Anders Schmidt Vinther

Bio: Anders Schmidt Vinther is an academic researcher from Aarhus University. The author has an hindex of 1, co-authored 1 publications receiving 1 citations.

Applying insights from implementation and intervention science to improve the evidence base on image and performance-enhancing drugs (IPEDs) interventions

Abstract: Recent decades have seen increased public attention devoted to the use of image and performance-enhancing drugs (IPEDs). As research into the epidemiology and aetiology of IPED use has grown substantially, so has interest amongst scholars and policy makers in developing and implementing a variety of public health interventions that target potential and current IPED users. However, the evidence base on IPED interventions remains underdeveloped and few firm conclusions can be made about their impact. In short, we know very little about whether IPED interventions are appropriate, effective, ineffective, or even harmful, or why and how this is the case. In this article, we make the case for applying recent insights from intervention and implementation science to better assess the problems that require intervention, enhance the development, implementation and evaluation of IPED interventions, and improve the quality and size of the evidence base. This is necessary if we are to develop evidence-based IPED interventions that support good health and avoid the potential to do harm. We begin by discussing the different types of IPED interventions that have been introduced and what we know about their impact from the limited evaluations that have been published to date. We then discuss how methods and frameworks from intervention and implementation science can provide important insights that will greatly enhance the development, implementation, and evaluation of these interventions. Drawing on examples of IPED interventions implemented in a variety of countries we explore how these methods can be applied by those working in this field and identify guidance and tools that support their uptake. We conclude by proposing five key priorities to support the development of a more robust evidence base of IPED interventions that will, ultimately, support an evidence-based public health response to IPED use.

Harm reduction strategies for androgen users: providing appropriate support and improving engagement with healthcare.

Abstract: Purpose of review As evidence continues to emerge of the harms associated with nonmedical androgen use, this review explores the implications from recent studies for designing strategies to reduce harm and support good health amongst androgen users. Recent findings Studies have predominantly come from researchers in the UK and Australia. Major themes include questioning the scope and content of harm reduction strategies and identifying approaches to improve engagement between the androgen using community and healthcare providers. Findings suggest that a broader range of interventions and forms of advice are needed than are commonly provided. This must be supported by efforts to increase opportunities to deliver harm reduction through new engagement approaches, better relationships with health professionals and more guidance on identifying and managing associated adverse health impacts. Summary A fully developed harm reduction-based response to nonmedical androgen use will be one that not only seeks to reduce risk of bloodborne virus transmission and injecting-related harms, but that considers the range of needs amongst the diverse community of androgen users and respects their decisions and rights. Co-producing interventions with members of this community will help develop effective and engaging approaches. Rigorous studies are needed to evaluate new harm reduction interventions as well as those already delivered.

Two sides of the same coin: A qualitative exploration of experiential and perceptual factors which influence the clinical interaction between physicians and Anabolic-Androgenic Steroid using patients in the UK

Abstract: Patient-physician interactions involve complex interplays between patient and physician autonomy. This is intensified in stigmatised populations, such as anabolic-androgenic steroid (AAS) users. The current study investigated what factors influence clinical interactions between physicians and AAS users, thus providing a holistic understanding of the underlying dynamics. For this exploratory two-cohort qualitative study, UK-based physicians (n = 6) and AAS-users (n = 6) were recruited via purposive and snowball sampling. Data were collected using semi-structured interviews. These interviews were audio-recorded, transcribed verbatim, and inductively analysed using reflexive thematic analysis. Six themes were identified for AAS-using patients (perceived bias and lack of clinical knowledge; perceived power imbalance; riskiness of disclosure; feeling misidentified; experiencing hostility and prejudice; and collaborative clinical interactions) and four for physicians (professional barriers: lack of knowledge, guidelines and resources; preconceptions and prior understandings; direct exposure influences clinical confidence; and professional role quandary). The overall picture suggests primary impactive factors involve stigma management techniques amongst AAS-using patients and coping with clinical uncertainty for physicians. Blurred lines between enabling versus management impact both the AAS-using patient and the physician. Greater clarity is required regarding what constitutes appropriate management. Further discussion is warranted about the role of physician and patient autonomy. Improving access to healthcare services and expertly guided AAS cessation, if necessary, are vital for effective harm-reduction.

Facilitators and barriers in preventing doping among recreational athletes: A qualitative interview study among police officers

Abstract: Background Doping is a societal problem associated with health problems, violence, and other crimes, especially when combined with alcohol and drugs. Elite, as well as recreational athletes who exercise in gyms may use doping to enhance their performance and/or improve their appearance. According to Swedish law, manufacturing, selling, supplying, possessing, and using anabolic androgenic steroids and growth hormones is forbidden. Exceptions apply if these substances are used for medical purposes and prescribed by doctors. As doping is illegal, the police authority is vital in counteracting doping. Aim We aimed to identify facilitators and barriers to effective doping prevention at gyms by examining police officers' views on doping as a societal problem, their experiences of doping prevention efforts, and their perceptions on what enables or hinders doping prevention. Methods Interviews with police officers (n = 15) were conducted from December 2021 to May 2022. The interviews were recorded and transcribed verbatim. A targeted content analysis of the material was performed. Results Facilitators for effective doping prevention involving the police included the recognition of doping as a societal problem; mobilization of key actors; motivated police management and officers; adequate resource allocation; collaboration between the police, gyms, and other relevant authorities; and skills development for police and other professions. Barriers to effective doping prevention included a lack of knowledge about doping, time-consuming processes around the detection and collection of evidence in doping offenses, and competing tasks for police officers. Conclusion Doping prevention should become more efficient by taking advantage of existing facilitators and removing remaining barriers. This study could guide recommendations linked to the police organization and the surrounding society regarding doping prevention.

“The Challenge Is That Steroids Are So Effective”: A Qualitative Study of Experts’ Views on Strategies to Prevent Men’s Use of Anabolic Steroids

Abstract: Despite persistent efforts in many countries to prevent the use of anabolic androgenic steroids (AAS) and other image and performance-enhancing drugs (IPEDs), very little is known about effective prevention strategies. This study aimed to explore experts’ views on strategies to prevent AAS use in the context of recreational strength training in gyms. The study builds on in-depth interviews with 46 researchers and practitioners from 15 countries, whose main area of expertise is IPED use, prevention and education in physical activity settings (IPED experts). Participants were asked about their views on AAS use prevention and what intervention strategies may be effective in preventing this behavior. Data were analyzed using thematic content analysis in accordance with recommendations for this technique. The findings showed that the IPED experts generally agree that some, but not all, instances of AAS use can be prevented through targeted prevention in gyms. They pointed to three key priorities for AAS use prevention in gyms: (1) make the case for drug-free training, (2) promote safe and effective ways to enhance muscularity, and (3) attempt to change the physical and social environment in the gym to make the training milieu less conducive to AAS use. Importantly, however, none of the experts were able to pinpoint any specific behavior change strategies that have proven effective.