Developing a sexual assault emergency action plan: modified Delphi consensus recommendations from the American Medical Society for Sports Medicine

Sexual assault affects an estimated 0.5-12% of athletes and can seriously affect athlete health. Concerted efforts are needed to support survivors in receiving timely and appropriate care. Despite recognition from leading sports organisations about the need to prevent and respond effectively to sexual assault, many sports medicine physicians feel inadequately prepared to handle sexual assault disclosures. Emergency action plans (EAPs) offer a promising strategy to support adequate responses and ensure competent and consistent care. This modified Delphi study aimed to identify consensus-based components of a sexual assault EAP designed for sports medicine clinicians responding to sexual assault disclosures. A diverse panel of 24 individuals with lived and practical experience related to sexual violence in sport participated in one anonymous open-ended round and three anonymous voting rounds. The open-ended round generated important components in eight key domains: General Guidance; Mandatory Reporting, Confidentiality and Consent; Initial Evaluation; Follow-up Planning; Athlete Safety and Trauma-Informed Care; Legal Considerations; Established Contacts and Resources and Implementation. Overall, 90/130 proposed items (69%) achieved consensus (≥80% agreement for non-ranking items). The sexual assault EAP framework may improve clinician competency and support adequate responses, addressing common barriers such as low disclosure rates, personnel turnover and confidentiality concerns. Adoption of such plans has the potential to increase athlete trust in reporting mechanisms and foster more comprehensive care for athlete-survivors of sexual violence in sport. Example EAP templates are provided to assist sports organisations in implementing protocols that enhance self-efficacy among clinicians and support survivors throughout the reporting and recovery process.