Introduction: Youth high performance athletes are at an increased risk of injury and illness. This may affect their long-term health and ultimately performance due to the training and competition loads on their growing bodies. Long-term surveillance of health problems in youth diving high- performance athletes in Australia is via reporting for medical attention to their health care professional. This study aimed to assess the validity of implementing the OSTRC-H2 questionnaire as a surveillance tool and report on these health problems. Earlier detection of health problems may minimize the impact of growing injuries, illnesses, and time loss to training and competition schedules, leading to a higher chance of performance success. Methods: Australian high performance youth divers aged 10-18 years were recruited for participation over a 10-week period. The OSTRC-H2 questionnaire was completed every week by the athletes and responses recorded on the AMS (Athlete Management System) for health problem reporting. Three (3) competition age categories were used for comparison with athlete engagement of the OSTRC-H2: 10-13years, 14-15years and 16-18years. Results: Mean athlete engagement was 72.3% with the odds of responding to the OSTRC-H2 0.79 times less (95% High-density credible interval (HDI) = 0.73 - 0.89) than the previous week over 10 consecutive weeks. The 16- 18 years age group showed evidence of engagement being lower and required more reminders than the younger age groups. The 10-13year-olds had the best engagement across the 10 weeks. The OSTRC-H2 identified 9 body locations reported for injury, with the elbow reported as the highest severity of injury. There were 70 reports of health problems in total. The OSTRC-H2 detected more illnesses than medical attention records and also detected low-grade 'niggles'; specifically lower leg pain. Discussion: Lumbar spine injuries (including stress fractures) and typical growing injuries; Osgood Schlatter's, Sever`s disease, contributed mostly to modified time loss to training over the 10 weeks with an elbow apophyseal injury contributing the most amount of time loss to training. Previous diving studies on adolescent divers suggest that lumbar pain is associated with the adolescent growth spurt. Monitoring growth through the 10-18 years age groups and limiting overall dive load; including jump volume, heights (to minimize entry force on wrists and elbows) and landing repetitions would seem beneficial in reducing growing injury risks and may decrease modified and time loss to training for better long-term consistency of training and competition. Impact/Application to the field: This study assessed the degree of athlete engagement with the OSTRC-H2 in a youth high performance Australian diving cohort and reported on their health problems. The OSTRC-H2 provides a valid tool to identify health problems in this cohort, especially illness, and may be beneficial for administering longer term to minimise the severity of and reduce modified time-loss and time loss health problems in youth diving athletes as they grow and mature.
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