Athletes Training and Learning to Avoid Steroids (ATLAS) (OJJDP Model Program Guide)

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Athletes Training and Learning to Avoid Steroids (ATLAS)

Intervention:

Athletes Training and Learning to Avoid Steroids (ATLAS) is a multicomponent school-based drug and alcohol prevention program for male high school athletes. ATLAS is designed to reduce or stop adolescent male athletes’ use of anabolic steroids, sport supplements, alcohol, and illegal drugs, while improving healthy nutrition and exercise practices. It is delivered to a school sports team, with instruction led by student–athlete peers and facilitated by coaches. ATLAS promotes healthy nutrition and exercise behaviors as alternatives to substance use (alcohol, illegal drugs, anabolic steroids, and unhealthy sport supplements).

ATLAS is delivered in a classroom to an entire sports team. Students are divided into small social learning groups, with a peer (squad) leader for each group. ATLAS’s team-centered approach works to exert positive peer pressure and promote positive role modeling. It is easy to implement because it is highly scripted with explicit instructions. Each of the program’s ten 45-minute sessions consists of the following interactive activities:

Educational games
Building skills (resistance, goal setting, nutrition, strength training)
Role-playing exercises
The creation of mock public service campaigns
Friendly competition between squads

The program concentrates on potential immediate consequences, because of their significance for adolescents, rather than on the future adverse effects of substance use. Athletes learn how to achieve their athletic goals by using state-of-the-art sports nutrition and strength training and how to avoid harmful substance use that will impair their physical and athletic abilities. Team workbooks, sports menus, and training guides complement the instructional materials. A 1-day training program, offered by the program developer, is not required but is recommended for school districts with multiple teams and coaches. Training will enhance the fidelity of the curriculum delivery. Successful replication of ATLAS also requires

A highly committed coach–facilitator
A coach “instructor package,” which includes a) program background information, b) the Squad Leader Training Guide, which explains how to train effective squad leaders, c) the Ten-Session Curriculum Guide, and d) overhead slides
Use of student materials (workbook, sports menu, and training guide booklets)
Team-based presentation of the program with one peer leader in each small group (i.e., squad) of six to eight students
Distribution of the Ten-Session Curriculum Guide for each peer leader

During 2006–07, ATLAS and its sister program ATHENA were sponsored by Sports Illustrated. Since 2007, 14 NFL teams have sponsored 30,000 student–athletes (males and females) in all sports under a program funded by the National Football League Youth Football Fund.

Evaluation Methodology:

Study 1
Goldberg and colleagues (1996), in a randomized prospective trial, compared the ATLAS intervention with a control condition that provided only a commercially produced antisteroid informational pamphlet. Thirty-four schools in the Portland, Ore., area were matched in pairs on the basis of demographic characteristics such as school size, family socioeconomic status, school attendance, student participation in a free-lunch program, number of students attending college, and the football team’s win–loss record for the season before participation. Seventeen schools were then randomized to the experimental condition and 17 to the control condition. Three experimental schools ultimately withdrew from the study owing to lack of time and local control over curricular components. Thus, two of the unpaired control schools were matched on demographics, and one of these was randomized to the experimental condition.

The final sample consisted of students at 15 experimental schools (n= 702) and 16 control schools (n= 804). All participants were male high school football players. The majority of students (81 percent of the control group and 77 percent of the experimental group) were white, with the remaining students from other racial/ethnic groups (including Asian, Native American, Hispanic, African American, and mixed heritage). Control subjects were slightly younger (a mean difference of roughly 7 weeks), had a somewhat higher mean grade point average (3.12 versus 3.02), had fathers who were slightly more educated, and had higher family incomes.

The main outcome measures consisted of self-report questionnaires administered before and after the intervention and at 9- or 12-month follow-up. The questionnaires assessed AAS and other drug use, knowledge of drug effects, attitudes toward and behavioral intent to use AAS, nutrition, exercise knowledge, perceived normative drug use behaviors, belief in media messages, impulsivity, drug refusal skills, body image, feelings of athletic competence, and beliefs about parents’ and coaches’ AAS attitudes. Regression analyses were used for both school- and individual-level data.

