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November 20, 1996

Effects of a Multidimensional Anabolic Steroid Prevention Intervention: The Adolescents Training and Learning to Avoid Steroids (ATLAS) Program

Author Affiliations

From the Oregon Health Sciences University, Portland (Drs Goldberg, Elliot, Moe, and Zoref, Mr Green, Ms Wolf, Mr Greffrath, and Mr Miller); the Kaiser Permanente Center for Health Research, Portland (Dr Clarke); and the Department of Psychology, Arizona State University,; Tempe (Dr MacKinnon and Ms Lapin).

JAMA. 1996;276(19):1555-1562. doi:10.1001/jama.1996.03540190027025

Objective.  —To test a team-based, educational intervention designed to reduce adolescent athletes' intent to use anabolic androgenic steroids (AAS).

Design.  —Randomized Randomized prospective trial.

Setting.  —Thirty-one high school football teams in the Portland, Ore, area.

Participants.  —Seven hundred two adolescent football players at experimental schools; 804 players at control schools.

Intervention.  —Seven weekly, 50-minute class sessions were delivered by coaches and student team leaders, addressing AAS effects, sports nutrition and strength-training alternatives to AAS use, drug refusal role play, and anti-AAS media messages. Seven weight-room sessions were taught by research staff. Parents received written information and were invited to a discussion session.

Main Outcome Measures.  —Questionnaires before and after intervention and at 9- or 12-month follow-up, assessing AAS use risk factors, knowledge and attitudes concerning AAS, sports nutrition and exercise knowledge and behaviors, and intentions to use AAS.

Results.  —Compared with controls, experimental subjects at the long-term follow-up had increased understanding of AAS effects, greater belief in personal vulnerability to the adverse consequences of AAS, improved drug refusal skills, less belief in AAS-promoting media messages, increased belief in the team as an information source, improved perception of athletic abilities and strength-training selfefficacy, improved nutrition and exercise behaviors, and reduced intentions to use AAS. Many other beneficial program effects remained significant at the long-term follow-up.

Conclusions.  —This AAS prevention program enhanced healthy behaviors, reduced factors that encourage AAS use, and lowered intent to use AAS. These changes were sustained over the period of 1 year. Team-based interventions appear to be an effective approach to improve adolescent behaviors and reduce drug use risk factors.