Perceptions, awareness and knowledge of the Female Athlete Triad amongst coaches – Are we meeting the expectations for athlete safety?

Abstract

Female Athlete Triad (FATr) is a condition with the potential of long-term adverse effects on health and sports performance in female athletes. Coaches’ awareness and knowledge can play a critical role for primary prevention, early detection, and management of the triad. The primary objective of this study was to investigate the awareness, knowledge and perceptions of Singaporean coaches on Female Athlete Triad. The study was a cross-sectional survey with 106 participant coaches (81 males; 25 females) from the Singapore National Registry of Coaches. A 31-item questionnaire was developed to determine the perceptions, awareness, and knowledge on Female Athlete Triad. The coaches’ responses were obtained in the presence of the research team. Data analyzed included demographic and coaching practice information, awareness and knowledge levels, gender differences in knowledge and differences in awareness, and knowledge between participants with different levels of coaching qualification. A 100% response rate was achieved. The knowledge levels were found to be low with 85% coaches not having heard of the Female Athlete Triad, 89% coaches not able to identify at least one component of the triad, and only two coaches being able to correctly identify the three components of Female Athlete Triad. A significant proportion of coaches had misperceptions related to low body fat, leanness, menstrual irregularity, and bone health in female athletes. There was no significant difference in knowledge based on gender, level of coaching qualification, and years of coaching experience. Coaches have low levels of awareness and knowledge on Female Athlete Triad. The misperceptions and knowledge gaps need to be addressed through multifaceted coach education programs developing the awareness and knowledge on Female Athlete Triad, skills for early recognition of warning signs, early athlete referral to health professionals and attitudes and skills for regular communication with the athletes on nutrition, menstrual history, and bone health.