Evaluation Outcome:

Study 1
Substance Use
The study by Goldberg and colleagues (1996) found that ATLAS–trained students experienced distinct advantages, compared with students in the control group. The intervention was associated with significant reductions in adolescent intent to use anabolic–androgenic steroid (AAS), greater knowledge of AAS and other drug effects, greater belief in personal vulnerability to the harmful effects of AAS use, more negative attitudes about AAS users, reduced impulsivity, improved feeling of athletic abilities, higher self-esteem, stronger belief that coaches and parents were against AAS use, more competent drug refusal skills, less belief in media messages, increased belief in the football team as an information source, increased knowledge about advertised “ergogenic” supplements, and improved nutrition and exercise behaviors.

In addition, students in the intervention group were more likely to increase their strength-training practice in the school environment rather than in local gyms, which is important because local gyms are the Nation’s greatest reported source for acquiring AAS. Many of these positive results, including a reduced intent to use AAS, persisted at the long-term follow-up (9- or 12-months’ postintervention), despite students’ being away from the football team setting.

Other Information:

Required materials: Successful replication of Athletes Training and Learning to Avoid Steroids (ATLAS) requires the following:

A coach “instructor package,” which includes program background information, the Squad Leader Training Guide (which explains how to train effective squad leaders), the Ten-Session Curriculum Guide, Coach training DVD, Squad Leader training DVD, overheads, and a CD with templates for student-athlete achievement documents and slide show.
Use of student materials (Squad Leader Guide, Athlete Workbook, Athlete Guide)
Distribution of the Ten-Session Squad Leader Manual for each peer leader

Training requirements/provider certification: Training will enhance the fidelity of the curriculum delivery. A 1-day training program, offered by the program developer, is not required but is recommended for school districts with multiple teams and coaches

Costs: The program developers offer their Coach Instructor Package for $280, their Squad Leader Package for $11, and their Athlete Package for $11. These packages include training materials, curricula, and workbooks. The ATLAS developers also offer onsite training services. For more information about the cost of the implementation materials visit www.atlasprogram.com

Other Information: During 2006–07, Athletes Training and Learning to Avoid Steroids (ATLAS) and its sister program Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) were sponsored by Sports Illustrated. Since 2007, 14 National Football League teams have sponsored 30,000 student–athletes (males and females) in all sports under a program funded by the National Football League Youth Football Fund.

References:

Backhouse, Susan, Jim McKenna, and Laurie Patterson. 2009. “Prevention Through Education: A Review of Current International Social Science Literature.” Prepared for the World Antidoping Agency. Carnegie Research Institute, Leeds Metropolitan University, Leeds, England, 1–120 http://www.wada-ama.org/rtecontent/document/backhouse_Prevention_through_Education_final_2009.pdf

Durham, Melissa B., and Linn Goldberg. 2007. “Drug Prevention and Health Promotion for High School Athletes: A Summary of the ATLAS and ATHENA Programs.” In Hande Sarikaya, Christiane Peters, Thorsten Schulz, Martin Schönfelder, and Horst Michna (eds.). Congress Manual: Biomedical Side-Effects of Doping. Munich Germany: 262–77.

Elliot, Diane L., and Linn Goldberg. “Intervention and Prevention of Steroid Use in Adolescents.” 1996. American Journal of Sports Medicine 24:46–47.

Elliot, Diane L., Linn Goldberg, Kerry S. Kuehl, and Don H. Catlin. 1987. “Characteristics of Anabolic–Androgenic-Steroid–Free Competitive Male and Female Bodybuilders.” Physician Sports Medicine 15:169–79.

Fritz, Matthew S., David P. MacKinnon, J. Williams, Linn Goldberg, Esther L. Moe, and Diane L. Elliot. 2005. “Analysis of Baseline by Treatment Interactions in a Drug Prevention and Health Promotion Program for High School Male Athletes.” Journal of Addictive Behaviors 30(5):1001–05.

Goldberg, Linn, Robert T. Bents, Eric E. Bosworth, Louis Trevisan, and Diane L. Elliot. 1991. “Anabolic Steroid Education and Adolescents: Do Scare Tactics Work?” Pediatrics 87:283–86.

Goldberg, Linn, Eric E. Bosworth, Robert T. Bents, and Louis Trevisan. 1990. “Use, Knowledge, and Attitudes of Anabolic Steroids Among High School Football Players.” Journal of Adolescent Health Care 11:1–5.

Goldberg, Linn, and Diane L. Elliot. 1994. “Steroid Use Rises From ’87 to ’91; Prevention Strategy Program in Works.” National Federation News 11:44–45.

