Dr Laurie Patterson

Limited effort has been invested in understanding doping in Paralympic sport. The limited evidence that exists suggests that factors influencing doping in parasport are similar to Olympic sport. However, based on the design and nature of the previous studies, where methods have been mostly limited to qualitative data and prevalence numbers, further research is warranted to extend previous findings. Informed by current evidence from Paralympic and Olympic sport, we aimed to investigate (1) para-athletes’ perceptions of Anti-Doping Rule Violations (ADRVs) and responsibility for them, (2) descriptive norms for doping in parasport (3) perceptions of anti-doping education and legitimacy of anti-doping authorities, and (4) coach engagement in doping prevention and levels of doping confrontation efficacy. In total, valid survey responses from 126 Paralympic athletes and 35 coaches from four countries (Germany, Austria, Switzerland, UK) were analysed for experience with anti-doping, descriptive norms, anti-doping education, perceived legitimacy, knowledge, and doping confrontation efficacy (coaches only). Across both athletes and coaches, , the level of education was generally good and doping willingness was low. Classification cheating was considered a form of doping and seems to be an important issue for athletes and coaches, especially within the UK sample. For 33.3% of the athletes a doping control was their first experience with anti-doping. Coaches’ engagement with doping prevention activities and their perceived efficacy to confront doping-related matters appears to be higher compared to Olympic coaches’ samples. Sport organisations/NADOs in Paralympic sport could use synergies with those organisations in Olympic sport, adopting similar approaches to anti-doping education, also focusing on a balanced communication of doping prevalence number and testing figures. Effort to ensure athletes are educated about anti-doping before they are tested should be upheld. It seems that in para sport, different compared to able-bodied coaches, anti-doping organizations do not have to convince the coaches about their roles (i.e., being responsible for anti-doping education) anymore but can directly build on these resources. Overall, it seems that there are little differences between parasport and able-bodied sports and thus responsible organisations could use the existing programmes in Olympic sport and only adapt special content (e.g., boosting) which is unique to Paralympic athletes.

Sports Nutrition Online Conference 2.0

British Dietitian Association, Sports Nutrition Study Day

INTRODUCTION: Poor adherence to nutritional guidance by athletes may compromise their health and performance. Improving athlete nutritional adherence is a growing priority for sport and exercise nutritionists and high-performance sport systems. To advance understanding, we utilised the Capability, Opportunity, Motivation – Behaviour (COM-B) model (Michie et al., 2011) and the Theoretical Domains Framework (TDF) (Cane et al., 2012) to qualitatively explore the barriers and enablers of elite athletes’ adherence to nutritional guidelines. METHODS: Seven semi-structured focus groups were conducted with a purposive sample of 39 UK-based funded athletes (M = 23 years, SD = 3.81), participating in either Olympic and Paralympic sport (n = 30) or professional sport (n = 9). All participants had access to a nutritionist. The focus groups explored the barriers and enablers to nutritional adherence in high-performance sport (M = 90 minutes, range 1 hour – 2 hours). Data were analysed using thematic analysis and the interpretations of the findings were guided by COM-B and the TDF. RESULTS: Athlete adherence to nutritional guidance was seasonal and included inadequate energy intakes and episodes of binge eating. This behavioural analysis identified capability, motivation, and opportunity as barriers and enablers to athlete nutritional adherence, exemplifying the complexity of the behavioural system. For the first time, this study illustrates athletes’ motivational barriers are mutually reinforced through their social interactions within the high-performance environment (social opportunity). To achieve nutritional adherence, this research has illuminated the need to intervene across all three interacting COM-B components. Person-environment interactions noted are directly relevant to the sport and exercise science community who are architects of the environment within which athletes are situated. CONCLUSION: Using a theory-based approach ensured systematic and comprehensive identification of a wide range of barriers and enablers for nutritional adherence in high performance sport; laying the foundations for the development of targeted and multifaceted behavioural interventions that can help to protect athletes’ overall health, well-being and performance.

