Low energy availability (LEA) is common among female student-athletes and contributes to reduced bone mineral density and hormonal dysfunction. However, limited research exists on student-athletes of color, making it difficult to generalize results across populations, particularly Historically Black Colleges and Universities (HBCUs) student-athletes. Objectives: This study examined the energy needs and LEA prevalence, with or without eating disorder (ED) risk, among HBCU female student-athletes. Methods: Twenty-seven female student-athletes (age = 19 ± 1 year; height = 166.9 ± 7.6 cm; weight = 68.8 ± 11.3 kg) completed baseline measures, including the Eating Disorder Inventory-3 (EDI-3), EDI-3 symptom checklist (EDI-SC), anthropometric measures, and resting metabolic rate (RMR). Participants maintained a dietary log to measure energy intake and wore a heart rate monitor to estimate exercise energy expenditures for 7 days. LEA was defined as <30 kcal/kg of fat-free mass (FFM)/day. Results: The mean energy availability (15.9 ± 10.1 kcal/kg FFM/day) indicated 92.6% of participants (n = 25) displayed LEA; of those, 60% (n = 15) had LEA with ED risk. ED risk was identified in 59.3% of student-athletes (n = 13; EDI-3: n = 2; SC: n = 3; Both: n = 11). Interestingly, of the two student-athletes without LEA, one was identified at risk for EDs using both the EDI-3 and SC. Conclusions: HBCU female student-athletes face high risks of LEA and EDs, with most showing signs of both. This underscores the need for culturally sensitive interventions to improve EA and support mental health in this underserved group. Clinicians should focus on nutrition education and early ED identification to enhance long-term health and athletic performance.
Context: While increasing telehealth use throughout sports medicine has improved patients’ access to health care, some communities may not have the same opportunities to connect with a provider. Barriers to telehealth implementation can be influenced by internal (eg, provider’s digital health literacy and resources) and external (eg, community’s social determinants of health or “SDOH”) factors. This study aimed to assess the impact of internal and external factors on telehealth use by athletic trainers (ATs). Design: Cross-sectional survey. Methods: In total, 767 ATs participated in the study. Participants (age = 39 [13] y) completed a survey containing the electronic health literacy scale and digital health literacy instrument, reported professional use of telehealth as a provider (yes/no), provided resources at their clinical site, and provided the zip code for the community they served. After data collection, the researchers extracted SDOH information using the zip code data from 2 US databases, including population density, median household income, poverty index, education level, and technology access. Chi-square or independent samples t tests were conducted to compare telehealth use by each SDOH factor. Results: In total, 62.3% (n = 478/767) of ATs reported using telehealth, and 81.6% of ATs (n = 626) had a dedicated facility to offer health care services. We identified a significant difference in digital health literacy scores between users and nonusers of telehealth (P = .013). We did not identify any significant differences between telehealth users by community type (P = .957), population density (P = .053), income (P = .462), poverty index (P = .073), and computer (P = .211) or broadband internet access (P = .295). Conclusions: Our data suggest that internal factors such as digital health literacy and clinical site resources may have contributed to an AT’s previous telehealth use in clinical practice. However, the SDOH data extracted from the community zip code where the AT provided clinical services were similar for those with and without previous telehealth use.
1 March 2025 in Sports Medicine and Health Science
Marching band (MB) artists are often part of the general student population and not required to complete a pre-participation health screening to identify predisposing medical conditions or risks for injury/illness. Anecdotally, exertional heat illnesses (EHI) are a concern for MB artists. As more athletic trainers provide MB healthcare, research is needed on EHI occurrence and MB associated EHI risk factors. We utilized an exploratory cross-sectional study design to determine EHI risk factors, including previous EHI occurrence, among collegiate MB artists. MB artists (n = 1 207; age = [19.6 ± 1.3] years) actively participating in their college/university's MB during the 2019 football season completed an online survey to characterize demographics, medical history, medication and supplement use, and nutrition behaviors. Chi-square and binomial logistical regressions assessed associations between categorical variables. Previous EHI was reported by 50.6% of MB artists, with 466 (76.3%) experiencing exertional heat exhaustion and 31 (5.1%) exertional heat stroke. More females reported exertional heat exhaustion overall (68.2%, p < 0.001) and in the previous year (73.3%, p < 0.001). Experiencing a previous EHI was significantly associated with having a mood/neurological condition (63.5%, p < 0.001), diagnosed (74.3%, p = 0.004) or perceived eating disorder (66.7%, p < 0.001), and taking prescription medications (59.4%, p < 0.001), over-the-counter medications (58.9%, p = 0.002), and supplements (55.4%, p = 0.037). Half of collegiate MB artists reported experiencing previous EHIs and engaged in behaviors known to increase EHI risk. MB artists should complete pre-participation examinations to identify pre-existing medical conditions and risks for adverse medical events. Healthcare providers working with MB artists should develop policies and procedures to mitigate EHI risks and occurrence.
