Factors associated with physical activity levels in late adolescence: a prospective study.

BACKGROUND: Reaching an appropriate physical activity level (PAL) in adolescence is an important public health problem. This study aimed to evaluate factors associated with PAL and changes in PAL in late adolescence. MATERIAL AND METHODS: The sample involved 411 adolescents (201 girls) who were 16 years of age at study baseline; the participants completed a structured validated questionnaire at baseline (the beginning of the third grade of high school) and again at follow-up (the end of the fourth grade; when they were 18 years of age). Variables were obtained at both testing waves and included the following predictors: sociodemographic indices (sex, socioeconomic status, parental education), sports factors (participation in individual and team sports, competitive sports achievement, experience in sports), and PAL (the primary outcome), which was measured using the Physical Activity Questionnaire for Adolescents. RESULTS: A significant decrease in PAL between baseline and follow-up testing was evidenced (t-test = 6.17, p < 0.001). A logistic regression model calculated with a dichotomized outcome (normal PAL vs. low PAL), and sex as a covariate, showed a significant influence of participation in team sports and maternal education on PAL, both at baseline (OR = 1.56, 95% CI: 1.11-1.87; OR = 1.38, 95% CI: 1.02-1.90) and at follow-up (OR = 1.45, 95% CI: 1.01-1.90; OR = 1.35, 95% CI: 1.08-1.70, for team sports and maternal education, respectively). CONCLUSIONS: The study confirmed certain associations between the studied variables and PAL, but there was no significant influence of the observed indicators on changes in PAL in late adolescence. Further studies evaluating other predictors of changes in PAL are warranted. Med Pr. 2020;71(6):637-47.

Toward Prevention of Doping in Youth Sport: Cross-Sectional Analysis of Correlates of Doping Tendency in Swimming.

Doping is recognized as one of the most important problems in sports, but a limited number of studies have investigated doping problems in youth athletes. This study aimed to evaluate doping tendency (potential doping behavior (PDB)) and correlates of PDB in youth age swimmers. The participants were 241 competitive swimmers (131 females; 15.3 ± 1.1 years of age, all under 18 years old). Variables included predictors and PDB (criterion). Predictors consisted of sociodemographic factors (gender and age), sport-related variables (i.e., experience in swimming and sport achievement), variables explaining coaching strategy and training methodology, consumption of dietary supplements (DS), knowledge about doping, and knowledge about sports nutrition and DS (KSN). In addition to the descriptive statistics and differences between genders, a multinomial regression using PDB as the criterion (negative-, neutral-, or positive-PDB, with a negative-PDB as the reference value) was calculated to define associations between predictors and criterion. With only 71% of swimmers who declared negative-PDB results indicated an alarming figure. Boys with better KSN were more negatively oriented toward positive-PDB (OR: 0.77, 95%CI: 0.60-0.95). In girls, lower competitive achievement was evidenced as a risk factor for neutral-PDB (OR: 0.39, 95%CI: 0.24-0.63). Also, higher neutral-PDB (OR: 0.88, 95%CI: 0.81-0.96) and positive-PDB (OR: 0.90, 95%CI: 0.83-0.99) were identified in girls who began with intensive training in younger age. Because of the alarming figures of PDB, there is an evident need for the development of systematic antidoping educational programs in youth swimming. In doing so, focus should be placed on girls who began intensive training at an earlier age and those who did not achieve high competitive results.

Identification of Factors Associated with Potential Doping Behavior in Sports: A Cross-Sectional Analysis in High-Level Competitive Swimmers.