Objectives: The phenomenon of doping is rarely researched in Paralympic sport, especially from the coach perspective. This study responds directly to this gap in research by exploring coaches' doping-related perceptions, knowledge, and opinions of the current anti-doping system in order to inform future interventions specific to disabled elite sport contexts. Method: Eleven coaches from Germany (n = 6) and the UK (n = 5) working across physiological (n = 7) and skill-based (n = 4) sport disciplines at an elite level (Paralympic, n = 10 and World Championship, n = 1) took part in semi-structured interviews. Data were analysed using abductive reflexive thematic analysis (Braun & Clarke, 2019a). Findings: Four themes were developed to capture the coaches’ perspectives. The first represents coaches’ perception that doping is an issue in Paralympic sport. The second theme shows that risk factors to dope are typically multiple and intertwined, stemming especially from financial incentives and pressure to win. Theme three captures coaches' opinion of differences in testing and education across countries due to budget, resource, or infrastructure issues. Finally, data showed that coaches prefer to refer responsibility for doping prevention to their national anti-doping organisation, rather than taking on personal responsibility for anti-doping efforts. Conclusions: According to the interviewed coaches, doping has the potential to be a big issue in disabled elite sport. The main risk factors of money and pressure to win (earn prize money or funding/sponsorship) are knitted together and can be additionally impacted (negatively) by a nation's sporting system. These factors should be addressed by thinking both on an individual level (e.g., support dual careers) and a structural/policy level (e.g., aim to have minimum standards to level the global inconsistent anti-doping systems, including anti-doping education/testing). Furthermore, coaches should take their role and be proactively made aware of their responsibility in doping prevention to coach clean and protect their athletes properly.

Invited presentation for the Clean Sport Connect - Report your concerns and protect your sport webinar hosted by United Kingdom Anti-Doping

To protect the integrity of sport and the health of athletes, global anti-doping programmes seek to prevent doping behaviours and elicit clean sport behaviours through education, deterrence, detection, enforcement and rules. To guide programme development, this meta-synthesis of qualitative research applied a behavioural science framework to identify participants’ perspectives and experiences of (anti-)doping to further understanding of the barriers and enablers of clean sport.

Introduction: As the core policy document in the anti-doping landscape, the World Anti-Doping Code (World Anti-Doping Agency [WADA], 2015) provides clear guidelines on the roles and responsibilities of signatories to the Code. One such directive is that National Anti-Doping Agencies and International Federations should ‘promote anti-doping education’, including ‘requiring National Federations to conduct anti-doping education in coordination with the applicable National Anti-Doping Organisation’ (WADA, 2015, pp. 65 and 67). Although these guidelines are communicated widely, our understanding of the lived experience of key stakeholders operationalising these directives is limited. Thus, the purpose of this qualitative study was to gain an in-depth understanding of the system through which anti-doping education is delivered from those who deliver it. Methods: Semi-structured interviews were conducted with thirteen individuals responsible for anti-doping education within national and international sporting and anti-doping organisations. All interviews were transcribed verbatim and analysed using inductive thematic analysis (Braun & Clarke, 2006). Findings: The complexities and challenges of the anti-doping education system emerged from the accounts of the key stakeholders. Specifically, interviewees described a landscape in which limited resources – including money and personnel – were available for anti-doping education. At the same time, interviewees called for more coordinated efforts (e.g., better communication and sharing best practice) across all levels of the anti-doping system (i.e., WADA, NADOs, IFs and NGBs) and the importance of individuals at every level of the system ‘buying in’ to and valuing anti-doping was articulated. They noted a specific challenge in this regard was the negativity of ‘anti-doping’ messages that become associated with ‘catching cheats’. To address this, several individuals endorsed a shift in narrative from anti-doping to ‘Clean Sport’, whereby positive educational messages prevail and the focus is on protecting the rights of Clean athletes. Finally, there was a consensus that anti-doping education requires long-term planning, with several individuals highlighting the need for patience in allowing the impact of education to be shown in the next ‘generation’. Conclusions: The findings suggest that individuals tasked with managing anti-doping education within national and international sporting and anti-doping organisations are under strain to fulfill their Code obligations. In acknowledging this stress in the system, the study underscores the importance of coordination and cooperation between organisations at every level. Moreover, if WADA’s vision for prevention through education is to be realised, increased fiscal and human capital investment into ‘clean sport’ education is required. Without this investment, anti-doping education might never be highly valued by sports organisations and engagement with preventive programmes will remain perfunctory.

Doping refers to engaging in one or more of eleven anti-doping rule violations (ADRVs) outlined in the World Anti-Doping Code; these include possession, administration and trafficking of prohibited substances or methods, as well as complicity in any of these activities, prohibited association with anyone who has been found to have committed an ADRV, and acts to discourage or retaliate against anyone who reports doping-related information to authorities. Testing statistics likely show only a fraction of the true number of athletes doping. Evidence shows that specific situations individuals find themselves in are pivotal. The suggestion for psychological support aligns well with recent developments in the United Kingdom, where there are plans to introduce new Professional Standards for Personal Development Practitioners,1 whose role will include supporting athletes throughout transitions, including beyond their sporting career.

