A program for the prevention of ED in adolescent female athletes, the HADAS: Protocol for a randomized controlled trial study

Objective This paper describes the study protocol for the HADAS Program, a multidimensional psychoeducational intervention aimed at preventing eating disorders (ED) in adolescent female athletes by involving the entire "sports triangle": athletes, coaches, and families. Methods A cluster randomized controlled trial with a longitudinal design will be conducted in aesthetic sports clubs. Randomization will be executed at the club level. A sample of 236 female athletes (aged 12–16), their coaches, and family members will be randomized into an experimental group (EG) or a control group (CG). The EG will receive a multi-component program consisting of five psychoeducational sessions for athletes, four for coaches, and two for families, supported by specific workbooks. Primary outcomes include ED risk (EAT-26) and body dissatisfaction (BSQ-34), while secondary outcomes encompass psychological well-being, competitive anxiety, perfectionism, media literacy, coaching leadership styles, and family communication dynamics. Assessments will be conducted at baseline (T0), immediate post-intervention (T1), and at 6-month (T2) and 12-month (T3) follow-ups. Longitudinal data will be analyzed using robust linear mixed models (rLMM) to account for the nested structure of the data within clubs and to perform intention-to-treat analyses. Conclusion The HADAS Program protocol proposes a comprehensive, multi-level framework for ED prevention in sports, aiming to address both individual and contextual risk factors within the athlete's immediate environment. Trial registration The study was prospectively registered on ClinicalTrials.gov.