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Randomized Controlled Trial
. 2009 Nov-Dec;34(10):1069-83.
doi: 10.1093/jpepsy/jsp025. Epub 2009 Apr 22.

A mediation analysis of the ATHENA intervention for female athletes: prevention of athletic-enhancing substance use and unhealthy weight loss behaviors

Krista W Ranby  1 , Leona S Aiken, David P Mackinnon, Diane L Elliot, Esther L Moe, Wendy McGinnis, Linn Goldberg
Affiliations
Randomized Controlled Trial

A mediation analysis of the ATHENA intervention for female athletes: prevention of athletic-enhancing substance use and unhealthy weight loss behaviors

Krista W Ranby et al. J Pediatr Psychol. 2009 Nov-Dec.

Abstract

Objective: To explain, through mediation analyses, the mechanisms by which ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives), a primary prevention and health promotion intervention designed to deter unhealthy body shaping behaviors among female high school athletes, produced immediate changes in intentions for unhealthy weight loss and steroid/creatine use, and to examine the link to long-term follow-up intentions and behaviors.

Methods: In a randomized trial of 1668 athletes, intervention participants completed coach-led peer-facilitated sessions during their sport season. Participants provided pre-test, immediate post-test, and 9-month follow-up assessments.

Results: ATHENA decreased intentions for steroid/creatine use and intentions for unhealthy weight loss behaviors at post-test. These effects were most strongly mediated by social norms and self-efficacy for healthy eating. Low post-test intentions were maintained 9 months later and predicted subsequent behavior.

Conclusions: ATHENA successfully modified mediators that in turn related to athletic-enhancing substance use and unhealthy weight loss practices. Mediation analyses aid in the understanding of health promotion interventions and inform program development.

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Figures

Figure 1.
Figure 1.
CONSORT diagram depicting participants’ assignment to condition and retention.
Figure 2.
Figure 2.
Multiple mediator model predicting intention to use steroids and creatine and intention to engage in unhealthy weight loss and subsequent behaviors. The number in the lower right hand corner of construct boxes indicates the session in which the corresponding intervention material was introduced. Each construct measure in the model is a post-test score with the corresponding pre-test score partialed out. All pre-test measures were allowed to correlate with each other and with the ATHENA treatment variable. Post-test mediator measures within each step were allowed to correlate (i.e., the three knowledge measures, social norms and mood; the two outcome expectancies and self-efficacy; the two intention measures; the two follow-up behavior measures; the two follow-up intention measures). All direct effects of ATHENA were included in the model but only significant paths are depicted. Unstandardized path coefficients are reported. *p < .05, **p < .01, ***p < .001.
See this image and copyright information in PMC

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