Effective engagement of survivors of harassment and abuse in sport in athlete safeguarding initiatives: a review and a conceptual framework

A Rapid Review on Complaint Mechanisms for Interpersonal Violence: Integrating Research-Based Recommendations from Multiple Sectors to Inform Sport Settings

Past studies have highlighted the lack of independent formal complaint mechanisms as one of the most significant barriers to reporting interpersonal violence (IV) in sport. Some countries have since implemented complaint mechanisms specific to sport settings. Evaluations of similar mechanisms in other sectors could inform the development and implementation of complaint mechanisms for IV in sport. This rapid review included studies inside and outside the sport context to document the characteristics of complaint mechanisms of IV, barriers or limitations related to such mechanisms, and recommendations resulting from their evaluation. Following the Cochrane Rapid Reviews Interim Guidance, six databases were searched for peer-reviewed references in English or French, published between 2012 and 2022, and pertaining to the evaluation of formal reporting mechanisms of IV. The 35 references covered mechanisms mainly targeting IV in general (any type) or sexual violence specifically. Complaint mechanisms varied in scope and as a function of their setting, including work, university, military, and medical. We identified barriers and limitations concerning fear of consequences, lack of knowledge, lack of efficiency, lack of trust, and unsupportive culture. Finally, we documented 18 recommendations to improve complaint mechanisms of IV, spanning four categories: (a) organizational accountability, (b) awareness and accessibility, (c) adapted process, and (d) ongoing evaluation. This rapid review draws recommendations from various research disciplines and types of mechanisms to offer a comprehensive portrait of best practices. The findings show that numerous aspects of complaint mechanisms at multiple levels should be considered when developing and implementing complaint mechanisms of IV.

#WhatWouldYouDo? A cross-sectional study of sports medicine physicians assessing their competency in managing harassment and abuse in sports

OBJECTIVES

To assess the clinical competence of sports medicine physicians to recognise and report harassment and abuse in sports, and to identify barriers to reporting and the need for safeguarding education.

METHODS

We implemented a cross-sectional cohort study design recruiting through social media and international sports medicine networks in 2023. The survey captured participant perceptions related to the harmfulness of harassment and abuse. The survey incorporated the reasoned action approach as a theoretical framework to design survey questions to identify attitudes and self-efficacy to detect and report suspicions of harassment and abuse and to identify barriers to reporting.

RESULTS

Sports medicine physicians (n=406) from 115 countries completed the survey. The situations of harassment and abuse presented in the survey were described by sports medicine physicians as having occurred in the 12 months before participating in the survey. Despite recognising the situations as harmful, sports medicine physicians were somewhat uncomfortable being vigilant for the signs and symptoms and reporting suspicions and disclosures of harassment and abuse (M=2.13, SD=0.67). In addition, just over one-quarter (n=101, 26.9%) was unaware of where to report harassment and abuse, and over half did not know (n=114, 28.1%), or were uncertain (n=95, 23.4%) of who the safeguarding officer was in their sports organisation. Participants identified many barriers to reporting harassment and abuse, including concerns regarding confidentiality, misdiagnosis, fear of reprisals, time constraints and lack of knowledge. Over half felt insufficiently trained (n=223, 57.6%), and most respondents (n=324, 84.6%) desired more education in the field.

CONCLUSIONS

Educational programmes to better recognise and report harassment and abuse in sports are needed for sports medicine trainees and practising clinicians. An international safeguarding code for sports medicine physicians should be developed.

