Review of the literature on negative health risks based interventions to guide anabolic steroid misuse prevention

• Negative health consequence information (NHCI) has a role in anabolic steroid use prevention.
• NHCI effect is moderated by personal, situational and contextual factors.
• Low perceived vulnerability to health threats undercuts the effectiveness of NHCI.
• Persuasive information has a greater effect when the information is relevant and the source has high credibility.
• Future research into NHCI should incorporate self-affirmation priming and consider culture.

BackgroundDespite the Internet and the WorldWideWeb providing ready access to information on the risks and health consequences of anabolic steroid (AS) misuse for all ages, AS use remains a public health concern. The aim of this narrative review is to examine the ability of negative health consequences information (NHCI) to prevent adolescent AS misuse in the era of the Internet information revolution.MethodsA search of the literature published between January 2000 and March 2014, was conducted to identify studies that examined the effect of NHCI on AS use and other health-related social cognitive constructs and behaviour in adolescent samples.ResultsNo empirical study was found that specifically investigated the isolated effect of NHCI on AS use. Other health-related intervention studies – involving adolescents – showed that the severity of the consequences tied to social disapproval can be more effective than the severity tied to health consequences. Relevance of NHCI can operate as a moderator or a mediator of the relationship between NHCI and social cognitive constructs and behaviour change. Pre-existing knowledge about negative health consequences functions as a mediator of the relationship between NHCI and social cognitive constructs and outcomes.ConclusionThe best way to understand the effect of NHCI on social cognitive constructs and behaviour is to consider it in a larger nomological network that includes perceived severity, vulnerability, relevance and pre-existing knowledge. The review highlights gaps in the literature and suggests directions for future research. Implications for prevention programmes are discussed.