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Invited workshop for coaches and coach developers hosted by World Triathlon

OBJECTIVES: To investigate coaches’ roles in anti-doping efforts; specifically their behaviours in everyday coaching practice and their opinions of current anti-doping policy expectations. DESIGN: A qualitative research design was adopted and the investigation was guided by Social Ecological Theory (Bronfenbrenner, 1977). METHODS: Semi-structured interviews were conducted with a purposive sample of twelve male UK-based coaches (aged 27-54 years) working in a performance development context within Football (n=6) and Rugby League (n=6). The data were analysed using thematic analysis (Braun & Clarke, 2006). RESULTS: Coaches saw themselves in a supporting role in anti-doping efforts by monitoring player behaviour and giving advice to players when approached with questions. However, coaches did not fulfill all responsibilities outlined in the current World Anti-Doping Code and questioned the feasibility of doing so in the future. Several individual and environmental factors contributed to coaches’ opinions and behaviours, including a perceived lack of knowledge, a reliance on colleagues or external partners to take the lead, and the taboo nature of doping in sport. CONCLUSIONS: The study provides unique insights into coaches’ perceived and actual anti-doping roles to reveal that the policy-ascribed expectations for this key stakeholder group are not being operationalised in practice. Further research should explore coaches’ willingness to act in line with their responsibilities under the Code in order to gain a better understanding of the individual and environmental factors that influence coach behaviours. Such research is necessary to inform not only future policy developments, but also appropriate coach-based education programmes.

The anti-doping system operates in a complex, morally charged, and high-stakes environment. Within this framework, the principle of strict liability and the tension between transparency, the protection of clean sport, and athletes’ rights amid intense public scrutiny can inflict harms that extend well beyond sporting ineligibility. Despite this, limited research has examined the lived experiences of athletes sanctioned for Anti-Doping Rule Violations (ADRVs) under the World Anti-Doping Code. This review identified 25 English-language studies between 2011 and 2025 involving sanctioned athletes, of which only 12 considered athletes’ experiences during and after the sanctioning process, reflecting the perspectives of 49 athletes found to have committed ADRVs. All but one received a sanction, and several claimed the violation was unintentional. The included studies were analyzed using descriptive and bibliometric techniques, narrative synthesis, and citational analysis to assess the composition, scholarly impact, and practical relevance of this emerging body of work. Through narrative synthesis, we identified five recurring themes across athletes’ accounts of the sanctioning process and its aftermath: (1) psychological and emotional distress; (2) social isolation and reputational damage; (3) perceived procedural injustice and institutional abandonment; (4) disruption to career trajectories and athletic identity; and (5) a sense of resolution or clarity despite adversity. However, the direct translation of this research into anti-doping policy remains limited. Difficulty in reaching and recruiting participants was common across the reviewed studies. Significant gaps persist in reporting standards, gender representation, and regional diversity, which hinder a comprehensive understanding of the personal consequences of ADRVs. Despite limitations, this review represents a critical step toward assessing the legitimacy of anti-doping enforcement from the perspective of those most affected. The findings underscore the urgent need for interdisciplinary research and policy development that consider athletes’ experiences and promotes more equitable and humane regulatory practices. Future work should be directed toward wellbeing and support needs of athletes facing ADRV sanctions, including those later acquitted, and structured pathways for transitioning out of, or returning to, sport post-sanction. Research should also expand to explore the perspectives of athletes impacted by doping within their environment for a comprehensive evidence-base for future anti-doping policies.

Introduction: Compared to anti-doping research in Olympic sport, the issue of doping is under-researched and poorly understood in Paralympic sport. However, with the growth of the Paralympic Games and the increased number of disabled elite athletes, the number of doping controls and doping cases has also increased. Therefore, there is a need to address the dearth of evidence in disabled sport contexts and develop an understanding of disabled elite athletes' perceptions, reasons and knowledge related to doping to ensure appropriate policy and programmes are implemented. Method: Sixteen disabled elite athletes from Austria (n = 9) and the UK (n = 7) participated in semi-structured interviews. Data were analysed using inductive reflexive thematic analysis (Braun & Clarke, 2019a). Findings: Four themes were generated during the analysis. The first showed that athletes perceive doping to be a well-known and wide-spread issue in Paralympic sport. The second theme illustrated that disabled elite athletes are exposed to extreme pressure (e.g., to earn money), which they state poses a risk for using prohibited methods and/or substances. Thirdly, athletes suggested that there are several ways to cheat if someone would like to find ‘loopholes’ (e.g., misuse of Therapeutic Use Exemptions) in the current anti-doping system, which they reported only works partially. Lastly, although it is not officially named as an anti-doping rule violation, athletes proposed cheating on classification as a form of doping – and the greatest threat to the integrity of disabled sport. Conclusions: For the first time, the current study shows that doping in the context of disabled elite sport likely stems from only a few main factors; a perception of pressure and faults in the anti-doping system. To address these risks, prize money could be distributed more broadly, the TUE process and classification system should be more closely scrutinised, and targeted anti-doping education that addresses the main risk factors in disabled elite sport should be provided for all athletes and their support team worldwide.