Assessing the Reliability of the Sexual Violence Questionnaire in Sport among Spanish-Speaking Athletes

The prevalence of sexual harassment and abuse in school sport, specifically by coaches against their athletes, remains a concerning and pervasive issue. In an attempt to better understand and prevent specific coach-behaviours associated with such sexual misconduct, researchers have developed the Sexual Violence Questionnaire in Sport. While the reliability of this measurement tool has been tested in Anglo-Saxon cultural contexts, it is not known whether the questionnaire is applicable to other cultural contexts. This study aimed to analyse the internal consistency and reliability of the questionnaire on sexual harassment in sport, originally designed and developed in English. A sample of 146 (52 female, 94 male) undergraduate students from a university in the Basque Country participated in this cross-sectional study. The questionnaire was administered twice over a two-week period to assess test-retest reliability. The internal consistency of the Sexual Violence Questionnaire in Sport was high, with Cronbach's alpha values of 0.891 for perceptions and 0.813 for experiences across all participants. Gender-specific analysis showed similar reliability, with females having slightly lower alpha values for perceptions. Although significant differences were observed between the test and the retest on eight perception items and one experience item, Cohen's kappa analysis indicated agreement on all items; however, some of them were low (e.g., 0.13). In conclusion, the study highlights the questionnaire's overall reliability and suggests its effectiveness as a tool for measuring sexual violence in sport within the Spanish context. Nonetheless, the findings of this study underscore the need for further research to enhance the instrument's stability and to better understand gender differences in perceptions and experiences of sexual violence in sport contexts.

The role, readiness to change and training needs of the Athlete Health and Performance team members to safeguard athletes from interpersonal violence in sport: a mini review

Safeguarding athletes from interpersonal violence (IV) in sport is an important topic of concern. Athlete Health and Performance (AHP) team members working with athletes have a professional, ethical, and moral duty to protect the health of athletes, prevent IV, and intervene when it occurs. However, little is known on their respective roles regarding IV in sport and their needs to fulfill their responsibility of safeguarding athletes. The aim of this review is to synthesize knowledge about the roles, readiness to change and training needs of AHP team members to navigate IV in sport. A total of 43 articles are included in the review. Results show that all AHP team members have a role to play in safeguarding athletes and should therefore be trained in the area of IV in sport. Overall, very little research has directly assessed AHP team members' needs to positively foster safety and eliminate IV in sport. There are common training needs for all types of AHP team members such as the ability to recognize signs and symptoms of IV in sport. However, there are also specific needs based on the role of the AHP team members such as ways of facilitating behavioural change for sport managers. Findings from this review are mostly experts' recommendations and should therefore be interpreted as such. The results of the review can guide the development of future research and recommendations.

Effect of mindfulness-based programmes on elite athlete mental health: a systematic review and meta-analysis

OBJECTIVE

To determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Eight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes.

RESULTS

Of 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedges g=-0.87, number of studies (n)=6, p=0.017, I ²=90) and stress (g=-0.91, n=5, p=0.012, I ²=74) and increasing psychological well-being (g=0.96, n=5, p=0.039., I ²=89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity.

CONCLUSION

MBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport.

PROSPERO REGISTRATION NUMBER

CRD42020176654.

Gender-specific psychosocial stressors influencing mental health among women elite and semielite athletes: a narrative review

Elite and semielite athletes commonly experience mental health concerns and disorders. Compared with men athletes, women athletes are at greater risk of a range of psychological stressors that contribute to health concerns and mental health disorders, which can impact their career satisfaction and longevity. In order to address and improve the mental health of women athletes, it is necessary to simultaneously tackle the gender specific psychosocial stressors that contribute to mental health outcomes. This narrative review examines the gender-specific stressors that affect mental health and well-being in women athletes, some of which are modifiable. Psychosocial stressors identified include exposure to violence, be it psychological, physical or sexual in nature, which can result in a myriad of acute and long-lasting symptoms; and inequities as reflected in pay disparities, under-representation in the media, fewer opportunities in leadership positions and implications associated with family planning and motherhood. Strategies to promote mental health in women athletes should be considered, and where possible, should proactively address gender-specific stressors likely to influence mental health in order to maximise positive outcomes in women athletes.

