North Carolina high school coaches’ knowledge of the Female Athlete Triad

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Michael C. Lowery (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
William Karper

Abstract: A condition unique to female athletes is the Female Athlete Triad, which can present as: (1) low energy availability (EA) or energy deficiency, to clinical eating disorders; (2) subclinical menstrual dysfunction or deficiencies to functional hypothalamic amenorrhea; and (3) low bone mineral density (BMD) or osteopenia to frank osteoporosis (De Souza et al., 2014; Javed et al., 2013; Loucks, Stachenfeld, & DiPietro, 2006; Nattiv et al., 2007). The likelihood of athletes presenting the full Triad simultaneously is only 1-16%, but the percentages of presenting with one (16-60%) or more (3-27%) of the components are considerably greater (De Souza, Koltun, Etter, & Southmayd, 2017; Gibbs, Williams, & De Souza, 2013). Current research regarding high school coaches has found only 2-14% of responding coaches could name all three components of the Female Athlete Triad (Triad) – low energy availability, low bone mineral density, and menstrual dysfunction (Brown et al., 2014; Mukherjee et al., 2016; Pantano, 2017; Troy et al., 2006). At present time, few studies investigating the reasons for this lack of Triad knowledge have been published. My primary objective was to identify Triad knowledge levels in NC high school coaches of female athletes, along with secondary objectives of identifying if Triad knowledge levels were associated with the gender or formal training of the coach. The survey used in this study was the exact same survey used for a previous study of collegiate coaches (Frideres, 2016). The questions were input into an online survey format using Qualtrics software. Participants were recruited via an email which included an anonymous link to the survey. Responses were collected from 137 current North Carolina high school coaches of female athletes, 96 of whom completed every knowledge question - 62 males (65%) and 34 females (35%). Twenty-five percent of the 137 responding coaches correctly identified the three components of the Triad, and of the 96 who completed all questions, the average score was 67% correct. Female coaches (72% correct) scored significantly higher than male coaches (64% correct) on the entire survey (p < .0005). Respondents who identified as having Kinesiology-related degrees (N = 36) scored slightly better on the total survey (69% correct) than those with other subject area degrees (66% correct), but the difference was not significant (p = .258). There has been a significant amount of research done on the Female Athlete Triad in general, and enough done specifically on the Triad knowledge of coaches at various levels to know that overall education is lacking (Brown et al., 2014; Frideres et al., 2016; Mukherjee et al., 2016; Pantano, 2006; Pantano, 2017; Troy et al., 2006). Since only 25% of the coaches in this survey could correctly answer the question that asked them to identify the three components of the Triad, it would be beneficial for Triad-specific professional development to be presented to coaches of female athletes on a yearly basis. The Triad should similarly be included as part of the curriculum during the formal training of any discipline where graduates will have contact with adolescent female athletes as part of their profession. School-level policies need to be put in place to help identify athletes who are at risk for the Triad, and stakeholders need to be given the knowledge, skills, and resources to ensure those at-risk athletes get the help they need.

Additional Information

Language: English
Date: 2018
Athlete, Female, Triad, Female athlete triad
Coaches (Athletics) $z North Carolina
Women athletes $x Health and hygiene
Female high school athletes $x Health and hygiene

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