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of Victoria
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Faculty of Graduate Studies

Vanessa Zoras

  • BASc (University of Guelph, 2014)

Notice of the Final Oral Examination for the Degree of Master of Science

Topic

Co-Designing a Theory-Driven Severity/Risk Outcome Report for Relative Energy Deficiency in Sport (REDs) with Experts and Athletes Leads to Higher Knowledge, Attitudes, and Motivations

School of Exercise Science, Physical and Health Education

Date & location

  • Monday, December 2, 2024

  • 9:00 A.M.

  • Clearihue Building, Room B021

  • and Virtual

Reviewers

Supervisory Committee

  • Dr. Marc Klimstra, School of Exercise Science, Physical and Health Education, University of Victoria (Supervisor)

  • Dr. Trent Stellingwerff, School of Exercise Science, Physical and Health Education, UVic (Member)

  • Dr. JoAnne Arcand, Department of Health Sciences, Ontario Tech University (Non-unit Member) 

External Examiner

  • Dr. Therese Fostervold Mathisen, Faculty of Health, Welfare and Organization, Ostfold University 

Chair of Oral Examination

  • Dr. Abdul Vahabpour Roudsari, School of Health Information Science, UVic 

Abstract

Background: Relative Energy Deficiency in Sport (REDs) negatively affects athlete health and performance. Although the International Olympic Committee (IOC) recommends a validated REDs clinical assessment tool (REDs CAT2) for use by physicians, no evidence-informed tool exists to facilitate its implementation.

Objective: This study aims to co-design a severity/risk outcome report with end users and evaluate its effect on athlete REDs-related knowledge, attitudes, and motivations (KAM) compared to a control report.

Methods: A prototype of a REDs CAT2 report was developed through discussions with REDs experts (n=10), an environmental scan, and the integration of theory (Phase 1). The report underwent iterative testing with athletes (n=15, Phase 2) and questionnaire-based usability and acceptability (U&A) assessments and verbal feedback were used to determine design modifications. A two-arm randomized controlled pilot study (Phase 3) was conducted to test the hypothesis that REDs-related KAM scores would be higher in athletes who used the refined REDs CAT2 report (n=47), compared those who used the control report (n=37).

Results: Five report revisions based on four user testing sessions resulted in mean U&A scores exceeding 90%. Post-intervention assessments showed significantly higher U&A and REDs related KAM scores in the experimental group (U&A = 66.7 ± 5.0; K = 10.5 ± 1.2; AM = 75.3 ± 5.1) compared to the control group (U&A = 60.3 ± 10.5; K = 9.5 ± 2.1; AM = 71.3 ± 6.6), after controlling for pre-intervention KAM scores.

Conclusions: The report developed through this study offers a practical and cost-effective tool to facilitate the implementation of IOC policy recommendations and the REDs CAT2.

 

Keywords: Relative Energy Deficiency in Sport (REDs); Athlete health; Behavioural theory; Implementation tools; Usability and acceptability

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