Impact of anti-doping education and doping control experience on anti-doping knowledge in Japanese university athletes: a cross-sectional study

A Behaviourally Informed Approach to Reducing the Risk of Inadvertent Anti-doping Rule Violations from Supplement Use

For many reasons, athletes' use of supplements is highly prevalent across sports and competitive levels, despite the risk of these products containing a substance on the World Anti-Doping Agency Prohibited List. Contravening anti-doping rules through supplement use could have serious consequences for competitive athletes (e.g., ineligibility from major competitions, loss of medals and funding) due to the principle of strict liability. Indiscriminate supplement use also poses a risk to athlete health. To reduce the possibility of ingesting a supplement containing prohibited substances, independent quality assurance and certification programs have been established (e.g., Informed Sport). However, these programs do not completely eliminate risk, leading to some anti-doping organisations promoting a 'just say no' to supplements stance. Yet, this approach can be problematic as a small number of supplements may be necessary for athletes to consume, in certain situations. Recognising that athletes will continue to use these heavily marketed products, this narrative review describes a theoretically underpinned and systematic approach to preventing inadvertent doping by considering the barriers to and enablers of athlete adherence to risk minimisation supplement use guidelines (RMSUG). By outlining a conceptual shift towards a behaviourally informed approach, this review serves to stimulate the development of multifaceted interventions to prevent inadvertent doping through supplement use. Recognising that risk-minimised supplement use involves a myriad of behaviours, the problem of inadvertent doping through supplement use is framed, and research appraised, through the lens of the Behaviour Change Wheel.

The association between subjective anti-doping knowledge and objective knowledge among Japanese university athletes: a cross-sectional study

Introduction

This study aimed to assess the association between subjective anti-doping knowledge (subjective ADK) and objective anti-doping knowledge (objective ADK) among Japanese university athletes, framed within the context of the Theory of Planned Behavior (TPB).

Methods

Eligible participants were 486 university athletes [320 men (65.8%), 166 women; mean age of 18.9 ± 1.0 years]. The participants categorized themselves in terms of the quality of their anti-doping knowledge. This assessment resulted in an independent variable coded as "(1) substantial lack of adequate knowledge," "(2) some lack of adequate knowledge," "(3) fair amount of knowledge" or "(4) good amount of knowledge." Objective ADK was assessed using the Athlete Learning Program about Health and Anti-Doping (ALPHA) test, a set of questions derived from the ALPHA-a former World Anti-Doping Agency e-learning program. The test comprises 12 questions (four choices each; passing index: ≧10 points or 80% correct answer rate). ANCOVA was conducted using subjective ADK as an independent variable and ALPHA scores as a dependent variable, adjusting for confounding factors (anti-doping experience).

Results

The ALPHA corrected answer rate across subjective ADK levels for the group were 73.10% for "(1) substantial lack of adequate knowledge," 71.97% for "(2) some lack of adequate knowledge," 75.18% for "(3) fair amount of knowledge" and 72.86% for "(4) good amount of knowledge." Comparison between different levels of subjective ADK revealed no significant differences in ALPHA score considering the main effects or any of their interactions.

Discussion

The present results revealed that Japanese university athletes' subjective ADK did not match their objective ADK. In the context of the TPB, there may be limitations in the perceived behavioral control in anti-doping knowledge. Even if athletes view doping as a wrongful act and have formed attitudes and subjective norms to comply with the rules, the results suggest that errors may occur in the composition of behavioral intentions due to a lack of knowledge. This could lead to the possibility of facing the risk of unintentional anti-doping rule violations. It highlights the need for targeted educational interventions to align subjective ADK of athletes with their objective ADK.

"I Am on Top!": An Interactive Intervention Program to Promote Self-Regulation Processes in the Prevention of the Use of Doping in Sports High Schools

The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on a psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., digital learning based on the game. The experimental design included an intervention group (n = 167; F = 37.7%; Meanage = 17.5 years; SD = 0.58) and a control group (n = 112; F = 42%; Meanage = 17.6; SD = 1). Both of the groups completed the same questionnaire on two different occasions (i.e., time 1 and time 2) for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular in terms of the decrease in doping intention and the strengthening of doping knowledge. Moreover, the study demonstrated that the score obtained during the implementation of the SG could partially represent a coherent measure of the participants' beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions.

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.

Knowledge and experience of Kazakhstan athletes in anti-doping and the impact of past educational intervention

Background

Although Kazakhstan National Anti-Doping Organization (KazNADO) exists since 2013, but little is yet known about anti-doping (AD) knowledge of Kazakhstan athletes. The aim of this study was to assess the AD education knowledge level and experience among Kazakhstan athletes, as well as the impact of any past AD educational program on them.

Methods

Altogether, 590 athletes (the median was age 17 years (interquartile range 8)), representing various sports, participated in the web-based study and completed the questionnaire, which consisted of socio-demographic part and ALPHA test. We assessed the association of any past AD education and experience with anti-doping knowledge using adjusted regression models.