Objectives: Athlete support personnel (ASP) can play a significant role in protecting the integrity of sport and welfare of athletes. Yet, their perspective on how they proactively contribute to clean sport is rarely considered in anti-doping research. Studies with ASP working in elite disabled sport are rarer still. This study amplifies the voice of ASP working with international level disabled athletes to answer the following research questions: 1) What actions do ASP take in anti-doping? 2) What are the factors influencing ASPs’ actions? Methods: Individual semi-structured interviews were conducted with 41 ASP (Men n=17, Women n=23, n=1 did not report) in six European countries working as Psychologists (n=7), Mangers/Performance Directors (n=6), Physiotherapists (n=6), Doctors (n= 5), Nutritionists (n=5), Strength and Conditioning coaches (n=4), Agents (n=2), Technical coaches (n=2) and a dual role as a Coach/Manager (n=3) or Coach/Physiotherapist (n=1). Abductive reflexive thematic analysis was conducted, beginning with inductive coding and development of themes, followed by deductive identification of constructs from the COM-B Model and Theoretical Domains Framework. Results: Most ASP shared a narrow repertoire of behaviors that targeted helping athletes avoid ‘accidental’ doping through medicine and supplement use. However, psychologists’ actions addressed a broader range of doping vulnerability factors, such as self-esteem and emotion regulation. Regardless of the exact nature of ASPs’ anti-doping roles, behavior appeared to be influenced by ASPs’ professional role and identity, as well as ASP operating in performance pressured environments and/or ASP perceiving that doping would never occur among their athletes. Conclusions: ASP are primarily concerned with preventing inadvertent doping. This concern aligns with the content of anti-doping education programmes. To reduce the risk of intentional doping alongside inadvertent doping, a more behaviorally informed approach to anti-doping is required where ASP are deliberative agents in the pursuit of clean sport.

Despite its protective intent, the anti-doping system functions in a complex, high-stakes environment where strict liability and public scrutiny can produce unintended harms for sanctioned athletes. To date, limited insights exist into the lived experiences of individuals sanctioned for Anti-Doping Rule Violations (ADRVs) under the World Anti-Doping Code. We located twelve English-language outputs published between 2011 and 2025 containing relevant empirical data, and used descriptive and bibliometric techniques, narrative synthesis, and citational analysis to evaluate the composition, impact, and practical relevance of this emerging body of work. Through narrative synthesis, we identified five key areas of concern: (1) psychological and emotional distress; (2) social isolation and reputational damage; (3) perceived procedural injustice and institutional abandonment; (4) disruption to career and athletic identity; and (5) a sense of resolution or clarity despite adversity. Difficulty in reaching and recruiting participants was noted in most studies. Highly cited articles were referenced across diverse domains, often due to their dual focus on doping motivations and firsthand experiences with ADRV sanctions. The direct translation of existing research into anti-doping policy remains limited. Gaps in reporting standards, the underrepresentation of female athletes, and regional imbalances in the evidence base constrain a comprehensive understanding of the personal consequences of ADRV sanctions. Despite these early limitations, this review marks a critical step toward evaluating the legitimacy of anti-doping rule enforcement from the perspective of those most directly affected. The findings highlight the urgent need for future research to inform more humane, equitable, and athlete-centred regulatory practices.

Background There has been a lack of consideration of the specific needs of para-athletes and athlete-support personnel (ASP) when designing anti-doping and clean-sport education. To this, we developed recommendations for anti-doping and clean-sport education addressing the specific needs of these groups. Methods The Delphi method was used. Stakeholders with relevant expertise were invited to be panel members. In Round 1, the expert panel suggested novel elements for anti-doping and clean-sport education with para-athletes and ASP. These suggestions were integrated within a survey assessing the importance of 28 potential elements. In Round 2, the expert panel completed this survey. In Round 3, panel members ranked the relative importance of each topic area rated highest in Round 2. Based on these rankings, a draft set of recommendations was created. In Round 4, panel members rated the degree to which they accepted these recommendations and the feasibility of their delivery. Results The results of Round 2 and Round 3 were used to create education recommendations for para-athletes and ASP. In Round 4, most panel members fully accepted the para-athlete and ASP recommendations. Conclusions Adoption and implementation of the recommendations created should lead to greater engagement, enhanced learning, and more effective education for para-athletes and ASP.

