Development, Implementation, and Evaluation of the HADAS Program for the Prevention of Eating Disorders in Adolescent Female Athletes, Coaches, and Families. (The HADAS)
2026년 8월 1일 업데이트: Eva Maria Leon Zarceño, Universidad Miguel Hernandez de Elche
A Program for the Prevention of ED in Adolescent Female Athletes, the HADAS: Protocol for a Randomized Controlled Trial Study
Adolescent female athletes in aesthetic sports disciplines (such as rhythmic gymnastics, artistic gymnastics, synchronized swimming, and figure skating) face a complex interaction between general sociocultural beauty pressures and sport-specific aesthetic demands (e.g., the 'slim to win' culture and weight-focused performance expectations).
These combined pressures significantly increase their risk of developing body dissatisfaction and eating disorders (EDs).
To address these systemic vulnerabilities, the HADAS Program (Habits, Eating, Sports, Adolescents, and Health) was developed as a multi-level, synchronized psychoeducational intervention designed to target the complete "sports triangle": adolescent female athletes, their technical coaches, and their immediate family members.
The primary objective of this cluster randomized controlled trial (cluster RCT) is to evaluate the efficacy of the HADAS Program in reducing eating disorder risk (EAT-26) and body image dissatisfaction (BSQ-34) among competitive adolescent female athletes aged 12 to 16 years.
Sports clubs are randomly assigned to either the Experimental Group (receiving the HADAS intervention) or a Waitlist Control Group (maintaining standard training).
The program includes 5 interactive group sessions for athletes, 4 reflective workshops for coaches, and 2 structured sessions for family members, all supported by cohort-specific workbooks.
Outcomes are evaluated across four longitudinal time points: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
연구 개요
연구 유형
중재적
등록 (추정된)
236
단계
- 해당 없음
연락처 및 위치
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연구 연락처
- 이름: Eva María León Zarceño
- 전화번호: +34 606501888
- 이메일: eleon@umh.es
연구 연락처 백업
- 이름: Josué López Pozo
- 전화번호: +34 616510686
- 이메일: josue.lopezp@umh.es
연구 장소
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Alicante
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Elche, Alicante, 스페인, 03202
- Universidad Miguel Hernández de Elche - Department of Behavioral Sciences and Health
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연락하다:
- Eva María León Zarceño
- 전화번호: +34 96 665 8823
- 이메일: eleon@umh.es
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 어린이
건강한 자원 봉사자를 받아들입니다
예
설명
Inclusion Criteria:
- Athletes: Female gender; aged between 12 and 16 years old; actively possessing a formal federation license in an aesthetic sport discipline (e.g., rhythmic gymnastics, artistic gymnastics, synchronized swimming, figure skating) within Spain; providing signed informed assent concurrently with written informed consent from parents/legal representatives; and presenting no active, formal clinical diagnosis of an eating disorder (ED).
- Coaches: Serving as a primary trainer or technical staff member within the participating sports club; and providing written informed consent.
- Family Members: Operating as the primary parent, guardian, or legal representative of an included athlete; and providing written informed consent.
Exclusion Criteria:
- Athletes: Presenting a current, formal clinical diagnosis of an eating disorder (e.g., Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, or ARFID) at baseline (T0); or refusal to provide informed assent or parental consent.
- Non-compliance or failure to provide signed informed consent from coaches or primary legal guardians.
공부 계획
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연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 방지
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 삼루타
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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실험적: Experimental Group (HADAS Program)
Sports clubs randomly assigned to receive the multi-level HADAS Program .
The intervention is synchronized across three modalities: 5 interactive group sessions (90 min each) for adolescent female athletes, 4 reflective training sessions (90 min each) for technical coaches, and 2 structured psychoeducational workshops (120 min each) for parents/family members
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A synchronized, multi-level psychoeducational prevention program designed to target eating disorder risk and body image dissatisfaction across the sports triangle (athletes, coaches, and families).
Content focuses on media literacy, healthy life habits, emotional management, deconstructing body-weight myths in aesthetic sports, and promoting autonomy-supportive coaching and family environments
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간섭 없음: Control Group (Waitlist)
Sports clubs randomly assigned to the control condition maintain their standard active training routines and schedule without any component of the prevention program during the 12-month study window .
They will be offered the HADAS intervention after the final longitudinal follow-up (T3)
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Eating Disorder Risk and Symptomatology
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Eating Attitudes Test (EAT-26; Garner et al., 1982; Spanish validation by Rivas et al., 2010).
It assesses eating disorder risk behaviors and attitudes across 26 items.
