The Female Athlete Body (FAB) study: Rationale, design, and baseline characteristics

Abstract

Background Eating Disorders (EDs) are serious psychiatric illnesses marked by psychiatric comorbidity, medical complications, and functional impairment. Research indicates that female athletes are often at greater risk for developing ED pathology versus non-athlete females. The Female Athlete Body (FAB) study is a three-site, randomized controlled trial (RCT) designed to assess the efficacy of a behavioral ED prevention program for female collegiate athletes when implemented by community providers. This paper describes the design, intervention, and participant baseline characteristics. Future papers will discuss outcomes. Methods Female collegiate athletes (N=481) aged 17–21 were randomized by site, team, and sport type to either FAB or a waitlist control group. FAB consisted of three sessions (1.3 hours each) of a behavioral ED prevention program. Assessments were conducted at baseline (pre-intervention), post-intervention (3 weeks), and six-, 12-, and 18-month follow-ups. Results This study achieved 96% (N = 481) of target recruitment (N = 500). Few group differences emerged at baseline. Total sample analyses revealed moderately low baseline instances of ED symptoms and clinical cases. Conclusions Health risks associated with EDs necessitate interventions for female athletes. The FAB study is the largest existing RCT for female athletes aimed at both reduction of ED risk factors and ED prevention. The methods presented and population recruited for this study represent an ideal intervention for assessing the effects of FAB on both the aforementioned outcomes. We anticipate that findings of this study (reported in future papers) will make a significant contribution to the ED risk factor reduction and prevention literature.

The Female Athlete Body project study: 18‐month outcomes in eating disorder symptoms and risk factors

“…This is consistent with community participatory research methods and previous trials of this kind (e.g., Becker et al, ). See Stewart et al () for additional discussion.…”

“…ED symptoms were assessed with the eating disorder examination questionnaire (EDE‐Q; Fairburn & Beglin, ) and the eating disorder examination interview (EDE; Sysko, Walsh, & Fairburn, ). Internalization was assessed by the ideal‐body stereotype scale‐revised (IBSS‐R; Stice, Fisher, & Martinez, ) and the internalization of sport‐specific thin‐ideal scale (Stewart et al, ). The sadness, guilt, and fear/anxiety subscales of the positive and negative affect scale‐revised (PANAS‐X; Watson, Clark, & Tellegen, ) assessed negative affect.…”

“…Other measures included BMI calculated from self‐reported height and weight, knowledge of the female athlete triad questionnaire (Stewart et al, ), and the health survey utilization scale (Lane & Addis, ). We acknowledge the limitations of self‐reported height and weight; however, it was not practical to capture objective BMI given study design, which was heavily influenced (per community participatory research methods) by the partnering athletics departments.…”

“…The present analyses examine the outcomes of the FAB study. Details of the study rationale and design, data collection methods, and study sample baseline characteristics may be found in Stewart et al (). We hypothesized that FAB would outperform the control condition in (a) reducing ED symptoms, ED risk factors, onset of new ED cases, and healthcare utilization and (b) increasing Triad knowledge.…”

The Athletes’ Relationships with Training scale (ART): A self‐report measure of unhealthy training behaviors associated with eating disorders

“…Participants were asked to indicate how often they talked to a primary‐care doctor, psychiatrist, nurse, therapist, or support group about each domain in the past year. Internal consistency reliability for the HSUS in the parent study was good with Cronbach's alpha ranging from 0.77 to 0.87 (Stewart et al, ). In the current study, the HSUS was administered to the FAB sample to test the ART's criterion validity.…”