Protocol design for large-scale cross-sectional studies of sexual abuse and associated factors in individual sports: feasibility study in Swedish athletics.
To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasibility survey. 89% (n = 177) reported that they agreed with that the questions in the survey were important, and 95% (n = 189) reported that they answered truthfully to all questions. Similarly, 91% (n = 180) reported that they did not agree with that the questions were unpleasant for them. However, 16% (n = 32) reported that they did not find the survey to be of personal value, and 12% (n = 23) reported that the survey had caused them to think about issues that they did not want to think about. Responding that participation was not personally gratifying was associated with training more hours (p = 0.01). There is a scarcity of research on the prevention of sexual abuse in individual sports. The present protocol should be regarded as a means to overcome this shortcoming in athletics. When implementing the protocol, it is necessary to encourage athlete compliance and to adapt the web-based survey to the particular infrastructural conditions in the sports setting at hand. Key pointsA research protocol for cross-sectional epidemiological studies of sexual abuse in athletics was designed and its feasibility evaluated.The definition of sexual abuse, ethical soundness of the protocol, reference populations and study of co-morbidity, and means for athlete-level data collection were in requirements analyses identified as particularly complex design issues.The feasibility evaluation showed a high non-participation rate (61%), but also that the large majority of participants found the study important and that questions were answered truthfully.Responding that partaking in the study was not personally gratifying was associated with training more hours.When implementing cross-sectional epidemiological studies of sexual abuse in athletics, it is necessary to promote and facilitate athlete participation.
Athletics Research Center, Linköping University , Linköping, Sweden ; Department of Medical and Health Sciences, Linköping University , Linköping, Sweden ; Unit for Health Analysis, Centre for Healthcare Development, County Council of Östergötland , Linköping, Sweden.
Toomas
T
Timpka
Department of Public Health, Karlstad University , Karlstad, Sweden.
Staffan
S
Janson
Athletics Research Center, Linköping University , Linköping, Sweden ; Department of Medical and Health Sciences, Linköping University , Linköping, Sweden.
Jenny
J
Jacobsson
Athletics Research Center, Linköping University , Linköping, Sweden ; Department of Medical and Health Sciences, Linköping University , Linköping, Sweden ; Unit for Health Analysis, Centre for Healthcare Development, County Council of Östergötland , Linköping, Sweden.
Joakim
J
Ekberg
Athletics Research Center, Linköping University , Linköping, Sweden ; Department of Behavioural Sciences and Learning, Linköping University , Linköping, Sweden.
Örjan
Ö
Dahlström
Department of Clinical Science, Intervention and Technology, Pediatric Unit, Karolinska Institutet , Stockholm, Sweden.
Jan
J
Kowalski
Athletics Research Center, Linköping University , Linköping, Sweden ; Department of Medical and Health Sciences, Linköping University , Linköping, Sweden ; Department of Orthopaedics and Rehabilitation, Moi University , Eldoret, Kenya.
Victor
V
Bargoria
Department of Family Medicine, McMaster University , Kitchener, Ontario, Canada.
Margo
M
Mountjoy
Athletics Research Center, Linköping University , Linköping, Sweden ; Department of Medical and Health Sciences, Linköping University , Linköping, Sweden.
Carl G
CG
Svedin
Sports epidemiology; gender issues; research ethics; sexual abuse; survey methods