Background: Doping behavior, including the misuse of performance-enhancing drugs, is currently a serious problem in sports, and the efficacy of preventive efforts directly depends on information regarding the associations among different precipitating factors (PF) and doping behavior. This study aimed to establish the PF of potential doping behavior (PDB) in competitive swimmers. Methods: The study included 301 swimmers from Slovenia (153 females, 16.4 ± 2.4 years), tested during the 2017 National Championship. Variables were collected by previously validated questionnaires, which included questions on sociodemographics, sports-related factors, consumption of dietary supplements, knowledge of doping, factors of hesitation, and doping-related factors (i.e., number of doping tests, opinion about the presence of doping in sport). The PDB (positive, neutral, or negative intention toward doping) was observed as a criterion, while other variables were included as predictors in multinomial regression analyses (with "negative" as reference value), which additionally controlled for gender and age category (cadet-, junior-, and senior-level) as confounders. Results: The results confirmed higher susceptibility to doping in males (positive: odds ratio (OR): 2.77, 95% confidence interval (CI): 1.27⁻6.04), those swimmers who reported higher alcohol consumption (neutral: OR: 2.18, 95%CI: 1.06⁻4.16, positive: OR: 2.14, 95%CI: 1.05⁻4.37), and those regularly used dietary supplements (positive: OR: 3.62, 95%CI: 1.25⁻10.52). Competitive achievement in Olympic- (neutral: OR: 0.57, 95%CI: 0.41⁻0.81, positive: OR: 0.59, 95%CI: 0.39⁻0.88), and non-Olympic disciplines (positive: OR: 0.54, 95%CI: 0.35⁻0.83) was protective against PDB. Swimmers who were more concerned about the negative social consequences of doping behavior (i.e., condemnation by family and friends) were less likely to declare a positive intention toward the PDB (family condemnation: OR: 0.69, 95%CI: 0.56⁻0.86, friends' condemnation: OR: 0.65, 95%CI: 0.52⁻0.80). Conclusions: The results of the study provide more precise insight into the specific factors associated with PDB in swimming. The established precipitating factors should be incorporated into targeted anti-doping campaigns in this sport.

Evidencing Protective and Risk Factors for Harmful Alcohol Drinking in Adolescence: A Prospective Analysis of Sport-Participation and Scholastic-Achievement in Older Adolescents from Croatia.

Background: The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful alcohol drinking (HD) in older adolescents. Methods: The participants (n = 644, 53.7% females) were 16 years of age at study baseline and were tested at baseline and again 20 months later (follow-up). The predictors included four variables of scholastic achievement and four factors evidencing involvement in sport. Criterion was AD observed on the Alcohol Use Disorders Identification Test (AUDIT), and results were later categorized into harmful drinking (HD) and non-harmful drinking (NHD). The HD at baseline, HD at follow-up and HD initiation during the study course were observed as criteria in logistic regression analyses, which were additionally controlled for confounders (age, gender, socioeconomic status, and conflict with parents). Results: With 22% and 29% adolescents who reported HD at baseline and follow-up, respectively, the prevalence of HD remains among the highest in Europe. Scholastic failure was systematically related to HD at baseline and follow-up, but scholastic variables did not predict HD initiation during the course of the study. The higher odds for HD at baseline were evidenced for current and former team sport athletes. Those who quit individual sport were more likely to engage in HD at follow-up. Longer involvement in sport (OR: 2.10, 95% CI: 1.18⁻3.72), higher sport result (OR: 3.15, 95% CI: 1.19⁻8.34), and quitting individual sport (OR: 13.13, 95% CI: 2.67⁻64.62) were predictive of HD initiation. Conclusions: The results indicated specific associations between sport factors with HD initiation, which is understandable knowing the high stress placed on young athletes in this period of life, mainly because of the forthcoming selection between junior (amateur) and senior (professional) level. The results did not allow interpretation of the cause-effect relationship between scholastic failure and HD in the studied period.

Examination of Factors Explaining Coaching Strategy and Training Methodology as Correlates of Potential Doping Behavior in High-Level Swimming.

