Gender- and/or sex-specific considerations for sport-related injury: a concept mapping approach for the Female, woman and/or girl Athlete Injury pRevention (FAIR) consensus
Kay M. Crossley, M. Haberfield, Andrew G Ross, L. Gracias, Andrea M Bruder, Jackie L. Whittaker, Araba Chintoh, Jane S Thornton, Margie H. Davenport, Margo Mountjoy, Melanie Hayman, Brooke Patterson, Cheri Blauwet, Evert Verhagen, Carla van den Berg, Carole Akinyi Okoth, Caroline Bolling, Dina C. Janse van Rensburg, Ellen Casey, Naama Constantini, Nana Akua Achiaa Adom-Aboagye, Rita Tomás, Yuka Tsukahara, Carolyn A. Emery, H Paul Dijkstra, Alex Donaldson
Abstract
Objective This study aimed to gather and represent experts’ perspectives on the gender- and/or sex-specific factors relevant to injury risk for female/woman/girl athletes. Methods Mixed-methods concept mapping study. Sixty-six experts including cisgendered (1) athlete/coach/carers, (2) clinicians, (3) sports science/high-performance professional, (4) administrators and (5) researchers brainstormed statements to a prompt (‘What gender-specific and/or sex-specific factors do you think contribute to injury risk among female, woman and girl athletes?’) before thematically sorting and rating the statements/factors for importance and modifiability (5-point Likert scales). Results Ten clusters were constructed from 101 unique statements/factors. The clusters (number of statements) include: (1) Inequitable organisational funding and support (n=17); (2) Athletes’ lack of, and access to, resources (n=7); (3) Lack of knowledge and expertise among support staff (n=6); (4) Lack of evidence for, and implementation of gender and sex-appropriate injury prevention (n=20); (5) Sex-related factor s (n=14); (6) Gendered health (n=8); (7) Gendered expectations to conform to athletic ideals and norms (n=10); (8) Gendered harassment (interpersonal violence) and social biases (n=9); (9) Gendered sport environment (7); (10) Gendered communication (n=3). Lack of knowledge and expertise among support staff was deemed the most important and modifiable cluster to address gender- and/or sex-specific factors relevant to injury prevention for female/woman/girl athletes. Conclusion Ten gender- and/or sex-specific clusters, ranging from organisational to biological considerations and societal influences, were defined that could impact female/woman/girl athlete injury risk factors. Advancing stronger evidence for gender and sex appropriate injury prevention is urgently needed.