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DELTS project 2018-2019

About DELTS

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This 24-month Erasmus+ Sport project (2018 – 2019) is a significant step forward in improving doping prevention strategies in the EU. Prevention evaluation helps to improve the quality and delivery of anti-doping programs, and to save money and resources for services that are effective.

The project brings together a diverse team of academics, health care providers, fitness industry representatives and anti-doping workers. The consortium includes seven partners – Dopinglinkki at A-Clinic Foundation (FI), Lithuania Anti-Doping Agency (LT), The Mainline Foundation (NL), Public Health Institute at Liverpool John Moores University (UK), Folkhälsan (FI) Aristotle University of Thessaloniki (GR), and the University of New South Wales (AU) – who represent a geographically and expertise-wise wide spectrum of stakeholders in their respective countries.

The design of the project involves the following steps:

  1. Creating a standardized evaluation methodology: A mixed methods design will be used to evaluate eLearning tools incorporating an online survey and individual structured interviews.
  2. Evaluating PIED eLearning tools: During this project we will evaluate three e-learning tools. One is aimed at healthcare providers (Dopinglinkki Healthcare Provider Tool) and two are aimed at the fitness industry (Dopinglinkki Fitness Tool and the SafeYou app).
  3. Improve PIED Prevention: by evaluating the effectiveness of PIED eLearning tools we aim to improve prevention materials and health education in the field of PIEDs. Evaluation is essential for the quality assurance of eLearning tools and to determine if it achieves its goals and meets its objectives – in this case improving PIED-related knowledge of healthcare providers, fitness instructors, and other stakeholders/end-users.  

PIEDS: What is the problem?

People are increasingly using performance and image enhancing drugs (PIEDs) to help them meet their ‘body-image-related goals’. This includes substances such as anabolic-androgenic steroids to increase muscle mass and strength, and the use of weight-loss drugs for fat burning purposes.

Alongside this increase in use, there has been an associated rise in the number of reported health complications associated with the use of performance and image enhancing drugs. While many established harms reported are superficial (e.g. acne, balding), there are more severe physical (e.g. cardiovascular disease and liver function) and psychological (e.g. dependence and mood changes) problems. In addition, many people using PIEDs inject their drugs and are therefore at risk of injecting related harms, such as injection site infections (e.g. swelling and abscesses), and are also vulnerable to infection with blood borne viruses.

Despite the established health risks of PIEDs and the risky behaviours associated with their use, in 2014 the European Commission noted that little research exists on the prevention of recreational PIED use, which impedes the development and implementation of prevention measures and other policy initiatives. The same issues apply for secondary prevention programmes that aim to reduce health harms among current users (harm reduction).

Healthcare professionals in various countries report difficulties engaging with PIED users coupled with a lack of knowledge about these substances. Users are frustrated by this lack of knowledge, and often do not disclose enhancement drug use, turning to their peers or the Internet to obtain information or to seek help, instead of educational programmes or healthcare services. Effective education for healthcare professionals and other stakeholders on performance and image enhancing drugs is therefore urgently needed.

What does the DELTS project offer?

The Doping E-learning Tools (DELTS) project will evaluate the accessibility, usability and utility of several PIED e-learning programs focused on recreational athletes. E-learning tools are cost-effective, easily accessible and provide on-demand learning and scalability to large numbers of stakeholders (e.g. healthcare providers, fitness staff, etc.).

Our project also has the potential to drive clinical outcomes as the e-learning tools are focused on improving best practice in healthcare by offering tailored interventions to provide better health education and counselling. Not only will we test the effectiveness of several prevention programmes, but we will ensure that the evaluation tools can be easily replicated and implemented in different countries in order to improve communication and co-ordination.

DELTS Research Results

The research explored the adaption and implementation of an online e-learning module (work package 3) and app (work package 4) which were designed to support professional learning in those professionals working to prevent performance and image enhancing drug (PIED) use and harms among recreational athletes and fitness enthusiasts.

DELTS Research Report (pdf)

Dr. Amanda Atkinson presenting the results ”Evaluating the acceptability and usability of e-learning resources for healthcare and fitness industry professionals on PIED use” at the DELTS Conference in December 2019:

The infographics below highlight the main conclusions of the research.