———. 1996. “Offering Alternatives to Anabolic Steroids: Effects on Adolescent Intentions.” In Henriette Heiny (ed.). Children and Adolescents in Athletic Competition—Rewards and Adversities. No. 96–75529. Library of Congress Catalog, 103–08.

———. 2005. “Preventing Substance Use Among High School Athletes: The ATLAS and ATHENA Programs.” Journal of Applied School Psychology 21(1):63–87.

Goldberg, Linn, Diane L. Elliot, Eric E Bosworth, and Robert T. Bents. 1990. Letter to the editor, New England Journal of Medicine 322:775–76.

Goldberg, Linn, Diane L. Elliot, Gregory N. Clarke, and others. 1996. “The Adolescents Training and Learning to Avoid Steroids (ATLAS) Prevention Program: Background and Results of a Model Intervention.” Archives of Pediatric and Adolescent Medicine 150:713–21.

Goldberg, Linn, Diane L. Elliot, Gregory N. Clarke, David P. MacKinnon, Esther L. Moe, and others. 1996. “Effects of a Multidimensional Anabolic Steroid Prevention Intervention: The ATLAS (Adolescents Training and Learning to Avoid Steroids) Program. Journal of the America Medical Association 276:1555–62.

Goldberg, Linn, Diane L. Elliot, Gregory N. Clarke, David P. MacKinnon, Esther Moe, and Jee Won Cheong. 2000. “The Adolescents Training and Learning to Avoid Steroids Program Preventing Drug Use and Promoting Health Behaviors.” Archives of Pediatrics and Adolescent Medicine 154(4).

Kuehn, Bridget M. 2009. “Teen Steroid, Supplement Use Targeted. Officials Look to Prevention and Better Oversight.” Journal of the American Medical Association 302(21):2301–03.

MacKinnon, David P., Linn Goldberg, Gregory N. Clarke, Diane L. Elliot, JeeWon Cheong, A. Lapin, Esther L. Moe, and J.L. Krull. 2001. “Mediating Mechanisms in a Program to Reduce Intentions to Use Anabolic Steroids and Improve Exercise Self-Efficacy and Dietary Behavior. “Prevention Science 2(1):15–28.

Program Specification:

New Rating:

Promising

Re-reviewed Date:

June 2011

Program Type:

Alcohol and Drug Therapy / Education

Classroom Curricula

Leadership and Youth Development

School/Classroom Environment

Ethnicity:

American Indian or Alaska Native

Asian

African American

Hispanic or Latino (of any race)

White

Gender:

Male

Age:

14 - 17

Target Settings:

Suburban

Urban

Problem Behaviors:

Alcohol,Tobacco and Other Drug Use

Risk & Protective Factors:

Risk

Community

Availability of alcohol and other drugs

Individual

Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use

Poor refusal skills

Peer

Peer alcohol, tobacco, and/or other drug use

Protective

Individual

Healthy / Conventional beliefs and clear standards

Self-efficacy

Social competencies and problem solving skills

Peer

Involvement with positive peer group activities

School

High expectations of students

High quality schools / Clear standards and rules

Opportunities for prosocial school involvement

Presence and involvement of caring, supportive adults in school

Student bonding (attachment to teachers, belief, commitment)

Additional Information:

SAMHSA: NREPP

Department of Education

Status:

Program is in operation at this time.

Performance Measures:

Suggested OJJDP Performance Measures for the Program Types(s):

Delinquency Prevention
Classroom Curricula
Logic Model: PDF
Performance Matrix:PDF
School Programs
Classroom Curricula
Logic Model: PDF
Performance Matrix:PDF
Delinquency Prevention
Leadership and Youth Development
Logic Model: PDF
Performance Matrix:PDF
School Programs
School/Classroom Environment
Logic Model: PDF
Performance Matrix:PDF

Contact Information:

Program Developer:
Linn Goldberg, MD, FACSM
Division of Health Promotion and Sports Medicine,
3181 SW Sam Jackson Park Road, Mailcode CR110
Portland, OR 97239–3098
Phone: 1.503.494.8051
Fax: 1.503.494.1310
Email: Click Here
Website: Click Here

Training & TA Provider:
Michelle Otis
Division of Health Promotion and Sports Medicine, Oregon Health and Science University
3181 SW Sam Jackson Park Road, Mailcode CR110
Portland, OR 97239–3098
Phone: 1.503.494.4166
Fax: 1.503.494.1310
Email: Click Here
Website: Click Here