Harnessing the global expertise in drug use and drug prevention in physical activity settings: results from the Anabolic Steroid Prevention Survey

Recent decades have seen increased efforts internationally to prevent the use of anabolic androgenic steroids (AAS) and other image and performance-enhancing drugs (IPEDs) in gyms and fitness environments. Yet, very little is known about effective prevention strategies. This study aimed to identify key risk factors for AAS use and assess the relevance of these risk factors as targets of intervention. Seventy four (<i>n</i> = 74) IPED experts participated in the Anabolic Steroid Prevention Survey (response rate: 62.4%). A total of 18 psychosocial and two behavioral risk factors identified in a literature review were rated by participants along two dimensions: <i>importance</i> and <i>preventability</i>. The results show that most IPED experts (91%) believe that preventing AAS use in gyms is important to public health, and that AAS use can be prevented to a certain degree (91%), but not eliminated altogether (85%). Based on participants’ assessment, six risk factors were categorised as very promising (e.g. the descriptive norm and poor knowledge on AAS alternatives), 10 as promising (e.g. body dissatisfaction and drive for muscularity), and four as unpromising but worthy of consideration (e.g. AAS-using peers and perceived benefits of AAS use). To effectively prevent AAS use in gyms, interventions should attempt to reduce these risk factors.近数十年来，国际社会在健身房及健身场所中针对合成代谢雄激素类固醇（anabolic androgenic steroids, AAS）与其他形象与表现增强药物（image and performance-enhancing drugs, IPEDs）的滥用防控工作力度持续加大，但目前对有效的预防策略仍知之甚少。本研究旨在明确合成代谢雄激素类固醇滥用的关键风险因素，并评估这些风险因素作为干预靶点的相关性。本次共有74名（n=74）形象与表现增强药物领域专家参与了合成类固醇预防调查（Anabolic Steroid Prevention Survey），有效回收率为62.4%。研究团队通过文献综述筛选出18项社会心理风险因素与2项行为风险因素，参与者从重要性与可预防性两个维度对上述因素进行评分。结果显示，绝大多数参与调查的形象与表现增强药物领域专家（91%）认为，在健身房中防控合成代谢雄激素类固醇滥用对公共卫生具有重要意义，且该类药物滥用可在一定程度上得到遏制（91%），但无法完全杜绝（85%）。根据参与者的评估结果，6项风险因素被归类为极具干预潜力（如描述性规范及对合成代谢雄激素类固醇替代方案的认知不足），10项被归类为具有干预潜力（如身体不满情绪与肌肉量渴求），另有4项虽干预潜力有限但仍值得考量（如同伴使用合成代谢雄激素类固醇的行为及对该类药物益处的主观认知）。为有效防控健身房内合成代谢雄激素类固醇滥用问题，相关干预措施应致力于降低上述风险因素的影响。