Total scores range from 0 to 78, where higher scores indicate greater eating disorder risk and symptomatology (a worse outcome) .
Scores of 20 or higher indicate the presence of significant risk attitudes toward eating.
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Body Image Dissatisfaction
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Body Shape Questionnaire (BSQ-34; Cooper et al., 1987; Spanish validation by Raich et al., 1996).
It assesses body dissatisfaction and concern with weight and shape across 34 items.
Total scores range from 34 to 204, where higher scores indicate greater body dissatisfaction and psychological distress regarding body image (a worse outcome).
Scores are categorized into no dissatisfaction (<80), mild (80-110), moderate (111-140), and severe (>140), with moderate and severe categories indicating significant body image vulnerability.
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Psychological Well-Being
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Psychological Well-Being Scale for Youth (PWB-SF-Y; Ryff, 1989; Spanish adaptation by Stavraki et al., 2022).
It assesses well-being across 6 core dimensions using a single item per dimension.
Items are rated on a 6-point Likert scale ranging from 1 ("strongly disagree") to 6 ("strongly agree").
Total scores range from 6 to 36, where higher scores indicate greater psychological well-being and optimal psychological functioning (a better outcome)..
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Life Satisfaction
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Satisfaction With Life Scale (SWLS; Diener et al., 1985; Spanish validation in adolescents by Atienza et al., 2003).
It assesses global cognitive judgments of one's life satisfaction across 5 items rated on a 5-point Likert scale ranging from 1 ("strongly disagree") to 5 ("strongly agree").
Total scores range from 5 to 25, where higher scores indicate greater life satisfaction and positive cognitive evaluation of life (a better outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Competitive Anxiety
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Revised Competitive State Anxiety Inventory-2 (CSAI-2R; Martens et al., 1990; Spanish validation by Andrade et al., 2007).
It assesses pre-competitive state anxiety across 16 items rated on a 4-point Likert scale ranging from 1 ("not at all") to 4 ("very much").
The inventory measures three subscales: Cognitive Anxiety (5 items; scores range from 5 to 20, where higher scores indicate higher cognitive anxiety / a worse outcome), Somatic Anxiety (6 items; scores range from 6 to 24, where higher scores indicate higher somatic anxiety / a worse outcome), and Self-Confidence (5 items; scores range from 5 to 20, where higher scores indicate greater self-confidence / a better outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Perfectionism in sports
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Multidimensional Inventory of Perfectionism in Sport (MIPS; Stoeber et al., 2006; Spanish validation by Ramírez-Muñoz et al., 2023).
It assesses sport-specific perfectionism across 10 items rated on a 6-point Likert scale ranging from 1 ("never") to 6 ("always").
The inventory yields two distinct subscales (5 items each, with total scores ranging from 5 to 30 for each subscale): Striving for Perfection (evaluates personal standards of excellence) and Negative Reactions to Imperfection (evaluates negative reactions to mistakes and sensitivity to external pressure), where higher scores reflect greater maladaptive perfectionism and a worse outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Appearance awareness on social networks
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Appearance-Related Social Media Consciousness Scale (ASMC; Choukas-Bradley et al., 2020; Spanish validation by Rojo et al., 2023).
It measures the ongoing awareness and body monitoring of one's physical appearance in social media contexts across 13 items rated on a 7-point Likert scale ranging from 1 ("never") to 7 ("always").
Total scores range from 13 to 91, where higher scores indicate greater appearance-related social media consciousness and body surveillance (a worse outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Critical Thinking about Media
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Critical Thinking About Media Messages Scale (CTMM; Scull et al., 2010; Spanish validation by Rojo et al., 2023).
It assesses the degree to which individuals critically analyze and evaluate aesthetic and appearance-focused media messages across 6 items rated on a 6-point Likert scale ranging from 1 ("never") to 6 ("always").
Total scores range from 6 to 36, where higher scores indicate greater critical thinking toward media and social media messages (a better outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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General knowledge about nutrition in adolescents
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Questionnaire on Nutrition Knowledge for Adolescents (C.A.P.A.; Ladrón-Arana et al., 2021).
It assesses nutritional literacy and general healthy eating knowledge in adolescents across 26 multiple-choice items (with 4 response options per item).
Each correct response is awarded 1 point, yielding total scores ranging from 0 to 26, where higher scores indicate greater general nutritional knowledge and dietary literacy (a better outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Coach controlling behaviors
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Controlling Coach Behaviors Scale (CCBS; Bartholomew et al., 2010; Spanish validation by Castillo et al., 2014).
It measures athletes' perceptions of their coach's controlling interpersonal style across 15 items rated on a 7-point Likert scale ranging from 1 ("strongly disagree") to 7 ("strongly agree").