Although coaching is considered an important determinant of athletes' potential doping behavior (PDB), there is an evident lack of studies that have examined coaching-strategy-and-training-methodology (CS&TM) in relation to PDB. This study was aimed to identify the specific associations that may exist between CS&TM -factors and other factors, and PDB in high-level swimming. The sample comprised 94 swimmers (35 females; 19.7 ± 2.3 years of age) and consisted of swimmers older than 18 years who participated in the 2017 National Championship. Variables were collected by previously validated questionnaires, with the addition of questions where athletes were asked about CS&TM to which they had been exposed. Multinomial logistic regression was applied for the criterion PDB (Negative PDB - Neutral PDB - Positive PDB). The higher risk for positive-PDB was found in males (OR: 6.58; 95%CI: 1.01-9.12); therefore, all regressions were adjusted for gender. Those swimmers who achieved better competitive result were less prone to neutral-PDB (0.41; 0.17-0.98). The positive-PDB was evidenced in those swimmers who perceived that their training was monotonous and lacked diversity (1.82; 1.41-5.11), and who were involved in training which was mostly oriented toward volume (1.76; 1.11-7.12). The lower likelihood of positive-PDB is found in those who replied that technique is practiced frequently (0.12; 0.01-0.81), those who replied that coach regularly provided the attention to explain the training aims (0.21; 0.04-0.81), and that coach frequently reviewed and discussed the quality of execution of specific tasks (0.41; 0.02-0.81). The findings on the relationships between the studied variables and PDB should be incorporated into targeted anti-doping efforts in swimming. Further studies examining sport-specific variables of CS&TM in younger swimmers and other sports are warranted.

Prospective Analysis of the Influence of Sport and Educational Factors on the Prevalence and Initiation of Smoking in Older Adolescents from Croatia.

The prevalence of smoking among Croatian adolescents is alarmingly high, but no previous study has prospectively examined the sport- and academic-factors associated with smoking and smoking initiation. This study aimed to prospectively examine the associations between scholastic (educational) achievement and sport factors and smoking in 16- to 18-year-old adolescents. This two-year prospective cohort study included 644 adolescents who were 16 years of age at baseline (46% females). Baseline testing was implemented at the beginning of the 3rd year of high school (September 2014) when participants were 16 years old. Follow-up testing was completed at the end of the fourth year of high school, which occurred 20 months later. The evaluated predictor variables were educational-achievement- and sport-related-factors. The outcome variables were (i) smoking at baseline; (ii) smoking at follow-up; and (iii) smoking initiation over the course of the study. We assessed the associations between predictors and outcomes using logistic regression models adjusted for age, gender, socioeconomic status, and conflict with parents. The educational variables were consistently associated with smoking, with lower grade-point-average (Baseline: odd ratio (OR): 2.01, 95% confidence interval (CI): 1.61-2.55; Follow-up: 1.59, 1.31-1.94), more frequent absence from school (Baseline: OR: 1.40, 95% CI: 1.19-1.69; Follow-up: 1.30, 1.08-1.58), and lower behavioral grades (Baseline: OR: 1.80, 95% CI: 1.10-2.89; Follow-up: 1.57, 1.03-2.41) in children who smoke. Adolescents who reported quitting sports were at greater odds of being smokers (Baseline: 2.07, 1.31-3.32; Follow-up: 1.66, 1.09-2.56). Sport competitive achievement at baseline was protective against smoking initiation during following two-year period (0.45, 0.21-0.91). While the influence of the educational variables on smoking initiation has been found to be established earlier; sport achievement was identified as a significant protective factor against initiating smoking in older adolescents. Results should be used in development of an anti-smoking preventive campaign in older adolescents.

Prevalence and Factors Associated with Substance Use and Misuse among Kosovar Adolescents; Cross Sectional Study of Scholastic, Familial-, and Sports-Related Factors of Influence.

