Guide to Effective Programs
for Children and Youth

Adolescent Training and Learning to Avoid Steroids Program (ATLAS)

OVERVIEW

The Adolescent Training and Learning to Avoid Steroids Program (ATLAS) was designed to lower the use of anabolic steroids among high school athletes. The program combined classroom and weight-training sessions, to teach students about strength training, nutrition, and risk factors for steroid use. Overall, the ATLAS program was found to reduce the use of steroids (though this finding did not hold at the 1 year follow-up) and other illicit drugs, and to improve nutrition and exercise behavior and drug refusal skills.

DESCRIPTION OF PROGRAM

Target population: School-aged athletic team participants

The ATLAS program was designed to lower the use of steroids among high school athletes. The program was designed specifically for male students and integrated into team practice sessions. The program consisted of 7 classroom sessions (45 minutes each), 7 weight-training sessions, and 1 parent evening session. The classroom and weight-training sessions took place over 7 weeks. The classroom sessions were led by coaches and peer educators and observed by research staff. Approximately 60% of the curriculum was given in small student groups (6-8 students) by peer educators. The curriculum addressed risk factors for steroid use, strength training, and nutrition. Participants practiced drug refusal skills and presented anti-steroid media messages. The weight-training sessions were taught at school gyms by ATLAS staff trainers, who demonstrated different weight-lifting techniques and reinforced other elements of the classroom curriculum. The parent session focused on program goals and a description of the intervention.

EVALUATION(S) OF PROGRAM

Goldberg, L. Elliot, D., Clarke, G.N., MacKinnon, D.P., Moe, E., Zoref, L., Green, C., Wolf, S.L., Greffrath, E., Miller, D.J, and Lapin, A. (1996). Effects of a multidimensional anabolic steroid prevention intervention: The Adolescents Training and Learning to Avoid Steroids (ATLAS) program. Journal of the American Medical Association, 276(19), 1555-1562.

Evaluated population: 1,506 male football players in grades 9 through 12 at 31 Portland, Ore. high schools completed the pre-test questionnaire, and 1,226 completed the post-test assessment. In the control group, the average age was 15.8, 81% were white, 71% had family incomes greater than $40,000, and 30% had divorced parents. In the experimental group, the average age was 15.9, 77% were white, 62% had family incomes greater than $40,000, and 32% had divorced parents.

Approach: Using a matched-pairs design, schools were randomly split into experimental and control groups. All football players at the schools were contacted before the start of the football season (late summer 1994). Participants at experimental and control schools were assessed 3 times: just prior to the first intervention session, following the final intervention session (approximately 10 weeks later), and a 9- or 12-month follow-up (9 months for graduating seniors, 12 months for returning students). The principal assessment instrument was a self-report questionnaire that assessed steroid and drug use, knowledge of drug effects, and attitudes toward and intent to use steroids. Other items assessed nutrition and exercise knowledge, belief in media messages, drug refusal skills, body image, feelings of athletic competence, and beliefs about parents and coaches.

Results: Compared with students in the control group, students in the experimental group had increased understanding of steroid effects, greater belief in their own vulnerability to the adverse effects of steroids, reduced intention to use steroids, and improved drug refusal skills at the end of the intervention. The experimental group students also had less belief in media messages that promote steroid use, improved perception of athletic abilities and self-efficacy, and improved nutrition and exercise behavior. Most of these effects remained significant at the 9- or 12-month follow-up. Use of marijuana, amphetamines, and alcohol was not lower at the end of treatment, but was lower at the one-year follow-up.

Goldberg, L., MacKinnon, D. P., Elliot, D., Moe, E., Clarke, G., and Cheong, J. (2000). The Adolescents Training and Learning to Avoid Steroids program: Preventing drug use and promoting health behaviors. Archives of Pediatrics & Adolescent Medicine, 154, 332-338.

Evaluated population: In addition to the sample population described above, two more cohorts were recruited in subsequent football seasons (1995 and 1996). All participants were male and in grades 9 through 12. In total, 1,371 students in the control group and 1,145 in the experimental group completed both pre- and posttests. In the control group, the average age was 15.4, 81% were white, and 31% had divorced parents. In the experimental group, the average age was 15.5, 77% were white, and 34.5% had divorced parents. Attrition did not vary for the experimental and control groups.

Approach: The same schools used in the initial cohort described above were used in subsequent cohorts. Participants were given questionnaires at the same intervals (pre-intervention, post-intervention, and 9- or 12-month follow-up). Cohorts 2 and 3 received a compressed version of the intervention, which consisted of 5 classroom sessions and 3 weight-training sessions rather than 7 of each. The cohorts were combined into a single sample for data analyses. The 1 year follow-up includes cohorts 1 and 2, but not 3, as data were not yet available.

Results: At the time of post-intervention questionnaire, students in the experimental group had lower intentions to use steroids and lower actual use of steroids compared with the students in the control group. At the 1-year follow-up, actual use was no longer significantly lower, but intentions to use remained lower. Additionally, at the 1 year follow-up, experimental group students were less likely to use illicit drugs (including alcohol), less likely to report drinking and driving, and they reported improved nutrition behaviors.

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://www.ohsu.edu/hpsm/purchasing.html

References

Program categorized in this guide according to the following:

Evaluated participant ages: 9^th through 12^th grade / Program age ranges in the Guide: 12-14, 15-21

Program components: school-based; community/media component

Measured outcomes: physical health

Program information last updated 3/16/07