Program Is First to Reduce Drug Use and Eating Disorders Among Female High School Athletes

11/01/04    Portland, Ore.

ATHENA is one of two OHSU education programs included in $15M drug prevention bill signed by President Bush, recommended for use in schools nationwide.

A health promotion program created by Oregon Health & Science University researchers is the first to reduce disordered eating, body-shaping drug use and other health-harming behaviors among female high school athletes. The findings of this program, called ATHENA (Athletes Targeting Healthy Exercise & Nutrition Alternatives), are published in the Nov. 1 issue of the Archives of Pediatric & Adolescent Medicine.

"About half of female and male high school students participate in school sports, and contrary to popular belief, they are not protected from drug use and other harmful behaviors," said Diane Elliot, M.D., ATHENA principal investigator and professor of medicine in the OHSU School of Medicine. "For young women, the cultural pressures to be thin may be compounded by similar influences from their sport, resulting in more prevalent disordered eating behaviors and body-shaping drug use. These health-harming actions, even among those not diagnosed as anorexic or bulimic, can be associated with significant health problems. The abilities fostered by the ATHENA program had immediate benefits and may help these young women make healthier choices and avoid harmful behaviors in the future."

Elliot and her colleagues enrolled 928 female students from 18 northwest Oregon and southwest Washington high schools representing 40 sports teams, including dance and cheerleading teams. The athletes participated in eight weekly 45-minute intervention sessions during their teams' sport season. For each team that participated in the program, another team with similar demographics was recruited to serve as the control.

The program was taught primarily by student "squad leaders," who used scripted lessons. Coaches facilitated the program, and the sessions were incorporated into the team's usual practice activities. Topics were gender-specific and focused on healthy sport nutrition, effective exercise training, understanding media images of women, skills to prevent depression, and the effects of drug use and other unhealthy behaviors on sport performance.

The female athletes were surveyed before and after their sport season about diet, nutrition and exercise habits. The researchers found athletes who participated in ATHENA reported significantly less ongoing and new use of diet pills, and less use of amphetamines, anabolic steroids and sport supplements. The athletes also reported increased seatbelt use, less riding with a drinking driver, fewer injuries and less new sexual activity.

"Previous universal disordered eating and drug use prevention programs have changed students' knowledge, but have had limited influence on unhealthy behaviors," said Linn Goldberg, M.D., co-principal investigator, professor of medicine and head of the Division of Health Promotion and Sports Medicine in the OHSU School of Medicine. "ATHENA effectively reduced body-shaping drug use while promoting healthy eating habits, just as its male counterpart, ATLAS, decreased alcohol and drug use, reduced drinking and driving and improved nutrition behaviors among male high school athletes. These studies show sport teams are an untapped resource for positively altering the beliefs and actions of young athletes."

ATLAS is a five-year OHSU study initiated by Goldberg and Elliot in 1993 that proved successful in reducing a young male athlete's desire and use of anabolic steroids, sports supplements, and a wide variety of substances among male adolescent athletes in schools in Oregon and Washington and credited with significant drug prevention in other locales. ATLAS is a Model Program of the U.S. Department of Health & Human Services and one of nine Exemplary Programs of the Department of Education's Office of Safe and Drug Free School.

Both ATLAS and ATHENA have been funded by the National Institute on Drug Abuse, an institute of the National Institutes of Health, and schools in more than 20 states have already implemented them.

ATLAS and ATHENA have been recommended for use in elementary and secondary schools nationwide as a result of the recent passage of Senate Bill 2195, the "Anabolic Steroid Control Act of 2004," co-sponsored by Sens. Joe Biden and Orrin Hatch, and signed by President Bush Oct. 22, 2004. The bill provides $15 million for each of six years to teach kids about the dangers of steroids.

Other researchers in the OHSU School of Medicine's Division of Health Promotion and Sports Medicine who worked on ATHENA include: Esther Moe, Ph.D., M.P.H., research assistant professor of medicine; Carol DeFrancesco, M.A.L.S., R.D., L.D., senior research associate in medicine; and Melissa Durham, research assistant in medicine. Hollie Hix-Small, M.S., Oregon Research Institute, Eugene, Ore., also was a co-author.