Adolescence is considered to be the most important period for the prevention of substance use and misuse (SUM). The aim of this study was to investigate the problem of SUM and to establish potentially important factors associated with SUM in Kosovar adolescents. Multi-stage simple random sampling was used to select participants. At the end of their high school education, 980 adolescents (623 females) ages 17 to 19 years old were enrolled in the study. The prevalence of smoking, alcohol consumption (measured by Alcohol Use Disorder Identification Test-AUDIT), and illegal drug use (dependent variables), as well as socio-demographic, scholastic, familial, and sports-related factors (independent variables), were assessed. Boys smoke cigarettes more often than girls with daily-smoking prevalence of 16% among boys and 9% among girls (OR = 1.85, 95% = CI 1.25-2.75). The prevalence of harmful drinking (i.e., AUDIT scores of >10) is found to be alarming (41% and 37% for boys and girls, respectively; OR = 1.13, 95% CI = 0.87-1.48), while 17% of boys and 9% of girls used illegal drugs (OR = 2.01, 95% CI = 1.35-2.95). The behavioral grade (observed as: excellent-average-poor) is the factor that was most significantly correlated with SUM both in boys and girls, with lower behavioral grades among those adolescents who consume substances. In girls, lower maternal education levels were associated with a decreased likelihood of SUM, whereas sports achievement was negatively associated with risky drinking. In boys, sports achievement decreased the likelihood of daily smoking. Information on the factors associated with SUM should be disseminated among sports and school authorities.

Gender-Specific Analyses of the Prevalence and Factors Associated with Substance Use and Misuse among Bosniak Adolescents.

Ethnicity and religion are known to be important factors associated with substance use and misuse (SUM). Ethnic Bosniaks, Muslims by religion, are the third largest ethnic group in the territory of the former Yugoslavia, but no study has examined SUM patterns among them. The aim of this study was to explore the prevalence of SUM and to examine scholastic-, familial- and sport-factors associated with SUM in adolescent Bosniaks from Bosnia-and-Herzegovina. The sample comprised 970 17-to-18-year-old adolescents (48% boys). Testing was performed using an previously validated questionnaire investigating socio-demographic-factors, scholastic-variables, and sport-factors, cigarette smoking, alcohol drinking, simultaneous smoking and drinking (multiple SUM), and the consumption of other drugs. The 30% of boys and 32% of girls smoke (OR=1.13; 95% CI=0.86-1.49), 41% of boys and 27% of girls are defined as harmful alcohol drinkers (OR=1.94; 95% CI=1.48-2.54), multiple SUM is prevalent in 17% of boys and 15% of girls (OR=1.11; 95% CI=0.79-1.56), while the consumption of other drugs, including sedatives, is higher in girls (6% and 15% for boys and girls, respectively; OR=2.98; 95% CI=1.89-4.70). Scholastic achievement is negatively associated with SUM. SUM is more prevalent in those girls who report higher income, and boys who report a worse familial financial situation. The study revealed more negative than positive associations between sport participation and SUM, especially among girls. Results can help public health authorities to develop more effective prevention campaign against SUM in adolescence.

Sport nutrition and doping factors in swimming; parallel analysis among athletes and coaches.

The sport nutrition and doping are known to be important issues in sports, but there is evident lack of studies which investigated those issues in swimming, especially with regard to parallel analysis of coaches and athletes. The first aim of this study was to compare knowledge of swimming coaches and their athletes about nutrition and doping. Also, we have identified interrelationships between studied sociodemographic-, sport-; nutrition- and doping-related-factors. The sample of subjects comprised 55 athletes (20.3 +/- 2.2 years of age; 24 females) and 22 coaches (mean age 36.5 +/- 7.8 years; 4 females) from Croatia (98% of respondents). In the first phase of the investigation we have validated specific questionnaires to determine the knowledge of sport nutrition (KSN), and knowledge on doping (KD). The test-retest correlation and percentage of equally responded queries revealed both questionnaires as reliable. The discriminative validity was proven also since coaches scored better than their athletes on both questionnaires. Athletes declared their coaches as the primary sources of knowledge about nutrition and doping. Among coaches, formal and self-education are equally important sources of information about doping and nutrition. The age is negatively, while the formal education is positively correlated to KD and KSN scores among coaches. Consequently, permanent educational programs about nutrition and doping are emphasized, especially among older coaches and younger athletes.

Differential analysis of the doping behaviour templates in three types of sports.

