Athletes Targeting Healthy Exercise & Nutrition Alternatives (ATHENA)

An Evidence-Based Practice


The ATHENA (Athletes Targeting Healthy Exercise & Nutrition Alternatives) program advocates healthy eating habits and the avoidance of body-enhancing substances among middle and high school female athletes. Consisting of eight 45-minute educational sessions blended into a team's routine practice session, the program is delivered using scripted lessons in small learning clusters, each led by one coach-designated athlete squad leader. ATHENA promotes the concepts of sound sports nutrition and healthy body image through peer-led sessions. Role playing, student-created campaigns, public service announcements, and interactive games are a few examples of the types of activities that ATHENA participants engage in. Based on studies evaluating the effectiveness of ATHENA, the program has shown to successfully reduce the use of diet pills and sport supplements, improve nutrition, decrease the frequency of riding in a car with a drinking driver, reduce new sexual activity, limit injuries, and diminish the use of alcohol and controlled substances. Thus far, the ATHENA program has been implemented in over 60 schools.

Goal / Mission

The mission of the ATHENA (Athletes Targeting Healthy Exercise & Nutrition Alternatives) program is to promote healthy sports nutrition and discourage the use of body-enhancing substances among middle and high school female athletes.

Results / Accomplishments

The ATHENA program has been examined in a variety of studies looking at its initial and long-term effects on female teen athletes.

The first study was a prospective controlled trial that evaluated the initial efficacy of the program with 928 participants from 40 participating sports teams. Upon completion of the 8-week program, the experimental group reported significantly less ongoing and new use of athletic enhancing substances (amphetamines, anabolic steroids and sports supplements) (p < 0.05 for each); less riding with an alcohol-consuming driver (p = 0.05); more seat belt use (p < 0.05); less new sexual activity (p < 0.05); increase in strength-training self-efficacy (p < 0.005); healthier eating behaviors (p< 0.001); and reductions in the intended future use of diet pills, vomiting to lose weight, and use of tobacco (p < 0.05 for each). Factors such as mood (p < 0.005) ,refusal skills (p = 0.05), belief in the media (p < 0.005), and perceptions of closest friends' body shaping drug use (p < 0.001) were controlled for by altering the ATHENA program's components appropriately. The pre to post-sports season usage of tobacco, alcohol, and marijuana were unchanged and did not differ between conditions.

Another randomized controlled study inspected the long-term effects of the ATHENA program on sports nutrition choices and body-enhancing substance use with 368 graduates of the program and 389 control subjects. One to three years following high school graduation, ATHENA graduates reported significantly less regular marijuana use (p < 0.01 for both the last year and lifetime use), alcohol consumption (p < 0.03 for the last 3 months and p < 0.05 for the last year), and cigarette use (p < 0.05). More ATHENA graduates knew their daily calcium requirement (66.3% intervention versus 40.0% control, p < 0.0001) and indicated a significantly heavier body image than control participants when asked to select the most healthy (p < 0.05) and most attractive (p < 0.01) female physiques from a selection of images.

About this Promising Practice

Primary Contact
Michelle Otis
Oregon Health & Science University
3181 SW Sam Jackson Park Road, CR 110
Portland, OR 97239-3098
(503) 418-4166
Health / Teen & Adolescent Health
Health / Exercise, Nutrition, & Weight
Health / Substance Abuse
Oregon Health & Science University
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Target Audience
Submitted By
Nina Veeravalli