HEALTH PROFESSIONALS, PERFORMANCE AND IMAGE ENHANCING DRUGS (PIEDS), AND E-LEARNING IN AUS, FI, NL AND UK Participants filled out a survey (N=77) and were interviewed (N=38) to answer questions about the utility and acceptance of a PIED e-module (the Dopinglinkki e-module) targeted at health professionals. 68 % (N=52) agreed (quite a bit/very much) that the module would help them engage with a person who uses PIEDs. 72 % (N=55) felt that the module would help them identify some of the myths regarding fitness doping An urgent need to develop (online) educational materials to improve their knowledge around PIEDs and their (potential) users. Potential to reduce stigma amongst health professionals and to build rapport with those who use PIEDs. The e-module is currently too time-intensive and not appropriate for all types of health professionals. Different learning pathways are therefore needed. The e-module missed specific harm reduction and clinical advice that could be implemented in practise. This infographic forms part of the ERASMUS+ Sport funded DELTS project (https://deltsproject.eu), incl. Aristotle University of Thessaloniki, Dopinglinkki, Folkhälsan, Lithuanian Anti-Doping Agency, Liverpool John Moores University, Mainline, the University of New South Wales and the Human Enhancement Drugs Network.

Infographic 1

FITNESS PROFESSIONALS, PERFORMANCE AND IMAGE ENHANCING DRUGS (PIEDS), AND E-LEARNING IN FI, GR AND LT Participants filled out a survey (N=52) and were interviewed (N=24) to answer questions about the utility and acceptance PIED e-module (the Dopinglinkki fitness e-module) targeted at fitness professionals. 85 % (N=29) agreed (quite a bit/very much) felt that the module would help them to understand motivation of PIED use. 84 % (N=37) felt that the module would help them identify some of the myths regarding fitness doping Participants reported that the e-module has the potential to inform fitness trainers and to prevent someone’s willingness to use. The module requires adaption in terms of needing to be less time intensive and to be instantly accessible (e.g. mobile app). Raising awareness of PIED use as a public health issue is needed to encourage uptake of the e-module. Management support and endorsement is required to boost levels of completion. This infographic forms part of the ERASMUS+ Sport funded DELTS project (https://deltsproject.eu), incl. Aristotle University of Thessaloniki, Dopinglinkki, Folkhälsan, Lithuanian Anti-Doping Agency, Liverpool John Moores University, Mainline, the University of New South Wales and the Human Enhancement Drugs Network.

Infographic 1

FITNESS PROFESSIONALS, PERFORMANCE AND IMAGE ENHANCING DRUGS (PIEDS), AND SAFEYOU APP IN GR Participants filled out a survey (N=20) and were interviewed (N=10) to answer questions about the utility and acceptance of a mobile app containing information about PIEDs (the SafeYou App) targeted at fitness professionals. 89 % (N=17) agreed (quite a bit/very much) felt that the module would help them to understand the health risks associated with PIED use. 79 % (N=15) agreed (quite a bit/very much) that the module would help them encourage athletes and fitness participants to take responsibility for their decisions concerning PIED use Participants reported that the e-module has the potential to inform fitness trainers and to prevent someone’s willingness to use. Raising awareness of PIED use as a public health issue is needed to encourage uptake of the e-module. Management support and endorsement is required to boost levels of completion. This infographic forms part of the ERASMUS+ Sport funded DELTS project (https://deltsproject.eu), incl. Aristotle University of Thessaloniki, Dopinglinkki, Folkhälsan, Lithuanian Anti-Doping Agency, Liverpool John Moores University, Mainline, the University of New South Wales and the Human Enhancement Drugs Net

Infographic 3

Partners

Logos of the DELTS project partners

The international project team is composed of experts from all the partner institutions.

Aristotle University of Thessaloniki, Greece

Dopinglinkki, A-Clinic Foundation, Finland

Folkhälsan, Finland

Lithuanian Anti-Doping Agency 

Liverpool John Moores University, UK

Mainline, the Netherlands

University of New South Wales

More information

Jukka Koskelo

Jukka Koskelo

Tutkimus- ja kehitysyksikön päällikkö

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