Assessment of Certified Athletic Trainers' Levels of Cultural Competence in the Delivery of Health Care

Context: The concept of culture and its relationship to athletic training beliefs and practices is virtually unexplored. The changing demographics of the United States and the injuries and illnesses of people from diverse backgrounds have challenged health care professionals to provide culturally competent care. Objective: To assess the cultural competence levels of certified athletic trainers (ATs) in their delivery of health care services and to examine the relationship between cultural competence and sex, race/ethnicity, years of athletic training experience, and National Athletic Trainers' Association (NATA) district. Design: Cross-sectional survey. Setting: Certified member database of the NATA. Patients or Other Participants: Of the 13 568 ATs contacted, 3102 (age = 35.3 +/- 9.41 years, experience = 11.2 +/- 9.87 years) responded. Data Collection and Analysis: Participants completed the Cultural Competence Assessment (CCA) and its 2 subscales, Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behavior (CCB), which have Cronbach alphas ranging from 0.89 to 0.92. A separate univariate analysis of variance was conducted on each of the independent variables (sex, race/ethnicity, years of experience, district) to determine cultural competence. Results: The ATs' self-reported scores were higher than their CCA scores. Results revealed that sex (F-1,F-2929 = 18.63, P = .001) and race/ethnicity (F-1,F-2925 = 6.76, P = .01) were indicators of cultural competence levels. However, we found no differences for years of experience (F-1,F-2932 = 2.34, P = .11) or NATA district (F-1,F-2895 = 1.09, P = .36) and cultural competence levels. Conclusions: Our findings provide a baseline for level of cultural competence among ATs. Educators and employers can use these results to help develop diversity training education for ATs and athletic training students. The ATs can use their knowledge to provide culturally competent care to athletes and patients and promote a more holistic approach to sports medicine.