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The purpose of this study was to develop a knowledge base on factors associated with performance-enhancer usage among female athletes at the high school level in order to identify markers for a future prevention-education program. The study used a pretest-only, between-subjects Likert Scale survey to rank the importance of internal and external pressures that may lead to performance-enhancer usage among this population. Subjects included 122 female athletes from top-ranked sport programs at 7 New Jersey high schools. Descriptive and quantitative statistics were used to analyze the data at a p<.05 significance level. The Chi Square Test of Homogeneity, Spearman Correlation Coefficient, Kruskal-Wallis One-Way ANOVA, and Scheffé Post-Hoc Test were used to analyze associations between the nine survey issues and five levels of importance. Results indicated that subjects rated the pressure to win and self-induced competitive pressures as the two most important factors in leading to performance-enhancer usage. Chi-Square results showed significant differences in the level of importance for each of the nine issues presented, while the Spearman Correlation revealed several correlations among certain issues. The Kruskal-Wallis One-Way ANOVA showed significant differences in ranks when data were grouped by school and sport. Post-Hoc analysis supported findings of the Kruskal-Wallis One-Way ANOVA. This study provided descriptive and quantitative data that added to the existing research. The findings may be used by health educators and athletic coaches for performance-enhancer prevention-education programs.