Evaluation of Publicly Accessible Child Protection in Sport Education and Reporting Initiatives

Despite sport being a vehicle through which youth may achieve positive developmental outcomes, maltreatment in the youth sport context remains a significant concern. With increased athlete advocacy and research demonstrating the high prevalence of maltreatment in sport, and the urgent need to address it, many international organisations have created child protection in sport initiatives. Of particular focus to athletes and researchers is the provision of evidence-based comprehensive education and independent reporting mechanisms for athletes who experience harm. The current study examined the extent to which the publicly accessible information provided by three sport-specific child protection organisations regarding education and reporting is aligned with recommendations provided by researchers and athletes. With regard to education, the findings highlight accessibility, programming for various stakeholders, and coverage of topics of interest (e.g., forms of harm and reporting processes). However, educational information about equity, diversity, and inclusion and information on how to foster positive environments in sport was lacking. For reporting mechanisms, results showed that each organisation’s approach to receiving reports of maltreatment varied, including their ability to directly intake, investigate, and sanction instances of maltreatment. The findings are interpreted and critiqued considering previous literature and recommendations for future research and practice are suggested.

Navigating in the Gray Area of Coach-Athlete Relationships in Sports: Toward an In-depth Analysis of the Dynamics of Athlete Maltreatment Experiences

Several studies have revealed the abusive behaviors directed against athletes in various sports contexts, but knowledge about the processes by which the athletes realize and accept or reject maltreatment is underdeveloped. Thus, it is difficult to establish a solid scientific basis for characterizing the mechanisms of maltreatment from the athletes' perspective regarding the forms of maltreatment they endure and the impact on their performance and wellbeing. The main goals of this paper are to show how the enactive approach (including theoretical assumptions and methodological standards) can meet these challenges, as it is well-suited to (a) describe the evolving interactions between athletes and the sports situations that lead to maltreatment (i.e., navigating in the gray area of coach-athlete relationships), (b) identify those alert landmarks that help us assess the level of risk of athlete maltreatment, and (c) provide concrete guidelines to prevent and deal with sports-related maltreatment. We illustrate our approach by a case study that examines the experience of a retired high-level boxer who faced several forms of maltreatment. Our results reveal a dynamic change in the interactions between the boxer and the maltreatment situations that led her through (a) Acceptance (i.e., future-oriented positive involvement), (b) Regulation attempt (i.e., negative feelings about weight loss, exhaustion and loneliness, questioning the compromise between performance and health, acceptance and loneliness), (c) Distancing (i.e., reopening to others) and (d) Rejection (i.e., rebellion and the decision to stand up to her coach and leave). Based on our results, we present concrete guidelines to prevent and address sports-related maltreatment, with four progressive alert landmarks that help situate the athlete in the gray area of coach-athlete relationships and suggest a “timeline” of maltreatment escalation with key warnings.

Research and Implementation of Distributed Computing Management System for College Students' Sports Health Based on Integrated Regional Collaborative Medical Care

This paper constructs and applies a university student sports health management system through the theory of integrated regional collaborative medical care and distributed computing technology. Firstly, it analyzes the current situation and problems of cross-regional medical care, the root causes, and the corresponding business scenarios, reflecting the development trend of cross-regional medical care, in the light of the current practical needs of cross-regional medical care. In response to the strong demand for cross-regional medical care, this paper gives the overall design of the distributed computing system, for the deployment and architecture of the cross-regional platform; the registration of cross-regional patients, regional platforms, and health events and documents; and data exchange, service integration, and process integration, etc. The corresponding design is given. The research was conducted on several medical institutions to refine the functional requirements for the construction of the regional collaborative medical platform, and the requirements were analyzed to present the research results of the collaborative medical project. Based on this, requirements were made for the preparation of the project construction data center and medical institutions, and the remote consultation and two-way referral modules of the distributed collaborative medical platform were designed, which are processed and analyzed through a system composed of multiple servers. The results are returned to the user, and the design results were tested for functionality, compatibility, security, and other usability tests. The necessity and feasibility of the college physical health test data platform were analyzed. Students have various needs for physical test data management, the necessity of designing the college physical health test data platform, and the feasibility of the college physical health test data platform in terms of technical means, theoretical basis, and social environment.