Objectives: To document the use of performance-enhancing substances (PES) by young athletes and to identify associated factors.
Design: Retrospective survey.
Setting: Self-reported anonymous questionnaire.
Participants: Three thousand five hundred seventy-three athletes (mean age, 15.5 years) from Quebec provincial teams run by organizations recognized by the Government of Quebec.
Interventions: All subjects filled out a validated questionnaire on factors associated with the use of and the intention to use PES.
Main outcome measures: The use of and intention to use PES.
Results: In the 12 months before filling out the questionnaire, 25.8% of respondents admitted having attempted to improve their athletic performance by using 1 or more of 15 substances that were entirely prohibited or restricted by the International Olympic Committee. Multiple regression analyses showed that behavioral intention (beta = 0.34) was the main predictor of athletes' use of PES. Attitude (beta = 0.09), subjective norm (beta = 0.13), perceived facilitating factors (beta = 0.40), perceived moral obligation (beta = -0.18), and pressure from the athlete's entourage to gain weight (beta = 0.10) were positively associated with athletes' behavioral intention to use PES.
Conclusions: This study provides evidence that supports the predicting value of the theory of planned behavior. Results suggest that the athlete's psychosocial environment has a significant impact on the decision to use PES and support the need to integrate this factor into the development and implementation of prevention interventions.