Results

A total of 54.6% participants underwent doping control and 82,7% of athletes received AD education at least once. More than 300 participants (50.8%) provided correct answers for 10 questions. Age and years in sports (competition duration) were significantly associated with the ALPHA scores of athletes. Athletes who received AD education more than once in the past had significantly higher ALPHA scores than non-AD educated athletes in most questions.

Conclusion

AD education was associated with AD knowledge. Further research is needed to identify the adherence to anti-doping knowledge.

Effectiveness of the world anti-doping agency's e-learning programme for anti-doping education on knowledge of, explicit and implicit attitudes towards, and likelihood of doping among Chinese college athletes and non-athletes

Background

This study aimed to evaluate the effects of the World Anti-Doping Agency's e-learning programme for anti-doping education on knowledge of, explicit and implicit attitudes towards, and likelihood of doping among Chinese college athletes and non-athletes.

Method

Thirty-two young adults (including 16 college athletes) were recruited to receive the Athlete Learning Program about Health and Anti-Doping (ALPHA) intervention (Zh-hans version). Another 32 young adults were recruited for no-treatment control purposes. Before and immediately after the intervention, the ALPHA test, performance enhancement attitude scale, doping likelihood scale, and brief implicit association test (BIAT) were performed. Cortical activity during the BIAT test was monitored using a functional near-infrared spectroscopy instrument.

Results

Significant intervention effects were observed for knowledge (p < 0.01, η² = 0.21) and explicit attitude (p < 0.05, η² = 0.12) but not for doping likelihood (p > 0.05; benefit situation: η² = 0.04; cost situation: η² = 0.02). Compared with the non-athletes, the college athletes reported lower doping likelihood scores in benefit situations (e.g., financial gain, p < 0.05, η² = 0.10). Regarding the BIAT task, the experimental effect was successfully induced by different semantic associations between the concepts and the attitude (doping + like vs. doping + dislike). The mean reaction times (p < 0.01, η² = 0.36) and error rate (p < 0.01, η² = 0.34) in the doping-like block were higher than those in the doping-dislike block. Moreover, oxygenated haemoglobin (oxy-Hb) in response to BIAT interference in the temporoparietal junction-related channels was increased during the post-intervention test (p < 0.05, η² varied from 0.09 to 0.16).

Conclusions

The findings suggest that the online anti-doping education programme is partially effective among Chinese college athletes and non-athletes. Furthermore, our findings reflect enhanced cognitive control after the education intervention to suppress a prepotent implicit attitude towards doping.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13011-022-00459-1.

Anti-Doping Knowledge of Students Undertaking Bachelor's Degrees in Sports Sciences in Spain

In Spain, students pursuing a career in athletic training, physical education, or scientific evaluation of sports enroll in a bachelor’s degree in sports sciences. This degree provides knowledge and skills in a broad array of sports settings and promotes research-based interdisciplinary knowledge. However, the student’s syllabus rarely includes specific academic training on anti-doping regulations or doping prevention. The purpose of this study was to assess the anti-doping knowledge of the students undertaking a bachelor’s degree in sports sciences in Spanish universities. One thousand two hundred and thirty-three bachelor students in sport science (907 males, 322 females, and 4 participants with non-binary sex) from 26 Spanish universities completed a validated questionnaire about general anti-doping knowledge. The questionnaire is an adapted version of the Play True Quiz of the World Anti-Doping Agency and contains 37 multiple-choice questions. The score obtained in the questionnaire was transformed into a 0−100-point scale. The questionnaire was distributed among students within each university by a faculty member and it was filled out online. Students obtained a score of 65.8 ± 10.10 points (range = 32−92 points). There was an effect of the course in the score obtained (p < 0.001). Students of the first course (63.6 ± 9.5 points) had lower scores than the remaining courses (p < 0.037) while the students of the fourth course obtained the highest scores (68.7 ± 9.5 points; p < 0.019). The students with an itinerary on sports performance were the respondents with the highest anti-doping knowledge (67.2 ± 10.2) points, followed by the students with an itinerary on health (66.7 ± 9.5 points). The knowledge of basic anti-doping rules and doping prevention strategies of the bachelor students in sports sciences in Spain was suboptimal. Increasing doping prevention information in the syllabus of the bachelor’s degree in sports sciences is essential as these future professionals will directly work with populations at risk of doping.