Objectives: Under the World Anti-Doping Code coaches have designated anti-doping roles and responsibilities. Yet, their experiences, opinions and behaviours in relation to these expectations are poorly understood. This study responds directly to this absence of evidence in order to move the field forward. Design: A qualitative thematic analysis approach. Method: Twelve football and rugby league coaches, working in a performance development context, took part in semi-structured interviews to explore their (anti-)doping experiences, opinions and behaviours. Nine coaches participated in follow-up interviews where particular attention was paid to existing anti-doping policy directives. All interviews were analysed using inductive thematic analysis. Results: Coaches were supportive of anti-doping efforts and exerted their influence by monitoring, giving advice and creating the ‘right’ culture. Performance prioritisation rendered coaches reluctant to engage proactively in addressing anti-doping in their practice; a situation exacerbated by a lack of self-efficacy to advise/act in accordance with the rules. Consequently, coaches tended to rely on others (both internally and externally to their club) to provide anti-doping support, and anti-doping is deemed unnecessary/irrelevant. Critically, coaches’ current behaviours were not driven by policy, as they were unaware of expectations and consequences outlined in the Code. Conclusions: Coaches are willing to support anti-doping efforts, but are generally passive in their everyday practice. The gulf between anti-doping policy and coaching practice raises cause for concern for anti-doping policy makers. To bridge this gap systematic programming of activities designed to ensure coaches are able and willing to take a proactive role in doping prevention is required.

Objectives: To explore coaches’ perceived roles in doping prevention and investigate their previous experiences of working with athletes on doping related matters. Design: A cross-sectional online survey design was adopted. Methods: UK-based coaches (n=28) from various sports and coaching domains completed a self-devised web-based questionnaire. This consisted of thirty-eight questions divided into four sections (Demographics, Awareness, Experiences and Opinions). Data was analysed via non-parametric tests where applicable. Results: Almost half of the coaches (n=12, 43%) had never been approached by their athletes to discuss doping-related topics. Yet, 86% of coaches felt that they had to encourage an anti-doping viewpoint. Coaches working in the performance development domain were approached more often than those in participation domains. Coaches reported that athletes approach them because they value their opinions, believe they are knowledgeable and will tell them what to do (i.e. make the decision for them). Coaches also reported that athletes might not approach them because they gain support from elsewhere. When approached (n=16), nutritional supplements (n=15, 94%) and prohibited substances/methods (n=14, 88%) were most commonly discussed. Conclusions: Findings indicated that coaches are a source of anti-doping information or advice for athletes. When approached, there was a diverse exchange between the coach and athletes regarding the use of licit and illicit means of performance enhancement. Although coaches within the performance development domain were most commonly approached, coaches from other domains acknowledged that they have a role in doping prevention. Further research should explore coaches’ role expectations, including how anti-doping influences their every-day practice.

Problematic Low Energy Availability (LEA)* and Relative Energy Deficiency in Sport (REDs)* are threats to athlete health, wellbeing, and performance (*see Figure 1 for definitions). The prevalence of LEA/REDs in athletes ranges from 23% – 80% (females) and 15% – 70% (males) (1). Whilst scientific advances in LEA/REDs have strengthened understanding of how to identify, detect, and treat LEA/REDs (1), shifting focus upstream to preventing LEA/REDs is warranted.

Within anti-doping efforts, an emphasis has been placed on the importance of providing education programmes to key stakeholder groups, including coaches. Yet, very little is known about current coach education provision in the anti-doping domain across countries and sports. Therefore, this study aimed to: 1) establish the current status of antidoping education for coaches; 2) gain an understanding of the system through which antidoping education is provided to coaches; and, 3) explore the opportunities for future education provision. This was done through semi-structured interviews with thirteen individuals responsible for managing anti-doping education within national and international sporting and anti-doping organisations. Most stakeholders acknowledged the importance of providing education programmes for coaches; some already had provision in place and others were in the process of developing programmes. However, the current focus is on sportspeople and the degree to which sporting and anti-doping organisations are able to devise, implement and evaluate anti-doping education programmes for coaches is hindered by the contextual constraints they face. These include a lack of resources and limited interagency coordination, as well as challenges to overcome negative perceptions of ‘anti-doping’ efforts. Taken together, the findings indicate that policy expectations regarding anti-doping education for coaches are not being fully operationalised, and this situation is unlikely to change without: 1) greater direction and regulation of the system through which education is provided; 2) frequent and effective communication and cooperation between Code signatories; and, 3) increased fiscal and human capital investment at every level of the sporting hierarchy. Ultimately, until anti-doping education is shown to be a key priority for decision makers within sporting organisations (i.e., chief executives and board members), it is unlikely to become a central priority for coaches.

