Assessment Of Available Intelligence And Research Gaps To Inform Intervention Evaluation

Research question: What is the evidence to establish effective interventions to reduce image & performance enhancing drugs (IPEDs) related harms? Background: While prevalence of IPED use is undetermined, Crime Survey for England & Wales indicates a significant increase in the use of anabolic androgenic steroids since 2008/09. This is supported by international estimates of a global prevalence of approximately 3%. Recent evidence indicates multiple inter-related harms associated with the use of IPEDs. Furthermore, research now indicates diverse sub-populations of IPED users with varied motivations and profiles. Harms are associated with the illicit IPED market (adulteration and contamination) and injection as the common methods of administration (with 1-2% of IPED injectors identified as HIV positive), in addition to the deleterious effects of the specific drugs (e.g. anabolic androgenic steroids, human growth hormone, dinotrophemol, melanotan II, human chorionic gonadotrophin) complex polypharmacy and prolonged administration. Evidence reviews of service provision for the users of IPEDs and qualitative investigations into barriers to engagement with this population indicate a lack of robust data in relation to effective service provision. Objectives: i) establish the extent and distribution of IPED use in the UK; ii) map the topics, scope and conclusions of recent and forthcoming UK research; iii) map the current interventions targeting IPED users; iv) map and analyse the influences on IPED users' decision-making; and, further develop the network ASUK and website www.anabolicsteroids.org.uk for effective dissemination of findings and support of the IPED research and practice community. Methods: building on preliminary research we will i) utilise recently produced IPED prevalence models to establish estimates relating to extent and characteristics of use. A delphi technique will be used to garner expert opinion and generate consensus; ii) utilise an existing network of 40+ academics to enhance recent scoping reviews of evidence analyses providing a current and forward-looking summary of research conclusions and relevant research gaps; and, iii) draw on the existing network of service providers to contribute descriptive information plus specific data to inform future case study selection and evaluation. These data will inform iv) systems mapping of influences relating to IPED use. Two workshops of stakeholders (including people with lived experience of IPED use) will inform the analyses and generation of maps. Anticipated impact & dissemination: the research will generate a series of both academic and lay outputs, while WP5 will facilitate the dissemination of findings to maximise impact beyond academic recognition. ASUK and the associated the website will ensure optimal dissemination of findings and accompanying learning from the project. In addition to the development of a robust evidence base related to UK IPED use the findings will directly inform and facilitate the NIHR 2021 call to evaluate effectiveness of IPED interventions, providing key data regarding the population of IPED users, the current evidence base, potential interventions for evaluation and an understanding of the complex systems context. Additional immediate impact of this research will be in establishing greater collaboration and understanding between practitioners, academics and additional stakeholders together with the IPED using communities.