Anabolic steroid (AS) use has many detrimental health effects. Nevertheless, adolescent use, especially among those engaged in high school (HS) football, is increasing. AS availability has varied between 32 and 60%, with use increasing from 1.1% to 5.7% during the period 1987-1991 in the Portland, Oregon metropolitan area. During 1987, for every 36 HS football players claiming steroid availability, one student used AS. This increased to one player using AS for every 6 reporting availability in 1991. Over 250,000 adolescents are using or have used AS in the United States.
The aim of this proposal is to develop and evaluate a school-based AS prevention program designed to prevent initiation and use of AS and other drugs among high risk adolescents. The intervention is based on five years of prospective prevention research and uses a multidimensional, cognitive-behavioral approach, including knowledge of AS, promoting AS alternatives (nutrition and exercise), and resistance and communication skill training. The program intervenes at the individual, peer, adult and environmental levels. In study years 02, 03, 04, and 05 all students engaged in football at 36 high schools will be randomly assigned by school to one of two groups: 1) a 20 session intervention: 12 in a classroom setting and 8 weekly exercise training periods or 2) a minimum information control. Intervention components will be delivered by coaches, peers and certified athletic trainers. The intervention will be repeated annually for new players, with additional yearly booster sessions for returning athletes during years 03, 04 and 05. Coaches, parents and peer educators will receive instruction on program objectives and implementation. Questionnaires will be administered prior to and after the intervention and at year-end follow-up, to assess availability, knowledge, attitudes, intent to use and use of AS and other drugs. Attitudes and behaviors concerning nutrition and exercise will be examined, along with demographics, resistance skills, environmental factors, intrapsychic constructs, peer influences and anthropometric measures. Program implementation and its effects will be assessed by audiotape, observation and surveys. The link between mediators targeted by the program components and reduction of drug use will be studied. The relationship of intervention components with positive and negative outcomes (knowledge, attitudes, intent and behaviors) will be determined. The study will identify protective and risk factors for AS use and provide an understanding of how and under what conditions AS use can be prevented.
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