Psychosocial correlates of performance-enhancing substance use intentions and prevention needs among recreational gym users: a theory-informed mixed-methods study
Aug 2026· BMC Psychology· Vol 14· 0 citations· 51 references
Medicine
TL;DR
Associations of Theory of Planned Behavior constructs, selected Health Belief Model constructs, knowledge, and risk acceptance with PES-use intentions were examined and prevention needs were explored using a mixed-methods design.
Abstract
Performance-enhancing substance (PES) use is a potential public health concern in recreational fitness. Research suggests that use among recreational gym users is associated with psychosocial factors, gym culture, and peer norms. This study examined associations of Theory of Planned Behavior (TPB) constructs, selected Health Belief Model (HBM) constructs, knowledge, and risk acceptance with PES-use intentions and explored prevention needs using a mixed-methods design. A cross-sectional mixed-methods survey included 772 recreational gym users in Germany; 29.4% reported ever or current use of at least one of six assessed PES categories. Quantitative analyses examined TPB constructs, HBM-related constructs, knowledge, and risk acceptance. Qualitative data comprised 542 open-ended responses on prevention preferences. Subjective norms and lower perceived behavioral control over avoiding PES showed the strongest associations with higher PES-use intention. Greater knowledge was associated with lower intention, whereas higher risk acceptance, greater perceived benefits of PES use, and lower self-efficacy to resist PES were associated with higher intention. None of the examined psychosocial variables were significantly associated with the ever/current PES-use indicator. Qualitative findings emphasized credible information, peer-based support, and preferences for gym-based prevention approaches. Psychosocial factors were associated with variation in PES-use intentions among recreational gym users. Prevention development may consider social norms, perceived control over avoiding PES, resistance self-efficacy, knowledge, and preferences for credible, context-sensitive information. Given the cross-sectional design, the findings should be interpreted as associations and as hypothesis-generating evidence for future prevention research.
BACKGROUND
The use of performance-enhancing substances such as pre-workout supplements has become increasingly common in recreational fitness environments. Although behavioral interventions aim to reduce enhancement-related substance use, little is known about whether such interventions operate similarly across different psychosocial athlete profiles and which psychological mechanisms may underlie behavioral change.
METHODS
Data were analyzed from a cluster-randomized prevention trial conducted in ten fitness studios in Germany, including 602 recreational fitness athletes. Cluster-adjusted logistic regression models examined intervention effects on booster use at follow-up (T3). Moderation analyses tested differential responsiveness across psychosocial athlete profiles, while mediation analyses examined changes in risk acceptance as a potential psychological pathway.
RESULTS
Participants in the intervention group showed lower odds of booster use compared with the control group (OR = 0.58, 95% CI [0.33, 1.00], p = .052), corresponding to an absolute risk reduction of 6.65 percentage points. Risk acceptance decreased more strongly among motivationally ambivalent athlete profiles, whereas comparable moderation effects were not observed for booster use. These reductions were consistent with a partial mediation pathway linking the intervention to reduced booster use.
CONCLUSIONS
The findings suggest that behavioral interventions in recreational fitness settings may operate differently across psychosocial athlete profiles rather than producing uniform effects. Changes in risk acceptance appear to represent a key psychological mechanism associated with intervention-related reductions in booster use, highlighting the importance of psychologically informed prevention strategies tailored to psychosocial athlete profiles in recreational fitness populations.
René Paasch, Gunnar Mau· Psychology of Sport And Exer...· 0 citations
To address the public health issue of vaping among youth and inform messaging strategies, this study examines the psychosocial correlates of intention to avoid vaping. An online survey was conducted among 2,756 adolescents aged between 14 and 18 years in Quebec, Canada. The frequency of vaping and psychosocial correlates of intention were assessed by means of a questionnaire. Psychosocial variables were assessed using standardized measures from the reasoned action approach and the social norm approach. Specific beliefs pertaining to vaping (e.g., perceived risks, addiction, health impacts, etc.) were also assessed. Logistic regression analyses revealed that perceived behavioral control, attitudes and past behavior were associated with intention. Injunctive and descriptive norms were significantly associated with intention to avoid vaping. Some vaping beliefs were significantly associated with intention, representing promising themes to design anti-vaping messages (e.g., nicotine and mental health, stress management and addiction). Overall, findings recall the importance of norms in youth vaping behavior and the need to tailor messages on targeted audiences' beliefs. Future campaigns should integrate normative influences and specific beliefs into their messaging strategy to avoid negative reactions from youth, improve effectiveness and reduce the prevalence of vaping.
Ariane Bélanger-Gravel, Stefany Dufour, Amélie Brunet et al.· Health Communication· 0 citations
Despite robust evidence of its benefits, physical activity (PA) promotion is rarely integrated into routine mental health care. This study aims to investigate the long-term effects of a brief, theory-informed three-hour workshop on mental health professionals’ (MHPs’) PA prescription intentions and their psychological determinants.
A pre-test/post-test single-arm design was used. Eighty MHPs completed assessments before and after the workshop, and 44 completed a nine-month follow-up. Outcomes were framed using Ajzen’s Theory of Planned Behavior: attitudes (instrumental and affective), subjective norms, perceived behavioral control (PBC) and intentions.
