Are female athlete concerns being considered in preparticipation examinations? A needs assessment in Canadian...

Preparticipation examinations (PPEs) are commonly used to gather athletes' baseline health information. However, they often lack content specific to the health needs of female athletes. Therefore, this study aimed to: 1) identify which female-specific health questions athletes recall being asked during PPEs; 2) determine what questions athletes believe are missing; and 3) explore female athletes' comfort with disclosing health concerns.

Cross-sectional survey.

The survey was distributed to Canadian varsity female athletes during their 2023-2024 season. It included multiple-choice and open-ended questions spanning five domains: pelvic health, menstrual health, Relative Energy Deficiency in Sport (REDs), musculoskeletal (MSK) health, and mental health. Descriptive statistics were used to summarize quantitative data, while inductive content analysis was used for open responses.

Ninety-three athletes (mean age 21 ± 2.2 years) completed the survey. Sixty percent reported completing a PPE, and 84% indicated that there was no follow-up after completion. Fewer than half of athletes recalled being asked about mental health (42%), REDs (37%), menstrual health (33%), or pelvic health (2%). Athletes ranked inclusion of mental, MSK, REDs, menstrual, and pelvic health questions in descending order of importance. Athletes who felt comfortable disclosing health concerns recognized the performance and well-being benefits of doing so. Those who were uncomfortable cited not understanding the relevance of certain questions and/or mistrust regarding who would access their information.

PPEs in Canadian varsity sport are often lacking female-specific questions. Clarifying PPE purpose, benefits and data sharing may improve trust, disclosure, and athlete health outcomes.