Answering the call for values-based anti-doping education—An evidence-informed intervention for elite adolescent athletes in Germany and Austria

Doping has serious negative consequences for athletes and the integrity of sports, implying the need for effective prevention programs. Since educating young athletes about doping-related knowledge is deemed to be not sufficiently effective to minimize doping, a focus on values, emotions and morality is seen as a promising approach and previous research indicates which variables exactly could be addressed in anti-doping efforts. These variables are anticipated guilt, empathy, moral disengagement, and collective moral norms, since these constructs have been strongly and consistently linked to doping intention, likelihood, or behavior. Therefore, the purpose of this study was to develop a values-based anti-doping intervention, which targets the aforementioned variables, and to evaluate its effectiveness in producing changes in outcomes in comparison to an information-based intervention and a waiting control group. To evaluate their effectiveness, both interventions, which each consist of six 45-min sessions (one session per week) were implemented in a sample of 321 young elite athletes, aged 13–19 years, from a broad range of team and individual sports. Thirty different teams, training groups or classes were randomly assigned to either the values-based intervention, the information-based intervention, or to a waiting control group. Doping intention, doping susceptibility as well as the above mentioned variables were assessed at pre- and posttest and, for participants of the values- and information-based conditions also at a 3 to 4-month follow up. Within a multilevel modeling framework general linear mixed regression analyses revealed that the values-based intervention, compared to the control group, was able to decrease athletes' moral disengagement and increase their anticipated guilt immediately after the intervention (at posttest), whereas no effects for the information-based intervention emerged. Looking at how the outcomes developed over time (i.e., at the follow up measurement), it could be demonstrated that the reduction in moral disengagement sustained. The increase in anticipated guilt, however, was not sustainable and, surprisingly, decreased from post to follow up. Furthermore, athletes in the values-based intervention reported higher empathy from post to follow up, which could possibly indicate a “delayed” effect. This study provides support that a values-based approach can produce changes in some, yet, not all addressed variables and specific elements from this intervention could potentially be a useful addition to traditional anti-doping education (i.e., information provision).

Relationship between the level of willingness to learn about anti-doping and objective knowledge among Japanese university athletes: A cross-sectional study

Previous studies have indicated that athletes' anti-doping knowledge is inadequate. Athletes' willingness to learn about anti-doping (willingness to learn) may influence their anti-doping knowledge, but the actual situation is unclear. This study aimed to determine the relationship between athletes' willingness to learn about anti-doping and their objective measurement knowledge and explore directions for educational interventions. The eligible participants were 971 male and 802 female university athletes. We used the ALPHA test (12 questions/four choices; passing index: ≥10 points/80% correct answer rate) to assess objective anti-doping knowledge. The willingness to learn question was, “Would you like to learn more about anti-doping?” Responses were given on a 4-point scale ranging from 1: strongly disagree to 4: strongly agree. An ANCOVA was conducted with four levels of willingness to learn as the independent variable and ALPHA correct answer rate as the dependent variable, adjusting for confounding factors (years of athletic experience and anti-doping education experience). The percentage of athletes (%) and each ALPHA correct answer rate (%) by the level of willingness to learn was 1: strongly disagree, n = 1.64%, 61.78%; 2: somewhat disagree, n = 13.14%, 62.38%; 3: somewhat agree, n = 62.94%, 64.08%; 4: strongly agree, n = 22.28%, 67.11%. The ALPHA correct answer rates showed significant differences in the main effect by the level of willingness to learn [F_{(3, 1767)} = 2.873, p < 0.05, η² = 0.01], although the effect size was small, and multiple comparisons showed no significant differences between the levels. The results indicated that the ALPHA correct answer rate did not reach 80% even for the “strongly agree” level of willingness to learn, suggesting that information on anti-doping may be inadequate. The need to provide sufficient educational content to improve knowledge was evident.

A Supplementary Approach for Effective Anti-Doping Education: A Pilot Study Applying Refutation Texts to Modify Misperception of the Whereabouts System

Background: Over the past twenty years, a multifaceted anti-doping system was established to detect, deter, and prevent doping among athletes. However, perception of the whereabouts system has been a controversial issue. This pilot study aimed to evaluate the effects of refutation text intervention on the perception of the whereabouts system. Methods: In two studies, we tested whether (1) detailed refutation texts are perceived as more effective than simply refuting with a true or false claim among 132 athletes (47.73% female, mean age = 20.99 ± 2.11), and if (2) refutation text intervention can alter the perception of the whereabouts system among 177 athletes (53.11% female, mean age = 21.17 ± 2.27). Descriptive statistics were calculated, followed by a one-sample T-test, independent T-test, chi-square test, and a repeated-measures analysis of variance. Results: The results demonstrate that five true/false statements were developed as refutation texts, and the mean accuracy of the true/false test is less than the probability of guess (p < 0.05, d = −0.18). In addition, detailed refutation texts evoked significantly greater perceived effectiveness than the simple refutation texts (p < 0.01, d = 0.66). Furthermore, the refutation text intervention enhanced the positive perception of the whereabouts system (p < 0.01, η² = 0.15). Conclusions: Our findings support the efficacy of refutation texts to improve the misperception of anti-doping regimes among athletes and have implications for future education prevention initiatives.