AbstractBackground Previous concept mapping research has found a sample of stakeholders from a high-performance pathway system (HPPS) perceive athlete health, as a social and individual construct, to be the most important and feasible athlete attrition factors to address to retain talented athletes. Future sub-analysis was indicated following this initial study to compare within group perspectives.Objective This study builds on the authors' previous work to examine how 1) socioecological level and 2) gender influence high-performance pathway system stakeholders' perspectives on the relative importance and feasibility to address athlete attrition factors within an Australian HPPS.Design Mixed methods Setting Australian high-performance sport systemPatients (or Participants) Past athletes from an Australian state sporting institute; and internal and external HPSS stakeholders who supported past athletes.Interventions (or Assessment of Risk Factors) NilMain Outcome Measurements Concept mapping cluster map; cumulative link mixed model analysis.Results Mean rating for eleven and three out of 13 clusters were statistically significantly different between two of five socioecological levels, for importance and feasibility, respectively. Athletes had the largest variation in mean ratings from the most (athlete health 4.59), to least (performance potential 2.83) important cluster, when compared to the other four socioecological levels. There were statistically significant differences between the ratings between genders (Men:Women) for two clusters for each rating scale: Importance: 'athlete health' (M3.33:W3.84 [p0.012]); 'performance potential' (M3.35:W2.57 [p0.001]), Feasibility: 'abuse and mismanagement of health' (M2.97:W3.68 [p0.000]) and 'athlete health' (M2.54:W [p0.000]).Conclusions This study demonstrates a large variation in perceptions across socioecological levels of a HPPS regarding attrition factors to address, especially regarding health. Women value health as a priority more than men in an Australian HPPS. The association between health, gender and athlete attrition should be considered as an area to investigate further.
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