Conducted researches recognize various risk factors, as well as protective factors against doping behaviour in different sports i.e. sports disciplines or activities. The main goal of this research was to identify the correlation between selected socio-demographic, health-related, and sports-related predictors with doping factors in three different types of sports, which are (1) highly energetic demanding sports (weightlifting), (2) highly technical demanding sports (racquet sports), and (3) highly tactical demanding sports (sailing). The research consisted of three separate studies, each one of them researching one of the sports. The sample of subjects included altogether 293 athletes, senior level competitors (older than 18years of age). In total, the sample comprised three homogenous sub-samples, as follows: athletes in highly energetic demanding sports (weightlifters and power lifters; N=27), athletes in highly technical demanding sports (table tennis, tennis and badminton players; N=188), and athletes in highly tactical demanding sports (sailing; N=78). The first study involved weightlifters where we should point out the existence of high doping behaviour In this study, religiousness was interpreted as the most significant protective factor against doping behaviour, while sports factors are not found to be significantly related to doping. The study involving racquet sport athletes suggests a high risk of doping behaviour among those athletes who observe doping behaviour in their sport. We noticed low levels of athletes' trust in their coaches' and physicians' opinions on doping issues. This is an issue which should be researched in the future, because the underlying cause has not been studied as yet. Briefly, it seems that either the athletes are not convinced of their coaches '/physicians' expertise regarding doping issues, and/or they do not believe in their good intentions. It is particularly important, as the previous research has shown that with the increased trust in coaches and physicians, the chance that an athlete will use doping decreases. As expected, it is characteristic for sailing that it has a low likelihood of potential doping behaviour, although the consumption of dietary supplements is high. Substance abuse in sports spreads beyond those that enhance athletic performance. All of these issues should be studied in more detail in the future and, if appropriately validated, incorporated into anti-doping intervention programs.

Dietary supplementation and doping-related factors in high-level sailing.

BACKGROUND: Although dietary supplements (DSs) in sports are considered a natural need resulting from athletes' increased physical demands, and although they are often consumed by athletes, data on DS usage in Olympic sailing are scarce. The aim of this study was to study the use of and attitudes towards DSs and doping problems in high-level competitive sailing. METHODS: The sample consisted of 44 high-level sailing athletes (5 of whom were female; total mean age 24.13 ± 6.67 years) and 34 coaches (1 of whom was female; total mean age 37.01 ± 11.70). An extensive, self-administered questionnaire of substance use was used, and the subjects were asked about sociodemographic data, sport-related factors, DS-related factors (i.e., usage of and knowledge about DSs, sources of information), and doping-related factors. The Kruskal-Wallis ANOVA was used to determine the differences in group characteristics, and Spearman's rank order correlation and a logistic regression analysis were used to define the relationships between the studied variables. RESULTS: DS usage is relatively high. More than 77% of athletes consume DSs, and 38% do so on a regular basis (daily). The athletes place a high degree of trust in their coaches and/or physicians regarding DSs and doping. The most important reason for not consuming DSs is the opinion that DSs are useless and a lack of knowledge about DSs. The likelihood of doping is low, and one-third of the subjects believe that doping occurs in sailing (no significant differences between athletes and coaches). The logistic regression found crew number (i.e., single vs. double crew) to be the single significant predictor of DS usage, with a higher probability of DS consumption among single crews. CONCLUSION: Because of the high consumption of DSs future investigations should focus on real nutritional needs in sailing sport. Also, since athletes reported that their coaches are the primary source of information about nutrition and DSs, further studies are necessary to determine the knowledge about nutrition, DSs and doping problems among athletes and their support teams (i.e., coaches, physicians, and strength and conditioning specialists).

Is there a danger for myopia in anti-doping education? Comparative analysis of substance use and misuse in Olympic racket sports calls for a broader approach.