Objectives: To evaluate the effectiveness of an existing anti-doping education programme for coaches (CoachTrue Elite, designed by the World Anti-Doping Agency [WADA]). Design: A mixed-methods, pre- and post-test intervention design was adopted. Methods: UK-based coaches (N=28) from various sports and coaching domains (e.g. beginners/participation-oriented youth, participation-oriented adults, talent-identified/performance development athletes and full-time/high performance athletes) completed the WADA CoachTrue Elite online anti-doping education programme (six modules, 50 per cent attrition rate). Pre- and post-programme, coaches undertook an online survey assessing their knowledge, awareness, experiences and opinions of the programme and other doping-related issues. Data will be analysed via several non-parametric methods, including Mann Whitney U Tests, Kruskal-Wallis Tests, and Fisher’s Exact Tests. Results: Data regarding the coaches’ knowledge of doping-related topics and their awareness, experiences and opinions of the online education programme will be presented. Consideration will be given to several factors, including the gender, age and experience of participants, as well as the gender and stage of development of the athletes/players coached by the participants. Conclusions: This study facilitates the examination of the effectiveness of WADA’s online anti-doping education programme for increasing coaches’ knowledge of doping and anti-doping related topics. Further, the findings will highlight the extent to which the programme impacts on other factors such as the coaches’ perceptions of their own ability to deal with doping-related issues. It is hoped this research study will inform future anti-doping education policies for coaches at a local and global level.

Doping in sport remains a persistent global challenge, eroding sporting integrity, athlete welfare, and public trust. Over the past 25 years, psychological research on doping has progressed from individual-level explanations to embracing more nuanced, systemic perspectives. This narrative review synthesises key developments in the field, addressing definitional ambiguities, dominant theoretical frameworks, and emerging trends in anti-doping research. Social cognitive theories have been particularly influential, with meta-analytic evidence highlighting psychosocial predictors such as attitudes, perceived norms, and supplement use. However, the field remains constrained by a reliance on proxy measures of behaviour and a narrow conceptualisation of doping, typically defined as the use of prohibited substances. This review calls for a broader understanding of the behavioural violations that constitute doping, alongside a shift toward systemic thinking and transdisciplinary collaboration. It emphasises the need to engage with the lived experiences of athletes and support personnel, and to design behaviourally targeted, context-sensitive interventions. Meaningful progress depends not only intervention content but also on their alignment with the lived realities of those involved in sport. Future research priorities include co-created, theory-informed interventions, longitudinal designs, and globally inclusive agendas that reflect diverse voices and sporting cultures. Sustained investment and stronger alignment between research, policy, and practice are essential to protect sport integrity and safeguard athlete and support personnel welfare.

Global anti-doping policy indicates that athlete support personnel (ASP, e.g., doctors, nutritionists) can play an important role in fostering supportive environments that protect against intentional and inadvertent doping. Yet, research into ASP anti-doping roles is limited and no study has examined how (if at all) different members of ASP work together. Therefore, this study investigated anti-doping roles of ASP in a single sports club environment via semi-structured interviews. Through inductive reflexive thematic analysis, three overarching themes were constructed: 1) Everyone has responsibility for anti-doping, but most of the work rests unevenly on a few shoulders, 2) Education is fundamental to doping prevention, and 3) (Preventing doping) It’s all about the way we work with players and each other. As the first study of its kind, the findings indicated that actions taken to prevent doping varied across ASP working together in the same environment. The nutritionist and medical staff were most active in anti-doping efforts and least active were strength and conditioning coaches. Factors underpinning anti-doping roles were individuals’ relevant expertise/training and overall job responsibilities (e.g., supplements, medications) related to risk of doping. Staff also connected their doping prevention efforts to the club’s person-centred philosophy, which prioritised ‘individualisation’ and supportive relationships. While the data indicates potential for anti-doping responsibilities to be shared amongst ASP who work well together and trust one another, it revealed that reliance on one or two ASP in any environment might allow other ASP to neglect their opportunity to have a positive influence on players’ doping-related decisions.

