Program Goals/Target Population
ATHENA (Athletes Targeting Healthy Exercise & Nutrition Alternatives) is a sports team–based, peer-led harm reduction and health promotion program for high school female athletes. The program parallels ATLAS (Adolescents Training & Learning to Avoid Steroids), a drug and alcohol prevention program for male athletes. Both are school-based, team-centered programs that promote healthy nutrition and effective exercise training as alternatives to harmful behavior.
The primary objectives of ATHENA are to reduce young female athletes’ disordered eating habits and to deter the use of body-shaping substances, such as steroids and diet pills.
The curriculum specifically targets modifiable risk and protective factors associated with disordered eating and body-shaping drug use. ATHENA is delivered during a team’s sport season and includes eight 45-minute classroom sessions integrated into a team’s usual practice activities. The coach assigns team members to groups of approximately six students (known as squads) and designates one athlete per group as squad leader. Before the first classroom session, squad leaders attend a 90-minute orientation session. During the sessions, squad leaders direct most of the ATHENA group activities, with the coach or other team staff acting as facilitator or timekeeper. The act of players’ participating in the program with their coach and peers was designed to teach participants that their coach and peers endorse healthy norms.
Each classroom session is composed of three to five activities designed to foster learning and application of new abilities. Topics address such issues as depression prevention, mood and self-esteem, norms of behavior, effects of media depictions of women, perceptions of healthy body weight, and societal pressures to be thin. Media influences are countered by having female athletes discuss, deconstruct, and remake magazine advertisements for cigarettes, alcohol, and nutritional supplements. Participants share healthy behavioral expectations, practice refusal skills, and create and present public service campaigns to discourage drug use and disordered eating practices. At each session, participants also receive a specific short-term health goal, such as eating breakfast daily, to complete before the next session.
The squad leaders and coach use scripted lessons to lead meetings, while the other squad members use workbooks to follow along. All participants also receive a pocket-sized sport nutrition and training guide. The guide contains reference information and can be used by participants to monitor protein and calcium intake and to track their daily mood and enjoyable activities.
13 to 17
Disordered Eating Behavior
The results of the Athletes Targeting Healthy Exercise & Nutrition Alternatives (ATHENA) intervention showed a few significant effects. Elliot and colleagues (2004) found that female athletes who had participated in ATHENA self-reported significantly less use of diet pills in the previous 3 months. Although there were no significant differences between the ATHENA intervention group and the control group on questions asking if participants had vomited to lose weight or on use of athletic-enhancing substances (such as creatine), there were significantly more new users of muscle-building supplements in the control group.
There were significant differences on measures of intentions toward future disordered eating behaviors and drug use. The ATHENA intervention group reported that they were significantly less likely in the future to use diet pills, to vomit to lose weight, and to use athletic-enhancing substances such as creatine.
Although both the ATHENA intervention group and the control group reported reductions in smoking cigarettes in the previous 3 months, overall there were no significant differences between the groups on tobacco use. In regard to measures of intentions toward future drug use, the ATHENA intervention group did report that they were significantly less likely to smoke cigarettes in the future.
Disordered Eating Behavior
Overall, Elliot and colleagues (2008) studying Athletes Targeting Healthy Exercise & Nutrition Alternatives (ATHENA) found that graduates’ self-reported use of diet pills, diuretics, laxatives, and self-induced vomiting from both the intervention and control groups became less prevalent over time, with fewer than 10 percent of all graduates indicating those behaviors in the past 3 months. There were no significant differences between the self-reported behaviors of the groups.
Alcohol, Tobacco, and Illicit Drug Use
Graduates who had participated in the ATHENA intervention self-reported significantly less alcohol use in the past 3 months, compared with control group graduates (27 percent, versus 41 percent). ATHENA graduates also self-reported significantly less alcohol use in the past year (25 percent, versus 35 percent).
Although the prevalence of tobacco use was low overall for all graduates, ATHENA graduates self-reported significantly less regular ongoing tobacco use in their lifetime (9 percent, versus 16 percent). However, there was no significant difference between the groups on self-reported tobacco use in the past year.
ATHENA intervention graduates self-reported significantly less regular marijuana use, compared with graduates in the control group. Graduates in the ATHENA group self-reported less regular marijuana use in the past year (2 percent, versus 7 percent) and in their lifetime (5 percent, versus 13 percent).
Self-reported use of other substances (such as club drugs, ecstasy, GHC, or LSD) was low (fewer than 5 percent of all graduates reported any use in the past year). There were no significant differences between the groups on self-reported use of these substances.
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