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Athletes Training and Learning to Avoid Steroids (ATLAS) is a multicomponent school-based drug and alcohol prevention program for male high school athletes, 13 to 19 years old, 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 interactive activities, including
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
As of 2007 the ATLAS program is being sponsored by Sports Illustrated in several States. In 2008, 20,000 student–athletes will be sponsored by the National Football League.
A randomized prospective trial compared a comprehensive school-based anabolic–androgenic steroid (AAS) intervention (ATLAS) 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 based on demographic characteristics such as school size, family socioeconomic status, school attendance, student participation in a free-lunch, number of students attending college, and the football team’s win–loss record for the season prior to 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. Therefore, two of the unpaired control schools were matched on demographics, and one of these schools was randomized to the experimental condition. The final sample consisted of 15 experimental schools (n=702) and 16 control schools (n=804). All participants were male high school football players. 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, believe in media messages, impulsivity, drug refusal skills, body image, feelings of athletic competence, and beliefs about parents’ and coaches’ AAS attitudes.
ATLAS–trained students experienced distinct advantages, compared with students in the control group. For example, the intervention was associated with significant reductions in adolescent intent to use 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, 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, despite students’ being away from the football team setting.
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 D. Catlin. 1987. “Characteristics of Anabolic–Androgenic-Steroid–Free Competitive Male and Female Bodybuilders.” Physician Sports Medicine 15:169–79.
Fritz, M.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, E.E. Bosworth, L. Trevisan, and Diane L. Elliot. 1991. “Anabolic Steroid Education and Adolescents: Do Scare Tactics Work?” Pediatrics 87:283–86.
Goldberg, Linn, E.E. Bosworth, Robert T. Bents, and L. 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, E.E Bosworth, and Robert T. Bents, letter to the editor, New England Journal of Medicine 322:775–6, 1990.
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 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 JeeWon 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).
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.
Linn Goldberg, M.D., FACSM
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: (503) 494-8051
Fax: (503) 494-1310
E-mail: goldberl@ohsu.edu
Web site: http://www.atlasprogram.com
Sean Kolmer
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: (503) 494-3727
Fax: (503) 494-1310
E-mail: kolmers@ohsu.edu
Web site: http://www.atlasprogram.com