Qualitative research can facilitate an understanding of the richness and complexity of human experience, shedding light on multifaceted relationships that exist within sporting environments. Within the field of sport nutrition, such immersive methods are not commonplace. Yet could offer a significant contribution to our understanding and help practitioners navigate their values and identity within the challenging world of high-performance sport. The first author, a neophyte sport nutrition researcher-practitioner, reflects upon her experience over a four-year period of integrating into a high-performance organisation and embarking upon a research programme and career as a sport nutritionist. Drawing on field notes, reflexive journal entries, and regular research team discussions, three moments of discovery are shared: 1) Navigating the transition into high-performance sport, 2) Understanding the performance pressures and emotional burden experienced by athletes, and 3) Negotiating collaboration in the nutritionist-athlete relationship. Through this confessional tale, we recognise the development of a sport nutritionist’s values and identity is unlikely to be smooth or linear. Instead, it may be a bumpy voyage of self-inquiry and discovery, shaped by diverse cultural experiences. To help future sport nutrition researcher-practitioners entering the field, we offer three meaningful development activities including 1) engaging in reflexive practice with critical friends to explore the dilemmas and uncertainties that may impact personal and professional development, 2) fostering intellectual candour when engaging in reflexive practice to facilitate self-discovery and growth, and 3) prioritise reading the growing literature on sport and organisational culture to inform and influence the delivery of sport nutrition practice.

Objectives Doping threatens the integrity of sport and the health and wellbeing of athletes. Operating as both a risk and protective agent, coaches may influence athletes’ (anti-)doping thoughts, feelings and behaviours. The objective of this study was to systematically review empirical coach anti-doping literature over a 20-year period between World Anti-Doping Agency formation (1999) and the present day (2019) to help better understand coaches’ perspectives and behaviours in relation to doping and anti-doping in sport. Design A systematic review was conducted using PRISMA guidelines. Methods Electronic searches of seven databases, twenty-four journals and citation pearl growing identified published studies between 1999 and 2019. Results Thirty-eight studies were included in this review. Three higher order themes were identified (individual, behavioural and contextual factors), consisting of a total of five themes (self-reported behaviour, hypothetical behaviour, coach beliefs, knowledge, and psychosocial components). Findings documented a changing research landscape, which revealed a greater frequency of total publications and emergence of qualitative study designs in conjunction with the development and induction of the 2015 World Anti-Doping Code. Conclusion Over the last 20 years the anti-doping literature addressing coaches has developed and diversified from narrowly focused quantitative studies of coaches’ knowledge and beliefs, to broader considerations of behavioural and contextual factors through the use of qualitative and mixed/multi-method designs. Although the existing literature sheds some light on coaches’ perspectives and behaviours relating to doping prevention, further high-quality studies investigating the wider context surrounding coach behaviours, underpinned by meta-theory, are needed to fully understand the complexity of doping in sport and guide future policy and practice.

Although global policy states that coaches are a key stakeholder group for anti-doping education, very little is known about how performance and participation coaches develop their understanding of anti-doping policy and practice. Therefore, 292 UK-based coaches completed an online survey exploring their experiences of anti-doping education (i.e., topics covered, how and by whom the programmes were delivered and how knowledgeable and well-equipped coaches felt to deal with doping-related matters). The results showed that almost a quarter of the surveyed coaches reported never learning about anti-doping. Only a third had engaged with a formal anti-doping education programme and coaches typically received information on detection-deterrence related topics (e.g., banned substances, testing procedures). Many coaches perceived themselves as only having ‘a little’ knowledge about anti-doping and declared themselves as ‘a little’ equipped to work with their sportspeople on doping-related matters. Nonetheless, 96% of coaches were inclined to learn more about anti-doping in the future. Given the World Anti-Doping Code states that anti-doping education for coaches should be compulsory, it is crucial that insights from coaches are made public to inform the development of evidence- informed anti-doping programmes that are tailored and targeted.

Whistleblowing is effective for exposing doping in sport, garnering increased support and promotion within the global anti-doping community. However, limited attention has been afforded towards understanding the doping whistleblowing process. In response, the authors convey a sense of the whistleblowing context by using the actual words of whistleblowers to illuminate their experience. To achieve this aim, the authors have adopted a narrative approach. Three doping whistleblowers were interviewed regarding their lived experiences of whistleblowing on doping and the data has been represented in the form of one composite creative non-fiction story. The story narrates the whistleblowing experience as a process whereby individuals must (a) determine what they witnessed and experienced was doping, (b) make the decision and take action to report it, and (c) deal with the myriad of consequences and emotions. It also highlights the dilemma faced by whistleblowers who are likely equally compelled to adhere to the moral of loyalty and fairness; yet in this context they are unable to do both. Stemming from the story presented and the forms of retribution experienced, the authors offer practical suggestions for sporting organisations to address in order to empower others to whistleblow on doping in sport. Specifically, organisations should establish and implement whistleblowing policies that: (a) provide protection for whistleblowers, (b) mandate whistleblowing education, and (c) identify an independent person for individuals to seek guidance and support from before, during and following the act of whistleblowing.

