The role of the athletes’ entourage on attitudes to doping

"I RUN CLEAN Project"-An Innovative and Self-Sustainable Approach to Develop Clean Sport Behaviours in Grassroots Athletes

The phenomenon of doping is a public health issue that poses threats to sport and society. In recent decades, the emphasis on efforts to address the issue and reduce the incidence of doping by young people in sport has shifted from deterrence through testing and punishment to the promotion of clean sport behaviours through values-based education. The "I Run Clean project" sought to develop new and effective tools targeting grassroots athletes and those around them (coaches, medical support personnel, sport leaders, parents). These included sport-specific e-learning and in-person peer-to-peer workshops led by trained volunteer ambassadors. The aim of all "I Run Clean" measures is to go beyond the warnings and provision of factual information about early anti-doping campaigns to a more holistic educational approach that focuses participants on their personal and sport-related values in order to encourage good decision-making and resistance to doping-related behaviours. This study evaluates the efficacy of the peer-to-peer workshops and their impact on selected psycho-social variables. The collaboration of the volunteer ambassadors is shown to effectively transmit the desired reasoning, reduce doping risk factors and enhance protective factors.

Self-Affirmation and Image/Performance Enhancing Drug Use in Recreational Exercise

Objectives: The use of image and performance enhancement drugs (IPEDs) in recreational sport represents an emerging public health and societal problem. The present study investigated whether self-affirmation changed exercisers' intentions to use IPEDs, via the effects of mental construal and message acceptance. Method: Sixty-eight exercisers who self-reported IPEDs use participated in the study and were randomly assigned to either a self-affirmation or a control group. All participants read a health-related message about the 10 consequences of IPEDs and subsequently completed a survey measuring message acceptance, mental construal, doping intentions and IPEDs-related social cognitive variables. Results: There were no significant differences between the self-affirmed and the control groups. Hierarchical linear regression analysis further showed that message acceptance, subjective norms, and situational temptation were significantly associated with intentions to use IPEDs. Conclusion: Our findings raise the possibility that for recreational exercisers IPED's use is seen mostly as a health-related matter than a socio-moral transgression.

From Anti-doping-I to Anti-doping-II: Toward a paradigm shift for doping prevention in sport

Doping remains an intractable issue in sport and occurs in a complex and dynamic environment comprising interactions between individual, situational, and environmental factors. Anti-doping efforts have previously predominantly focused on athlete behaviours and sophisticated detection methods, however, doping issues remain. As such, there is merit in exploring an alternative approach. The aim of this study was to apply a systems thinking approach to model the current anti-doping system for four football codes in Australia, using the Systems Theoretic Accident Model and Processes (STAMP). The STAMP control structure was developed and validated by eighteen subject matter experts across a five-phase validation process. Within the developed model, education was identified as a prominent approach anti-doping authorities use to combat doping. Further, the model suggests that a majority of existing controls are reactive, and hence that there is potential to employ leading indicators to proactively prevent doping and that new incident reporting systems could be developed to capture such information. It is our contention that anti-doping research and practice should consider a shift away from the current reactive and reductionist approach of detection and enforcement to a proactive and systemic approach focused on leading indicators. This will provide anti-doping agencies a new lens to look at doping in sport.

Examining mindfulness and moral disengagement in doping: Perspective of Turkish wrestlers

Introduction

Studies related to attitudes toward the use of prohibited substances in Turkish athletes are scarce. The World Anti-Doping Agency (WADA) has implemented anti-doping educational policies emphasizing doping-related education in studies conducted among Turkish wrestlers. However, it is still unclear the extent to which the wrestlers comply and adhere to these anti-doping policies. No research has previously examined the effect of anti-doping education on athletes' mindfulness and moral disengagement in doping (MDD). Therefore, the present study has a two-fold objective: first, to examine whether doping-related education (DRE) and the status of being a national athlete (NA) have an effect on athlete mindfulness and MDD. Second, to analyze the relationship between each sub-dimensions of athlete mindfulness: awareness (ASD), judgment (JSD), and refocus (RSD) with MDD.

Methods

A total of 409 male wrestlers participated in this study. MANOVA analysis showed that NA and DRE alone have no effect on MDD but have a general effect on mindfulness.

Results

The highest effect was on the ASD of being an NA (ηp2 = 0.173). When the interaction effect of NA*DRE was examined, significant difference in MDD (F = 8.218, p = 0.004), ASD (F = 8.476, p = 0.004), JSD (F = 5.844, p = 0.016), and RSD (F = 11.476, p = 0.001) were found. MDD has a weak negative relationship with ASD (r = −0.126) and RSD (r = −0.041) and a weak positive relationship with the JSD sub-dimension (r = 0.140). Those results suggest that being a NA and having received anti-doping education affect moral disengagement in doping and athletes' mindfulness.

Discussion

As a conclusion, it is recommended to increase awareness and anti-doping education among national-standard Turkish wrestlers to prevent them from engaging in doping behaviors.

Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21st century

Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.

