Social Determinants of Health Analysis of Athletic Trainers’ Perspectives on Student-Athlete Food Security Constraints and Drivers: A Qualitative Study

Background: This study explored the observations and experiences of athletic trainers (ATs) regarding food security constraints and drivers among collegiate student-athletes through the framework of the social determinants of health (SDOH). Methods: Seventeen ATs from nine public Mountain West Division I schools participated in one of six 90 min, virtual focus groups conducted in July–December 2023. A phenomenological design and constructivist theoretical framework were employed to analyze transcripts, compile themes, infer food security constraints and drivers, and map them to SDOH domains. Results: Emerging constraints and drivers mapped to seven of the eight SDOH domains (education, employment, health systems and services, housing, income and wealth, physical environment, and social environment); no themes related to the public safety domain. Conclusions: ATs identified a considerable number of food security constraints and drivers; however, based on the findings of other studies, their observations were not comprehensive. Incorporating the findings of those other studies, food security constraints and drivers exist across all eight SDOH domains. Four concepts spanned multiple domains: student-athlete normative expectations, nutrition/food security prioritization, financial disparities, and residing off campus. To ensure food security among collegiate student-athletes, AT perceptions suggest that structural changes facilitating the implementation of necessary food drivers may be warranted.