Participate in development of e-learning to enhance knowledge of Performance and Image Enhancing Drugs (PIEDs)

New research supporting the development of an e-learning module to enhance health care providers' knowledge of Performance and Image Enhancing Drugs (PIEDs).

Liverpool John Moores

Your participation in this research will play an important role in further developing this resource, which will allow for better responses to support users of PIEDs, and to reduce the harms of use.

The use of substances to enhance performance and/or image within non-professional athletes is a growing public health concern. For example, while it is likely to be an underestimate, the Crime Survey for England and Wales estimated that 61,000 16-59 year olds used anabolic steroids in 2016/17. Although many users do not experience harms, for some, the use of Performance and Image Enhancing Drugs (PIEDs) can lead to a number of health problems as a result of cardiovascular and neuroendocrine effects, and the risks associated with mode of administration such as liver damage as a result of the oral administration of androgenic-anabolic steroids and infections and BBV as a result of injection. There is also evidence that some users can experience problems such as dependence and mood disorders, although the extent of this is currently uncertain.

There is little evidence on effective approaches to reducing PIED harms, but where it exists, it tends to focus on interventions aimed at preventing use in educational settings, or in elite athletes and competitors as part of anti-doping initiatives. There are even fewer sources of support for users who are engaging in non-competitive and amateur/recreational activities, or who are using PIEDs for image enhancement.

Health care workers provide an important point of contact for PIED users, yet often report difficulties with engaging and working with this group. This is because people who use PIEDs often do not see themselves as 'drug users' even if they are experiencing problems associated with their use, and are often hesitant to disclose use when they do visit a healthcare professional. This might be because of fear of what will happen if they reveal PIED use, or the belief that their healthcare provider does not have the necessary expertise. Substance use in general, and PIED use in particular, is not a prominent component of professional training, and few health care workers have been provided with the opportunity to develop expertise in this area post-qualification. It is therefore important to identify appropriate ways of providing credible training and information that will support healthcare providers to respond to the use of PIEDs among their client and patient population.

The Public Health Institute (PHI) at Liverpool John Moores University has international research expertise on the topic of PIEDs. We are currently working on a new European Commission ERASMUS+ funded programme in this area. As part of this, we have been asked to evaluate a new PIED e-learning module that is being developed by the Dopinglinkki organisation in Finland. The module supports the first stages of professional learning in order to improve knowledge and understanding of PIEDs and potential harms, and to improve the competence and confidence of professionals so that they are better able to engage with and respond to the health needs of people who may use PIEDs and who present to the surgery or clinic. The research aims to understand whether the module is appropriate for use in UK settings, and what changes are needed to improve the acceptability and usefulness of the module for a UK audience. These findings will help the developers further refine the module, with a view to making it freely available for use at the end of the overall project in 2020.

The module is targeted towards health care workers (e.g. GPs, nurses, psychiatrists) who are likely to come into contact with PIED users as part of their work. We would like to invite those working in relevant roles to take part in this project. You will be asked to work through the module and complete some of the self-learning and assessment exercises. You will then be asked to complete a short questionnaire to provide your feedback on the tool.

Further information on how to participate in the research you can found here

If you have any questions, then please contact Dr Amanda Atkinson (