Program

May 24, 2012

OVERVIEW

The Athletes Training and Learning to Avoid Steroids Program (ATLAS) is a school-based program 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.  Experimental evaluations of the ATLAS program found that the intervention did reduce the use of steroids (though this finding did not hold at the 1 year follow-up) and other illicit drugs, and improved nutrition and exercise behavior and drug refusal skills.

DESCRIPTION OF PROGRAM

Target population: Male school-aged athletic team participants

ATLAS is a 7-week school-based program designed to lower the use of steroids among high school athletes.  It is designed specifically for male students and is integrated into team practice sessions.  The program consists of 7 classroom sessions (45 minutes each), 7 weight-training sessions, and 1 parent evening session, which take place during the athletic season.  Classroom sessions are led by coaches and trained peer educators.  The curriculum addresses risk factors for steroid use, strength training, and nutrition.  Participants practice drug/steroid refusal skills and create and present anti-steroid media messages.  Nutrition guides and weight-training booklets are also given to each participant.  Weight-training sessions are taught at school gyms by ATLAS staff trainers and are designed to reinforce other elements of the classroom curriculum.  Parents and guardians are provided with a booklet on family sports nutrition that includes information about the ATLAS program.  In the parent session, ATLAS staff explain the program’s goals, describe the intervention, and hold a question-and-answer session.

The program materials can be purchased at a modest cost.  The Coach Instructor package costs $280.00.  This package includes an instruction manual, a guide to train squad leaders, a ten session curriculum guide, a team workbook, an athletes guide, a coach training DVD, and a squad leader training DVD and CD.  Each Squad Leader package (which includes one ten session curriculum guide and one athletes guide) costs $11.00.  There should be one student squad leader for every five athletes on a team.  Each Athlete package (which includes one team workbook and one athletes guide) also costs $11.00.  One should be purchased for each athlete who is not a squad leader.

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: Participants consisted of 1,506 male football players in grades 9 through 12 at 31 Portland, OR high schools.  At baseline, several statistically significant differences existed between the two groups.  Students in the control group were slightly younger, had a slightly higher mean grade point average, had higher family incomes, and had fathers who were slightly more educated.  Students in the experimental condition also had poorer nutrition behaviors, lower strength-training self-efficacy, perceived themselves as more athletically competent, were less likely to believe in media advertisements, were less likely to view peers as good sources of information, had greater knowledge of nutritional supplements/exercise, and believed their coaches were less tolerant of steroid use.  This is a notable limitation of the study.

Approach: Schools were randomly assigned to experimental (N=702 students from 15 schools) and control (N=804 students from 16 schools) groups.  Students in the control condition were given a standard, commercially produced pamphlet that described problems with steroid use and ethics of sportsmanship and fair play.  No other materials or instruction were provided.  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 three times: just prior to the first intervention session, immediately after the final intervention session (approximately 10 weeks later), and at a 9- or 12-month follow-up (9 months for graduating seniors, 12 months for returning students).  To assess the effectiveness of the intervention, data were collected on self-reported steroid and drug use, knowledge of drug effects, and attitudes toward and intent to use steroids.  Other data collected included 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, there were several statistically significant impacts on students in the experimental group; experimental group students had increased knowledge of steroid effects, greater belief in their own vulnerability to the adverse effects of steroids, reduced intention to use steroids, and imp roved 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 impacts 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: Adding to the sample evaluated in Goldberg et al., 1996, two more cohorts were recruited in subsequent football seasons (1995 and 1996).  All participants were male and from the same schools, 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.  There were some statistically significant differences between groups at baseline.  The experimental group had significantly more African Americans, fewer whites, lower parental education, greater knowledge of steroid effects, higher normative steroid use, worse nutrition behavior, and lower strength-training self-efficacy.  This is a notable limitation of the study.

Approach: Participants were given questionnaires at pre-test, post-test, and at 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.  All three cohorts were combined into a single sample for pre and post data analyses.  The 1 year follow-up includes cohorts 1 and 2, but not 3, as data were not yet available for that cohort.  For information about randomization methods, see Goldberg et al., 1996, above.

Results: At post-test, students in the experimental group had lower intentions to use steroids and lower use of steroids compared with the students in the control group. At the 1-year follow-up, impacts on steroid use were non-significant, while intentions to use steroids remained significant.  Additionally, experimental group students were less likely to use illicit drugs (including alcohol), less likely to report drinking and driving, and more likely to improve nutrition behaviors, than control group students.

SOURCES FOR MORE INFORMATION

References

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.

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.

Contact information

Center for Health Promotion Research

3181 SW Sam Jackson Park Road, CR110

Portland, OR 97239-3098

503-418-4166

503-494-1310 (fax)

chpr@ohsu.edu

www.atlasprogram.com

Link to program curriculum: http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/medicine/divisions/hpsm/research/atlas-and-athena-program.cfm

KEYWORDS: Adolescents, Youth, Young Adults, High School, Male Only, School-Based, Cost Information is Available, Manual is Available, Community or Media Campaign, Parent or Family Component, Skills Training, Nutrition, Marijuana/Illicit/Prescription Drugs, Alcohol Use

Program information last updated 5/24/12