The Theory of Planned Behavior as a Framework to Identify Attitudes and Perceptions of Athletic Trainers towards Quality Improvement

Document Type


Publication Date


Publication Title

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association: Vol. 8: Iss. 4, Article 2.


Purpose: The BOC announced a concept for continuing professional certification for athletic trainers (ATs), including an optional quality improvement (QI) project to examine practice performance. The purpose of this study was to examine current attitudes, perceived control and subjective norms of ATs regarding QI. Method: Data was collected using a qualitative descriptive design. A web-based survey was distributed via email and social media. Open-ended questions were evaluated by two independent coders using a general inductive approach. Results: Three major themes emerged: reservations about QI, benefits of QI, and impacts on the profession. Conclusions: When integrated into the Theory of Planned Behavior model, results show that ATs demonstrate positive attitudes towards QI and agree that optimal patient outcomes are essential. However, many ATs perceive that they lack the appropriate knowledge about QI, how to implement QI, and the resources needed to be successful. Possible recommendations include a systems approach in which athletic training organizations and regulatory bodies consider providing ATs strategies to improve perceived control, such as continuing education opportunities and tools to advocate for resources. Additionally, the integration of QI into athletic training is a cultural shift; professional organizations may benefit from acknowledging and promoting enhanced clinician and patient outcomes.