should seek to identify ways to overcome these barriers and encourage compliance with NATA recommendations.