title: Assessment of certified athletic trainers' levels of cultural competence in the delivery of health care.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Certified member database of the NATA.
  
  
  METHODS
  Of the 13 568 ATs contacted, 3102 (age = 35.3 +/- 9.41 years, experience = 11.2 +/- 9.87 years) responded.
  
  
  METHODS
  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(1,2929) = 18.63, P = .001) and race/ethnicity (F(1,2925) = 6.76, P = .01) were indicators of cultural competence levels. However, we found no differences for years of experience (F(1,2932) = 2.34, P = .11) or NATA district (F(1,2895) = 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.
authors.affiliation: Michigan State University, East Lansing, MI 48824, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Marra
authors.forename: Tracey
authors.initials: T
authors.lastname: Covassin
authors.forename: René R
authors.initials: RR
authors.lastname: Shingles
authors.forename: Renee Branch
authors.initials: RB
authors.lastname: Canady
authors.forename: Tom
authors.initials: T
authors.lastname: Mackowiak
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D016001:Confidence Intervals; D054521:Cultural Competency; D018864:Cultural Diversity; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011594:Psychometrics; D013178:Sports Medicine / Q000592:standards*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014481:United States