The Female Athlete Triad is a pervasive, multifactorial morbidity among college athletes. The geographic disparity of female athlete triad awareness and access to resources in NCAA is unknown. PURPOSE: To determine geographic disparities in awareness of Triad components and resource access in the National Collegiate Athletic Association (NCAA). METHOD: Division I-III NCAA compliance officers were sent an email containing a request to disseminate a web-based survey to cross country coaches in their respective conferences. The web-linked instrument included: a study synopsis; an informed consent statement, and; the IRB-approved survey tool. Respondents were grouped geographically based upon conference headquarters location, regions included; Northeast, Midwest, South, and West. Statistical analysis, using JMP software, included frequency distributions and chi-square tests for categorical association. RESULTS: Coaches (n = 143; age = 40.7 ± 11.9 years; coaching experience = 14.1 ± 10.3 years) from 45 conferences participated. Location impacted coaches’ awareness of the term “female athlete triad” (p = 0.0183), which was highest in the West (90%), and; lowest in the South (74%). Geography did not influence Triad component recognition (p = 0.3907) (i.e. low energy availability, amenorrhea, low bone mineral density), however; only 54% of coaches correctly identified all Triad components. Coaches who had Triad awareness were more likely to possess understanding that menstrual irregularities are not a normal result of exercise (p = \u3c0.001). No relationship was identified between location and access to body composition technology (p = 0.2031), or; a registered dietician (p = 0.4869). However, only 30% and 53% of coaches had access to these biometric and dietetic resources, respectively. Western cross-country athletes (p = 0.0276) had the highest access to sport psychologists (50%); lowest access was in the Midwest (20%). CONCLUSION: Triad awareness and geographic resource disparities exist: Western coaches have a higher level of Triad awareness and superior access to psychological counseling, whereas; the South and Midwest had the lowest, respectively. Greater uniform access to resources amongst NCAA schools, regardless of geographic region, may positively impact Triad prevalence and outcomes
