Preventing substance use and disordered eating - Initial outcomes of the ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives) Program

Department of Medicine, Oregon Health & Science University, Portland, USA.
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 12/2004; 158(11):1043-9. DOI: 10.1001/archpedi.158.11.1043
Source: PubMed


To implement and to assess the efficacy of a school-based, sport team-centered program to prevent young female high school athletes' disordered eating and body-shaping drug use.
Prospective controlled trial in 18 high schools, with balanced random assignment by school to the intervention and usual-care control conditions.
We enrolled 928 students from 40 participating sport teams. Mean age was 15.4 years, 92.2% were white, and follow-up retention was 72%.
The ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternative) curriculum's 8 weekly 45-minute sessions were incorporated into a team's usual practice activities. Content was gender-specific, peer-led, and explicitly scripted. Topics included healthy sport nutrition, effective exercise training, drug use and other unhealthy behaviors' effects on sport performance, media images of females, and depression prevention.
We assessed participants by confidential questionnaire prior to and following their sport season. We determined program effects using an analysis of covariance-based approach within the Generalized Estimating Equation framework.
Experimental athletes reported significantly less ongoing and new use of diet pills and less new use of athletic-enhancing substances (amphetamines, anabolic steroids, and sport supplements) (P<.05 for each). Other health-harming actions also were reduced (less riding with an alcohol-consuming driver [P = .05], more seat belt use [P<.05], and less new sexual activity [P<.05]). The ATHENA athletes had coincident positive changes in strength-training self-efficacy (P<.005) and healthy eating behaviors (P<.001). Reductions occurred in intentions toward future use of diet pills (P<.05), vomiting to lose weight (P<.05), and use of tobacco (P<.05) and muscle-building supplements (P<.005). The program's curriculum components were altered appropriately (controlling mood [P<.005], refusal skills [P = .05], belief in the media [P<.005], and perceptions of closest friends' body-shaping drug use [P<.001]).
Sport teams are effective natural vehicles for gender-specific, peer-led curricula to promote healthy lifestyles and to deter disordered eating, athletic-enhancing substance use, and other health-harming behaviors.

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    • "A club is more than a place for physical activity; a youth sports club is a setting in which children and adolescents are influenced by the people within that setting and receive advice on many health issues. Still, health and especially health promotion have been studied less in this context, and when studied, the main focus has been on injury prevention or different kinds of interventions in which sports have been used externally as a vehicle to execute prevention on some specific health topic such as alcohol use (Werch et al., 2003) or eating disorders (Abood & Black, 2000; Elliot et al., 2004). The idea of the HPSC concept, and therefore the associated guidelines , is (a) to get clubs to recognize that investment in health promotion is beneficial to their core business, that is, athlete development and sports performance, (b) to integrate the health promotion actions into the existing " sports " operations, and (c) to guide the clubs in this process to get more local-level health promotion actions. "
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    ABSTRACT: The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one's activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples.
    Health Promotion Practice 12/2013; 15(3). DOI:10.1177/1524839913513900 · 0.55 Impact Factor
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    • "There are several interventions that have been focused on adolescent athletes and/or executed through sports or sports programmes. Examples are the intervention on female college athletes to reduce eating disorders (Abood and Black, 2000) and the programme on multiple health risk-factors, such as substance use and disordered eating (Elliot et al., 2004). Positive results in favour of sports participation have been found. "
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    • "(Miller, Exner, Williams, & Ehrhardt, 2000) and substance use (Elliot et al., 2004; Worden et al., 1996) already have used interventions specifically aimed at girls. In these girl-targeted interventions, there is specific attention for the development of positive relationships, as girls tend to have stronger intimacy goals (Jarvinen & Nicholls, 1996) and relationship-maintaining goals (Rose & Asher, 1999) than boys. "
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    ABSTRACT: Implicit and explicit peer evaluations were assessed among 120 early adolescents (56 boys, 64 girls; M age= 11.1years). Explicit peer evaluations were round-robin ratings of likeability; implicit peer evaluations were assessed with an approach-avoidance task, also using a round-robin design. Prosocial behavior, aggression, and bullying were assessed with a standard peer nominations procedure. Prosocial behavior predicted explicit positive evaluations given and received. Bullying and physical aggression predicted receiving explicit negative evaluations from peers. Implicit negative biases were found for girls but not boys. Relationally aggressive girls and bullying girls showed a negative implicit bias toward their peers. Possible implications for intervention are discussed.
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