1 September 2024 in International Journal of Athletic Therapy and Training
Mindful Sport Performance Enhancement (MSPE) training is a relatively new concept, which focuses on helping athletes manage a variety of stressors experienced throughout a season, including performing well academically, staying fit, having a productive season in their sport, and maintaining a healthy social life. A need for a critical appraisal is needed to assess the effectiveness of the intervention. Two cohort studies and one randomized control trial were included in the study and assessed using STROBE and PEDro Scale. Key results show, all 3 studies identified participants experiencing benefits after MSPE with aspects of awareness, acceptance, and emotion regulation. Furthermore, student-athletes who attended either all the sessions or more sessions after the 6-week course showed greater satisfaction with mental and physical health. Overall, there is level “B” evidence to support effectiveness of MSPE for college athletes in reducing sport anxiety and improving their overall well-being.
Purpose: Female student-athletes attending Historically Black Colleges and Universities (HBCUs) may encounter distinct challenges related to food access, particularly when their campuses are situated in areas with limited food availability. This study assessed food security (FS) and explored the lived experiences of HBCU female student-athletes regarding their food environments and access to nutrition. Methods: This qualitative study used a semi-structured interview protocol derived from quantitative data. Participants were 10 HBCU female athletes (age = 19 ± 1 years) living in on-campus dormitories; recruited after completing a quantitative study examining energy needs. The three-part semi-structured interview protocol included questions about personal experiences surrounding food access and the U.S. Department of Agriculture Six-Item Short Form of the Food Security Survey Module. Interviews were recorded and transcribed verbatim. Three coders analyzed data using the consensual qualitative research tradition. Trustworthiness was established using member checking, multi-analyst triangulation, and external auditing. Results: FS status was evenly distributed among participants (five food secure, five food insecure). Four domains emerged: (1) on-campus living, (2) personal factors, (3) convenience, and (4) nutritional awareness. Participants described navigating limited cooking resources, inconsistent cafeteria offerings, and time constraints that influenced their food choices. While food sources were available both on and off campus, many participants expressed that these options did not consistently align with their preferences or nutritional needs. Reflections on dietary habits revealed varying levels of nutritional awareness and a desire for more tailored guidance. Conclusion: The findings suggest that while food options exist within HBCU campuses and surrounding communities, they may not fully support the unique needs of female student-athletes. Institutional stakeholders, including administrators, athletic trainers, and coaches, may consider collaborative efforts to enhance food access and nutritional support. This could include increasing awareness of community resources (e.g., SNAP, food banks), revisiting dormitory policies related to cooking, and expanding access to nutrition education. These insights underscore the importance of contextually responsive strategies to promote student-athlete well-being.
1 March 2024 in International Journal of Athletic Therapy and Training
Clinical scenarios have risen where females with Type 1 diabetes mellitus (T1-DM), whose demographics are similar to their male counterparts, have sustained bone injuries, whereas the males with T1-DM have not. These scenarios bring into question the effect of T1-DM on various aspects of bone health and injury risk in females. The purpose of this study was to investigate the impact of T1-DM in females on their fracture risk, glycemic control abilities, and bone mineral density when compared to their male counterparts. Results were consistent across all studies, indicating that individuals with T1-DM had poor glycemic control abilities during ages within peak bone accrual, had significantly lower bone mineral density, and had a greater fracture incidence. Given these results, there is a need for future education to emphasize the importance of glycemic management, future research to investigate differences in physically active populations, and for clinicians to recognize their at-risk patients and take the necessary measures to prevent injury.