A Quality Improvement Approach to the Underreporting of Sexual Abuse in Competitive Sports: A Conceptual Framework.

Continuing reports involving the sexual abuse of athletes in USA Gymnastics sounded a call to action for competitive sports organizations around the world. We propose a Quality Improvement (QI) approach to evaluate the dynamics of this problem. We do so by [1] defining the problem and its scope within competitive sports, [2] making the case for QI methodologies as an untapped resource to address this problem, and [3] suggesting novel approaches using these specific methodologies. We demonstrate how a systems approach and methodologies like Root Cause Analysis can identify cultural, systemic, and individual barriers to reporting. They can also expose inherent conflicts of interest and biases that compound this problem. A QI approach can identify previously unrecognized causes of underreporting sexual abuse of athletes and may guide targeted interventions.