Moral Disengagement, Social Norms, and Motivational Profiles Influence Attitudes Toward Doping Among Spanish Athletics Coaches

Coaches strongly influence athletes' attitudes toward doping and can shape athlete's beliefs, behaviors, and decisions to be for or against doping. Coached-centered studies examining multiple factors affecting coaches' doping attitudes and behavior are scarce. The aim of this study was to analyze for the first-time attitudes toward doping in athletics coaches using the Sport Drug Control Model (SDCM) as a theoretical framework. A secondary aim was to determine the factors in the model predicting attitude and susceptibility toward doping. A cross-sectional study was carried out using a sample consisting of 201 Spanish athletics competitive level coaches from whom 11.4% were female. Participants completed a cross-sectional online survey. Structural equation modeling showed a good fitness of the SDCM. Positive attitudes toward doping predicted high susceptibility to doping (β = 0.39, p < 0.001). Moral disengagement (β = 0.58, p < 0.001), descriptive norms (β = 0.42, p = 0.001), ego-oriented goals (β = 0.34, p < 0.05), and self-efficacy to refrain from doping (β = 0.26, p < 0.05) displayed a significant influence on attitudes toward doping. Self-reported doping prevalence in coaches was 4.5%. These variables should be considered when designing anti-doping research projects and educational programs aiming at modifying coaches' attitudes toward doping. It is recommended to focus more efforts on coaches, without putting aside the athletes, and therefore turn coaches into reliable doping prevention factors. To this end, it is necessary to enhance scientific research and then develop, implement, and promote more educational programs targeting coaches, on a mandatory basis while covering the specific needs of coaches so that they can perform their role as anti-doping educators in an effective, committed, and proactive manner.

Moral Identity and Attitudes towards Doping in Sport: Whether Perception of Fair Play Matters

Research evidence suggests that athletes' attitudes towards banned substances are among the strongest predictors of intention to use or actual practice of doping. Previous research has found that personal morality was negatively related to doping attitudes. However, less is known about the role of athletes' perceptions of fair play on their attitudes towards doping. First, we examined whether moral identity was associated with athletes' attitudes towards doping and whether their perceptions of fair play mediated this relationship. The second purpose was to determine whether these associations differed among non-athletes. Overall, 365 university students (49.9% males, 55.3% athletes) participated in this study (mean age 22.02, SD = 6.58). They completed questionnaires measuring the aforementioned variables. The results showed that athletes' moral identity and endorsement of fair play were negatively associated with their attitudes towards doping. The mediation analyses showed that the effect of moral identity on attitudes towards doping was partially mediated by perceptions of fair play (indirect effect, β = -0.10, p < 0.05). Unlike student athletes, non-athletes' moral identity negatively predicted attitudes towards doping only indirectly, via fair play perception (indirect effect, β = -0.08, p < 0.05). The study provides insights into how a person's morality and perception of moral values in sport may act as factors related to doping in sport. The practical implications for the promotion of anti-doping attitudes for athletes and separately for student non-athletes were provided together with future research perspectives.

Feasibility randomised controlled trial examining the effects of the Anti-Doping Values in Coach Education (ADVICE) mobile application on doping knowledge and attitudes towards doping among grassroots coaches

Objectives

Sports coaches are influential in whether athletes dope, but receive very little antidoping education, particularly within entry-level coaching qualifications. We tested the feasibility of an antidoping intervention, delivered via a mobile application, which was designed to increase coaches’ knowledge of doping and to reduce favourable doping attitudes.

Methods

A two-arm randomised controlled trial, with grassroots coaches who coach young amateur athletes aged between 14 and 18 years of age, was conducted. The Anti-Doping Values in Coach Education (ADVICE) mobile application included modules on fair play, substances, nutritional supplements, rules and leadership. The primary outcome was the change in doping knowledge, 6 weeks after receiving the mobile application. The secondary outcome was changes in doping attitudes.

Results

Grassroots coaches (n=200; aged between 18 and 71 years, with between 1 and 42 years of coaching experience) from 29 different countries completed baseline assessments, and 85 completed follow-up assessments, and were included in mixed analysis of variance analyses. The intervention increased coaches’ knowledge about doping and also reduced favourable doping attitudes in the experimental arm.

Conclusion

The ADVICE mobile application is a feasible method for delivering and increasing grassroots coaches’ knowledge of banned substances and the potential side effects of doping. Mobile application-based resources could facilitate a much wider dissemination of antidoping education.

An intervention to optimise coach-created motivational climates and reduce athlete willingness to dope (CoachMADE): a three-country cluster randomised controlled trial

Objectives

Coach-centred antidoping education is scarce. We tested the efficacy of a motivationally informed antidoping intervention for coaches, with their athletes’ willingness to dope as the primary outcome.

Methods

We delivered a cluster randomised controlled trial in Australia, the UK and Greece. This study was a parallel group, two-condition, superiority trial. Participants were 130 coaches and 919 athletes. Coaches in the intervention group attended two workshops and received supplementary information to support them in adopting a motivationally supportive communication style when discussing doping-related issues with their athletes. Coaches in the control condition attended a standard antidoping workshop that provided up-to-date information on antidoping issues yet excluded any motivation-related content. Assessments of willingness to dope (primary outcome) and other secondary outcomes were taken at baseline, postintervention (3 months) and at a 2-month follow up.

Results

Compared with athletes in the control group, athletes in the intervention group reported greater reductions in willingness to take prohibited substances (effect size g=0.17) and psychological need frustration (g=0.23) at postintervention, and greater increases in antidoping knowledge (g=0.27) at follow-up. Coaches in the intervention group reported at postintervention greater increases in efficacy to create an antidoping culture (g=0.40) and in perceived effectiveness of need supporting behaviours (g=0.45) to deal with doping-related situations. They also reported greater decreases in doping attitudes (g=0.24) and perceived effectiveness of need thwarting behaviours (g=0.35).

Conclusions

Antidoping education programmes should consider incorporating principles of motivation, as these could be beneficial to coaches and their athletes. We offer suggestions to strengthen these programmes, as most of the effects we observed were not sustained at follow-up.

Trial registration number

This trial has been registered with the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371465&isReview=true).