Archives of Pediatric and Adolescent Medicine Volume: 11 Issue: 158 Dated: 2004 Pages: 1043-1049
The objectives of this project were to implement and to assess the efficacy of a school-based, sport team-centered program to prevent young female high school athletes from engaging in disordered eating and body-shaping drug use.
A prospective controlled trial was conducted in 18 high schools, with balanced random assignment by school to the intervention and usual care control conditions. A total of 928 students from 40 participating sport teams were enrolled in the program. Their mean age was 15.4 years and 92.2 percent were White. Follow up retention was 72 percent. 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. The evaluation assessed participants by confidential questionnaire prior to and following their sport season. Program effects were determined by using an analysis of covariance based approach within the Generalized Estimating Equation framework. Athletes who participated in the program reported significantly less ongoing and new use of diet pills and less new use of athletic enhancing substances (amphetamines, anabolic steroids, and sport supplements) compared with non participants. Other health harming actions also were reduced (less riding with an alcohol consuming driver, more seat belt use, and less new sexual activity). The ATHENA athletes had coincident positive changes in strength training self efficacy and healthy eating behaviors. Reductions occurred in intentions toward future use of diet pills, vomiting to lose weight, and use of tobacco and muscle building supplements. The program's curriculum components were altered appropriately (controlling mood, refusal skills, belief in the media, and perceptions of closest friends' body shaping drug use). The study's overall conclusion is that sport teams are effective settings for gender specific, peer led curricula to promote healthy lifestyles and to deter disordered eating, athletic enhancing substance use, and other health harming behaviors. (publisher abstract modified)
United States of America