Research & Practice

Exploring the Role of High School Athletic Trainers in Relative Energy Deficiency in Sport and Eating Disorder Early Detection, Prevention, and Return to Play

Worldwide prevalence of eating disorders among adolescents is increasing and current research suggests that in the United States and Europe, 5.5-17.9% of young women and 0.6–2.4% of young men have experienced a DSM-5 eating disorder (ED) by early adulthood. Athletes are at greater risk of developing an eating disorder and the age of onset is commonly during adolescence. Athletes are also at a greater risk of nutritional deficiencies, with low energy availability (LEA) prevalence ranging from 22% to 58%. Inadequate nutrition during adolescence can results in long-term health consequences including, but not limited to, impaired brain development, stunted bone growth, and hormonal abnormalities. The aim of this project was to address the growing prevalence of EDs and relative energy deficiency in sport (RED-S) in high school athletes by exploring the role of athletic trainers (ATs) in 1) the early detection of EDs and RED-S in high school athletes and, 2) return-to-play protocols during/after an ED or RED-S diagnosis. After developing a continuing education (CE) workshop for the Seattle Children’s Hospital (SCH) AT department, a needs assessment was conducted to show that many healthcare providers are unaware of the role ATs play in local high schools and how they can assist in early detection and monitoring of EDs and RED-S. Next steps include:

  • Educating healthcare providers on how ATs can support in return to play monitoring.
  • Exploring how to improve communication pathways between ATs and health care providers.
  • Formalizing a referral pathway for ATs at SCH.
  • Identifying an approved screening tool for ATs.
  • Incorporating SEES Guidelines into AT protocols at local high schools.

Materials Available

Project Type(s): MPH Practicum, PH Concentration Poster

Author(s): Victoria Jansen

Program(s): Master of Public Health, RDN Training

Year: 2023