BACKGROUND: Racket sports are typically not associated with doping. Despite the common characteristics of being non-contact and mostly individual, racket sports differ in their physiological demands, which might be reflected in substance use and misuse (SUM). The aim of this study was to investigate SUM among Slovenian Olympic racket sport players in the context of educational, sociodemographic and sport-specific factors. METHODS: Elite athletes (N=187; mean age=22±2.3; 64% male) representing one of the three racket sports, table tennis, badminton, and tennis, completed a paper-and-pencil questionnaire on substance use habits. Athletes in this sample had participated in at least one of the two most recent competitions at the highest national level and had no significant difference in competitive achievement or status within their sport. RESULTS: A significant proportion of athletes (46% for both sexes) reported using nutritional supplements. Between 10% and 24% of the studied males would use doping if the practice would help them achieve better results in competition and if it had no negative health consequences; a further 5% to 10% indicated potential doping behaviour regardless of potential health hazards. Females were generally less oriented toward SUM than their male counterparts with no significant differences between sports, except for badminton players. Substances that have no direct effect on sport performance (if timed carefully to avoid detrimental effects) are more commonly consumed (20% binge drink at least once a week and 18% report using opioids), whereas athletes avoid substances that can impair and threaten athletic achievement by decreasing physical capacities (e.g. cigarettes), violating anti-doping codes or potentially transgressing substance control laws (e.g. opiates and cannabinoids). Regarding doping issues, athletes' trust in their coaches and physicians is low. CONCLUSION: SUM in sports spreads beyond doping-prone sports and drugs that enhance athletic performance. Current anti-doping education, focusing exclusively on rules and fair play, creates an increasingly widening gap between sports and the athletes' lives outside of sports. To avoid myopia, anti-doping programmes should adopt a holistic approach to prevent substance use in sports for the sake of the athletes' health as much as for the integrity of sports.

Substance use and misuse among professional ballet dancers.

This study investigated substance use and misuse among 16 female and 9 male Croatian ballet professionals in 2008 using an original questionnaire. We analyzed social, personal, activity- and training-related, and educational factors, and criteria such as: binge alcohol drinking, cigarette smoking, appetite suppressant consumption, analgesic use, and actual and potential "doping" habits. Frequency tables and rank-order correlation were calculated. More than one third of the male dancers reported binge drinking, while 20% of the females smoked more than a box of cigarettes per day. Almost 25% of these dancers will use "doping" if it will ensure successful ballet performance, regardless of negative health consequences. In males, the risk of potential "doping" behavior increased with age. In females, education level was negatively related to cigarette smoking, but positively correlated to potential "doping" habits and behavior. In both genders, religiousness was the factor negatively related to the following: (1) potential "doping" behavior and (2) belief that "doping" exists in professional ballet. Results suggest that there is evident need for more specific medical and/or psychological services in professional ballet. The study's limitations are noted.

Can we consider religiousness as a protective factor against doping behavior in sport?

Religiousness is rarely studied in relation to doping behaviors in sport. In this study, we sampled 27 weightlifting/powerlifting athletes from Bosnia and Herzegovina. Using the originally developed questionnaire and by means of Spearman's correlation, we interpreted data and discussed relationships between (a) social, religious, sport, and educational factors, and (b) substance use criteria, including cigarettes, alcohol, analgesics, nutritional supplementation, and doping behaviors. In conclusion, we found (1) that religiousness can be considered as a potential protective factor against doping, but also (2) that religious subjects tend to deny and underestimate the doping behaviors in their sport. Both of these findings should be extensively studied in future investigations.

Religiousness as a protective factor for substance use in dance sport.

Although religiousness is found to be a significant protective factor in substance use, there is an evidential lack of studies of such in athletes. The aim of the study was to identify the predictive value of the religiousness and some social, educational, and sport factors on substance use in 43 sport dancers. An originally developed questionnaire for studying substance use and precipitation factors was applied. The Chi-square showed male dancers as more religious than females. Using the Spearman's correlation, religiousness was found to be a significant protective factor in cigarette smoking, sport nutritional supplementation, and the likelihood of doping. Data were interpreted emphasizing the previous findings from the literature.