Significant improvements were observed across all constructs immediately post-intervention (all p < 0.001), with moderate effect sizes for PBC (d = 0.61) and intentions (d = 0.56). At nine months, improvements persisted for affective attitudes (d = 0.40), subjective norms (d = 0.27) and PBC (d = 0.39), while instrumental attitudes and intentions returned to near-baseline.
The single-arm design without a control group precludes causal inference, and attrition at nine-month follow-up may introduce selection bias. Future research should use randomized controlled designs and investigate booster sessions to sustain intention change.
Brief theory-informed workshops can produce meaningful and partially sustained improvements in MHPs’ readiness to prescribe PA, but should be embedded within broader organizational frameworks to translate motivation into routine clinical behavior.
To the best of the authors’ knowledge, this is the first study to examine nine-month outcomes following a brief PA counseling workshop for MHPs, highlighting both the utility and limitations of one-shot educational interventions.
J. Tecco, Arnaud Philippot, P. Ward et al.· Journal of Mental Health Tra...· 0 citations
There was a strong negative relationship between mental health and substance use and a positive relationship between peer influence and increased risk, whereas sport participation appeared to have a moderate protective relationship, but with a range of variation in participants.
Mila Inés, Moreno Pramatárova, Christian Silva-Paredes et al.· 0 citations
Background Physical activity and eating behaviors are co-occurring and often disrupted during the transition to university. Self-determination theory links motivational quality in one health behavior with self-regulation in other health behaviors. This study examined whether motivation for physical activity is associated with mindful eating among Turkish university students, whether this association differs between the awareness- and disinhibition-based facets of mindful eating, and whether motivational profiles derived from latent profile analysis differ in their associations with these facets. Methods A cross-sectional survey of 638 Turkish university students (aged 21.84 ± 3.27 years; 50% female) assessed motivation for participation in physical activity using the Scale of Motivation for Participation in Physical Activity (MSPPA) and mindful eating using the 18-item Mindful Eating Questionnaire (MEQ-18). Multiple linear regression models with heteroscedasticity-consistent (type 3) (HC3) robust standard errors were used to adjust for age, sex, and body mass index category; Benjamini–Hochberg false discovery rate control was applied across subgroup contrasts. Common method bias was evaluated using Harman’s test and a single-factor confirmatory factor analysis. Latent profile analysis of the MSPPA subscales yielded motivational profiles, which were compared across profiles using Welch’s analysis of variance. Results In covariate-adjusted models, MSPPA total scores were associated with MEQ-18 total scores (B = 0.145, 95% CI [0.102, 0.188], p < 0.001; R2 = 0.190) and with the Awareness facet (B = 0.243, 95% CI [0.167, 0.319], p < 0.001; R2 = 0.143) but not with the Disinhibition facet (B = −0.004, 95% CI [−0.069, 0.061], p = 0.916; R2 = 0.129). Low Disinhibition reliability (α = 0.568) constrains inference on this null finding. Harman’s test and the single-factor confirmatory factor analysis (CFA) did not support the common method bias. Coefficients were comparable across three age strata (age × motivation interaction, p = 0.618). Three motivational profiles differed in awareness-based (η2 = 0.049) and overall (η2 = 0.049) mindful eating but not in disinhibition-based eating (η2 = 0.001). Conclusion Higher motivation to participate in physical activity was associated with greater overall mindful eating, with the association appearing to be concentrated in the Awareness facet. Given the cross-sectional design and low Disinhibition reliability, this pattern is descriptive rather than evidence that the Awareness facet drives the overall association. The profile solution was derived within a single sample and was not externally validated. Longitudinal and mediation designs could help clarify explanatory pathways underlying these associations.
Bekir Erhan Orhan, W. Alkasasbeh, N. Solak et al.· Frontiers in Psychology· 0 citations
Background Physical inactivity among children and adolescents remains a major global public health concern, yet the ways in which behavioral theory is applied to inform physical activity (PA) interventions are often insufficiently described. The Behavior Change Wheel (BCW) model provides a systematic framework for linking behavioral determinants to intervention content, but its application in PA promotion for this population has not been comprehensively mapped. Methods This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA-ScR guideline. Seven electronic databases were searched for studies published since 2011 that explicitly applied the BCW to promote PA among children and adolescents. Data were charted on study characteristics, targeted components of the Capability, Opportunity, and Motivation-Behavior (COM-B) model, BCW intervention functions, behavior change techniques, and implementation outcomes. Results Fifteen studies met the inclusion criteria. Most applications focused on intervention development, co-design, or feasibility rather than effectiveness evaluation. Psychological capability and reflective motivation were the most frequently targeted COM-B components, and education, training, and enablement were the dominant intervention functions. Commonly used behavior change techniques included goal setting, action planning, self-monitoring, feedback, and social support. Functions involving coercion or restriction were rarely used. Reporting of implementation outcomes was inconsistent, with limited attention to reach, penetration, and sustainability. Conclusions In studies using the BCW framework, PA interventions for children and adolescents predominantly emphasize individual-level self-regulation strategies, with less focus on opportunity-level change and implementation sustainability. Greater transparency in theoretical mapping and stronger integration of implementation considerations are needed to enhance the translation of theory-based interventions into practice.