The scale assesses four subscales: Controlling Use of Rewards (4 items), Negative Conditional Regard (4 items), Intimidation (4 items), and Excessive Personal Control (3 items).
Total scores range from 15 to 105, where higher scores reflect higher perceived controlling behaviors from the coach (a worse outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Leadership style in sport
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the Leadership Scale for Sports (LSS; Chelladurai & Saleh, 1980; Spanish validation by Crespo et al., 1994).
It assesses perceived coaching leadership behaviors across 31 items rated on a 5-point Likert scale ranging from 1 ("never") to 5 ("always").
The Spanish adaptation measures 4 dimensions: Relationship-Oriented Behavior (13 items), Task-Oriented Behavior (10 items), Democratic Behavior (4 items), and Autocratic Behavior (4 items).
Dimension mean scores range from 1 to 5, where higher scores in Relationship-Oriented, Task-Oriented, and Democratic behaviors reflect more supportive and adaptive leadership styles (a better outcome).
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Coach Eating Disorder Literacy and Warning Signs Knowledge
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the ad hoc Coach Eating Disorder Knowledge Questionnaire, created specifically for the HADAS Program by its research group to evaluate program-specific learning objectives.
The instrument was developed and validated via a four-stage process (item generation, expert panel review, scoring design, and pilot testing).
It assesses sports-specific eating disorder (ED) literacy across 25 items structured in 5 core dimensions: (1) General multi-causal etiology (items 1-6); (2) Identification of behavioral/emotional warning signs in sports contexts (items 7-11); (3) Risk and protective factors in competitive environments (items 12-16); (4) Consequences on physical health and performance (items 17-20); and (5) Early detection and intervention protocols (items 21-25).
Items use a True/False/I Don't Know (1 point for correct responses; 0 points for others).
Total scores range from 0 to 25, where higher scores indicate higher sports-specific ED literacy and detection competence
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Parental Eating Disorder Literacy and Warning Signs Knowledge
기간: Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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Evaluated using the ad hoc Family Eating Disorder Knowledge Questionnaire, created specifically for the HADAS Program by its research group to align directly with the family intervention curriculum.
The instrument was developed and validated via a four-stage process (item generation, expert panel review, scoring design, and pilot testing).
It assesses family eating disorder literacy and management across 25 items structured in 5 core dimensions: (1) General ED knowledge (items 1-6); (2) Symptom identification in adolescent athletes (items 7-11); (3) Interpretation and behavioral action plans (items 12-15); (4) Risk and protective factors (items 16-19); and (5) Language, media literacy, and family role (items 20-25).
Items use a True/False/I Don't Know format (1 point for correct responses; 0 points for incorrect or 'I Don't Know' answers).
Total scores range from 0 to 25, where higher scores indicate greater parental eating disorder literacy and proactive family management skills.
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Baseline (T0), Immediate Post-intervention (T1), 6-month Follow-up (T2), and 12-month Follow-up (T3).
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Eva María León Zarceño, Universidad Miguel Hernández de Elche
- 수석 연구원: Josué López Pozo, Universidad Miguel Hernández de Elche
- 수석 연구원: Yolanda Quiles Marcos, Universidad Miguel Hernández de Elche
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
유용한 링크
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (추정된)
2026년 10월 1일
기본 완료 (추정된)
2028년 10월 1일
연구 완료 (추정된)
2029년 5월 1일
연구 등록 날짜
최초 제출
2026년 7월 28일
QC 기준을 충족하는 최초 제출
2026년 8월 1일
처음 게시됨 (실제)
2026년 8월 6일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 8월 6일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 8월 1일
마지막으로 확인됨
2026년 7월 1일
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- DCC.ELZ.251124
- https://doi.org/10.17605/OSF.I (레지스트리 식별자: Open Science Framework (OSF))
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
예
IPD 계획 설명
De-identified individual participant data (IPD) underlying the primary and secondary outcomes will be made available to qualified researchers upon reasonable request submitted to the principal investigator.
Data sharing will be subject to ethical review, a formal data-sharing agreement, and strict compliance with European Union GDPR regulations to safeguard minor participants' confidentiality.
IPD 공유 기간
Data will become available after the primary manuscript publishing the final longitudinal findings is accepted
IPD 공유 액세스 기준
Individual participant data will not be publicly shared to protect minor participants' confidentiality in compliance with GDPR and local data protection regulations.
Aggregate data and protocol materials are available upon request
IPD 공유 지원 정보 유형
- 연구_프로토콜
- 수액
- ICF
약물 및 장치 정보, 연구 문서
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이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .