Female athlete triad screening in National Collegiate Athletic Association Division I athletes: is the preparticipation evaluation form effective?

Clin J Sport Med. 2012 Mar;22(2):122-5. doi: 10.1097/JSM.0b013e3182425aee.


Objective: To evaluate the screening practices and preparticipation evaluation (PPE) forms used to identify college athletes at risk for the female athlete triad (triad).

Design: Phone and/or e-mail survey.

Setting: National Collegiate Athletic Association (NCAA) Division I universities.

Participants: All 347 NCAA Division I universities were invited to participate in a survey, with 257 participating in the survey (74%) and 287 forms collected (83%).

Main outcome measures: Information about the nature of the PPE was requested from team physicians and certified athletic trainers during a phone or e-mail survey. In addition, a copy of their PPE form was requested to evaluate for inclusion of the 12 items recommended by the Female Athlete Triad Coalition for primary screening for the triad.

Results: All 257 universities (100%) required a PPE for incoming athletes; however, only 83 universities (32%) required an annual PPE for returning athletes. Screening was performed on campus at 218 universities (85%). Eleven universities (4%) were using the recently updated fourth edition PPE. Only 25 universities (9%) had 9 or more of the 12 recommended items included in their forms, whereas 127 universities (44%) included 4 or less items. Relevant items that were omitted from more than 40% of forms included losing weight to meet the image requirements of a sport; using vomiting, diuretics, and/or laxatives to lose weight; and the number of menses experienced in the past 12 months.

Conclusions: The current PPE forms used by NCAA Division I universities may not effectively screen for the triad.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Athletes*
  • Feeding and Eating Disorders / diagnosis*
  • Female
  • Humans
  • Mass Screening / statistics & numerical data*
  • Menstruation Disturbances / diagnosis*
  • Osteoporosis / diagnosis*
  • Students
  • Surveys and Questionnaires*
  • United States
  • Universities / statistics & numerical data