Moving from Ethnic Exclusions to Cultural Safety: How is athlete ethnicity discussed in research on menstrual health in sports? A Scoping Review.

Objective: To investigate how athlete ethnicity is discussed in the inclusion and exclusion criteria, methodology, findings, and conclusions of research focused on menstrual health in sports science and medicine. Design: A scoping review of sports-based research conducted on athletes related to (1) menstrual health and ethnicity, (2) how researchers include/exclude participants based on ethnicity, and (3) how ethnicity is discussed. Data Sources: Electronic search of PubMed, and ProQuest. Eligibility criteria: Articles were included if they met the following criteria: (1) published before September 2023, (2) published in peer-reviewed journals, (3) participants were women athletes, (4) published in English, and (5) relating to menstrual health. Articles were assessed as good, fair, or poor quality using the Inclusion of Participant Ethnicity Quality Assessment Criteria. Results: From the 1089 studies available from the initial database search, 55 studies considered ethnicity. Nine studies met the inclusion criteria and were assessed as either good (22%), fair (44%), or poor (33%) in quality in their consideration of athlete ethnicity. 81% of research articles on menstrual health in sports do not consider athlete ethnicity, and when ethnicity is discussed, it rarely meets the criteria for cultural safety in the research process. Most studies did not factor ethnicity into the analysis and lacked cultural considerations in the research design and interventions. Conclusion: More careful inclusion of ethnicity in sports menstrual health-related research and recognition of social and cultural influences on health and research outcomes for indigenous and other ethnic minority groups is needed. Such research is required to support coaches, medical personnel, and support staff in designing culturally safe environments for sportswomen from diverse cultural and ethnic backgrounds.