A systematic review investigating the behaviour change strategies in interventions to prevent misuse of anabolic steroids

Abstract

A systematic review investigating the behaviour change strategies in interventions to prevent misuse of anabolic steroids.http://researchonline.ljmu.ac.uk/7477/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. Astract:This review aimed to examine strategies applied in interventions to prevent image and performance enhancing drug use in the context of intervention effectiveness. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow up times; however studies with components in addition to information provision may be more promising. Interventions are required outside of sport settings to reflect the transition of this form of substance use to the general population. 2 Introduction Anabolic steroidsAnabolic steroids (AS) are the most prominent of a range of substances used to modify appearance and performance known as image and performance enhancing drugs (IPEDs).Globally the lifetime prevalence of AS has been estimated at 3.3%, with higher prevalence amongst males (6.4%) (Sagoe et al., 2014b), and it is suggested that nearly one third of AS users will develop a form of dependence (Pope et al., 2014a). Although AS can be used without adverse consequences, such as when used therapeutically, risk of harm increases with the far greater doses observed when AS are used outside of clinical settings (Harmer, 2010).Additionally, the quality of illicitly produced AS cannot be controlled and those using them frequently do so as part of complex IPED regimens. This misuse of AS is associated with a range of acute and chronic adverse consequences (Pope et al., 2014b) that range greatly from cosmetic (e.g. acne) to critical (e.g. cardiovascular disease, liver function) with evidence of potential psychological harms (e.g. increased aggression, mania) (ACMD, 2010b). Harms appear to increase with long-term use, which may be characterised by polypharmacy, long or continuous cycles of use, body image disturbance and obsession with training and diet (Kanayama et al., 2009).The majority of th...

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“…However, little exists to guide the development of such strategies. In the sporting arena, behavioural change strategies that have involved educative strategies (particularly information provision and awareness raising in isolation) have resulted in poor outcomes—increasing knowledge, but having no clear impact on attitudes or intentions to use unsafe, banned DSs [38]. Meta-analyses have found attitudes, perceived norms, and self-efficacy (to refrain from use) were significant predictors of doping intentions, and as a result, interventions should attempt to de-normalise use in sports and exercise settings [39].…”

“…Meta-analyses have found attitudes, perceived norms, and self-efficacy (to refrain from use) were significant predictors of doping intentions, and as a result, interventions should attempt to de-normalise use in sports and exercise settings [39]. Behavioural change strategies with components designed to develop skills, change social norms or encourage goal setting are considered more promising than information provision [38]. Development of strategies for a military population will be reliant on understanding the motivators for supplement use; the benefits and barriers associated with those behaviours, as well as those associated with new or alternative behaviours.…”

An evidence-based socioecological framework to understand men’s use of anabolic androgenic steroids and inform interventions in this area

“…Further, this provides a framework through which to view routes for interventions to influence behavior and outcomes related to AAS use. To date, interventions have focused predominantly on individual level factors within school environments (Bates et al, 2017). As illustrated here however there are many other potential environments worthy of attention, and other influencing factors to consider when planning such interventions.…”

“…The socioecological framework suggests interventions need to address multiple levels in order to achieve sustained behavior change (Sallis & Owen, 2015). However, it appears that behavioral interventions have tended to focus solely on individual and intrapersonal factors and rarely sought to influence community, institutional and societal level factors (Golden & Earp, 2012) which has also been identified with AAS interventions (Bates et al, 2017).…”

“…Prevention interventions for AAS have typically focused on changing individual level factors (Bates et al, 2017) and evidence suggests that attitudes, beliefs and personal traits do contribute to decisions about AAS use. Recent work has sought to develop a typology of male AAS users based around their individual characteristics (Christiansen, Vinther, & Liokaftos, 2016).…”