Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1
Goldberg, L., MacKinnon, D. P., Elliot, D. L., Moe, E. L., Clarke, G., & Cheong, J. (2000). The Adolescents Training and Learning to Avoid Steroids Program: Preventing drug use and promoting health behaviors. Archives of Pediatrics and Adolescent Medicine, 154, 332-338. 
Supplementary Materials
Athlete Pack, including sports menu, training guide, and 10-session curriculum workbook
Coach/Instructor Package, including background information, squad leader guide, 10-session curriculum guide, and overheads
Fidelity Rating Form
Fritz, M. S., MacKinnon, D. P., Williams, J., Goldberg, L., Moe, E. L., & Elliot, D. L. (2005). Analysis of baseline by treatment interactions in a drug prevention and health promotion program for high school male athletes. Addictive Behaviors, 30, 1001-1005.
Goldberg, L., Elliot, D., Clarke, G. N., MacKinnon, D. P., Moe, E., Zoref, L., et al. (1996). Effects of a multidimensional anabolic steroid prevention intervention. The Adolescents Training and Learning to Avoid Steroids (ATLAS) Program. Journal of the American Medical Association, 276(19), 1555-1562.
Goldberg, L., Elliot, D. L., Clarke, G. N., MacKinnon, D. P., Zoref, L., Moe, E., et al. (1996). The Adolescents Training and Learning to Avoid Steroids (ATLAS) prevention program. Background and results of a model intervention. Archives of Pediatrics and Adolescent Medicine, 150, 713-721.
MacKinnon, D. P., Goldberg, L., Clarke, G. N., Elliot, D. L., Cheong, J., Lapin, A., et al. (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.
Outcomes
| Outcome 1: Intent to use anabolic steroids |
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Description of Measures
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Intent to use anabolic steroids was measured by a self-report instrument using primarily 5- to 7-point agreement scales.
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Key Findings
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Athletes participating in ATLAS were compared with athletes who were given commercially produced materials that emphasized the adverse effects of anabolic steroids and the benefits of a sports nutrition diet. Athletes in the ATLAS group were less likely than those in the comparison group to say they intended to use anabolic steroids, both at the end of the football season (p < .05) and at 1-year follow-up (p < .03).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.9
(0.0-4.0 scale)
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| Outcome 2: Anabolic steroid use |
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Description of Measures
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Anabolic steroid use was measured by a self-report instrument primarily using 5- to 7-point agreement scales.
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Key Findings
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Athletes participating in ATLAS were compared with athletes who were given commercially produced materials that emphasized the adverse effects of anabolic steroids and the benefits of a sports nutrition diet. At the end of the football season, 7 new anabolic steroid users were reported in the ATLAS group, while 18 were reported in the comparison group (p < .04).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.9
(0.0-4.0 scale)
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| Outcome 3: Alcohol and other illicit drug use |
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Description of Measures
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Alcohol and other illicit drug use (marijuana, amphetamines, and narcotics) were measured by a self-report instrument primarily using 5- to 7-point agreement scales.
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Key Findings
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Athletes participating in ATLAS were compared with athletes who were given commercially produced materials that emphasized the adverse effects of anabolic steroids and the benefits of a sports nutrition diet. Compared with athletes in the comparison group, athletes in the ATLAS group typically reported lower use of alcohol and illicit drugs, both at the end of the football season (p = .009) and at 1-year follow-up (p < .04).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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3.0
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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13-17 (Adolescent)
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100% Male
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79% White
7.4% Race/ethnicity unspecified
5.4% Black or African American
3.7% Asian
3.7% Hispanic or Latino
0.8% American Indian or Alaska Native
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
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1: Intent to use anabolic steroids
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2.7
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2.5
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3.3
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3.0
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2.6
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3.2
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2.9
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2: Anabolic steroid use
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3.0
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3.0
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3.3
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3.0
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2.0
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3.2
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2.9
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3: Alcohol and other illicit drug use
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3.0
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3.2
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3.3
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3.0
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2.6
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3.2
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3.0
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Study Strengths
The psychometric properties of the alcohol and drug use outcome measures, which were based on the Monitoring the Future survey, have been established by independent investigators. Intervention fidelity is clearly a strength of ATLAS. The investigators endeavored to assure fidelity by providing highly scripted materials and observing classroom sessions to confirm coach and peer-leader adherence to the protocol. Attrition among students was not unreasonably high given the relatively high student turnover (78.9% from preseason to postseason). Follow-up rates were impressive (68.7% for cohorts 1 and 2 at 1-year follow-up). There was no attrition among schools. Everyone who completed the program appears to have provided complete data. The longitudinal evaluation used a quasi-experimental design in which the schools were matched in dyads based on salient demographics, including school size, family socioeconomics, and the football team's prior win-loss record. The convergence of findings across studies and cohorts strongly supports the conclusion that ATLAS led to positive changes in participants' intentions to use anabolic steroids and reductions in their use of anabolic steroids, alcohol, and drugs. There was some evidence that the analyses may be appropriate to support outcomes seen in the short-term and 1-year follow-ups.
Study Weaknesses
More details could have been presented on questionnaire development and psychometric properties regarding anabolic steroid use. Because research staff could identify respondents through codes, students may have responded to the survey based on their awareness of what the experimenter expected to find. The authors noted that "some students who used or were considering using anabolic steroids may have been reluctant to enroll. Alternatively, these students may have enrolled in the study but not admitted to drug use." The methods used to analyze the effects of attrition, and most especially the effects of differential attrition, are unclear. One potential threat to internal validity was the significant baseline differences between the experimental and control groups. There were concerns about the selection of one-tailed rather than two-tailed significance tests, regardless of how promising the pilot data were, and the absence of alpha correction, given the number of separate regressions.
