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

Krista W. Ranby, Leona S. Aiken, David P. MacKinnon, Diane L. Elliot, Esther L. Moe, Wendy McGinnis, Linn Goldberg

Research output: Contribution to journalArticle

37 Scopus citations


ObjectiveTo 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.MethodsIn 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.ResultsATHENA 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. ConclusionsATHENA 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.

Original languageEnglish (US)
Pages (from-to)1069-1083
Number of pages15
JournalJournal of Pediatric Psychology
Issue number10
StatePublished - Jan 1 2009



  • Adolescents
  • Educational interventions
  • Health promotion and prevention
  • LLongitudinal research
  • Mediation analysis.
  • Peers

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology

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