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Journal of Pediatric Psychology Advance Access published online on April 22, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp025
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

A Mediation Analysis of the ATHENA Intervention for Female Athletes: Prevention of Athletic-Enhancing Substance Use and Unhealthy Weight Loss Behaviors

Krista W. Ranby, MA1, Leona S. Aiken, PhD1, David P. MacKinnon, PhD1, Diane L. Elliot, MD, FACP2, Esther L. Moe, PhD, MPH2, Wendy McGinnis2 and Linn Goldberg, MD, FACSM2

1Arizona State University and 2Oregon Health & Science University

All correspondence concerning this article should be addressed to David P. MacKinnon, Department of Psychology, Arizona State University, 950 S. McAllister, Room 237, Tempe, AZ 85287-1104, USA. E-mail: david.mackinnon{at}asu.edu


  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.

Key words: adolescents; educational interventions; health promotion and prevention; lLongitudinal research; peers; mediation analysis..

Received July 5, 2008; revision received February 11, 2009; accepted March 12, 2009


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