Field-based anti-doping interventions in sport are scarce and focus on athletes. However, coaches are recognized as one of the most significant source of influence in terms of athletes’ cognitions, affect, and behavior. In this paper we present the protocol for a cluster randomized control trial which aims to contrast the relative effects of a ‘motivation and anti-doping’ intervention program for coaches against an information-based anti-doping control program. In developing the motivation content of our intervention, we drew from Self-Determination Theory. The project is currently ongoing in Australia and has recently started in the UK and Greece. We aim to recruit 120 coaches and approximately 1200 of their athletes across the three countries. Various assessments will be taken from both coaches and athletes prior to the intervention, immediately after the 12-week intervention and at a 2-month follow up. The intervention comprises face-to-face workshops and weekly activities which are supported by printed and online material. The project aims to identify communication strategies that coaches can use to support athletes’ motivation in sport and also to promote self-determined reasons for athletes to comply with doping regulations.

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.

Objective: Understanding the lived experiences of athletes who have been sanctioned for violating anti-doping rules presents the opportunity to listen and learn. Yet, the academic field seldom draws on the voices of those affected when considering doping in sport. Our aim was to illuminate important aspects of sanctioned athletes’ experiences and highlight opportunities for prevention and rehabilitation. Design: A semi-structured interview research design was used, and data informed the development of composite vignettes, a form of creative non-fiction. Method: Semi-structured interviews were conducted with two elite rugby players sanctioned for violating the anti-doping rules within rugby league (n=1) and rugby union (n=1). Three composite vignettes were created illuminating player experiences before, during and after the violations. Findings: The vignettes highlight in participants’ own words the multiple impacts of sport demands and drug use: (1) Leading up to the violation: ‘You’re just treading water, you’re surviving’ (2) ‘There’s just this massive amount of social pressure in rugby, not just on the game, but on who you’re supposed to be’ (3) ‘It was like being hit by a train’. The ADRV aftermath. Conclusions: The role of social identity in the transitions experienced by a rugby player following a critical incident (e.g., serious injury) was a key influencing factor for doping. Alongside addressing the demands of the sport, the need for early intervention and evidence-based support for players experiencing critical incidents (e.g., injury) and transitions was evident to prevent doping violations.

Objective: To extend recent research examining the impact of game-based activities on the learning experience of undergraduate psychology students. Design: A counterbalanced repeated measures design was employed to evaluate students’ learning experiences following their involvement in active game-based learning activities. Method: Students on a Level 5 sport psychology module (N=134) were asked to participate in four practical classes demonstrating the impact of psychological factors (e.g. anxiety) on sports performance. Two sessions were designed for each practical: one included the use of active video games (e.g. Kinect Sports); the other included a traditional active game-based activity (e.g. Reaction Time Game). Students were randomly assigned to one of two groups in order to facilitate counterbalancing and to ensure that all students completed two active video game (AVG) and two non-AVG tasks. Following each practical, students provided ratings of perceived usefulness, interest/engagement, and enjoyment using a seven-point Likert scale. These data will be analysed via one way repeated measures analyses of covariance (ANCOVA), with students’ experience of AVGs being the covariate. The impact of sessions on students’ academic motivation and performance were also assessed and analysed via one-way ANOVAs. Results: Data is currently being collected alongside a semester one module. Results will be reported during the presentation. Conclusions: It is anticipated that the findings will provide further evidence to support the use of AVGs in the teaching of undergraduate psychology, and that the increased sophistication of AVG technology may be harnessed to provide multiple benefits for students in higher education.

In the 1960s, prohibitionist ‘anti-doping’ policy was introduced to curtail the use of illicit performance enhancing substances and methods in sport. Since then, anti-doping attention and funding has been directed towards detection-based deterrence activities. However, it is now acknowledged that investment in long-term, values-based education programmes may be more appropriate. Unfortunately, research into prevention and education is in its infancy, with very little indication of best practice. Therefore, in the interim, we must draw from more developed social science research fields. The following commentary highlights the findings of a recent systematic review of factors which, to-date, have been identified as the most successful preventive approaches across four established social domains; bullying, alcohol, tobacco and social drug use. Although the systematic review highlighted no ‘magical ingredients’ for ensuring effectiveness, there were common ‘recipes for success’, including (i) targeting young participants – when attitudes and values are forming; (ii) providing interactive material that develops social skills; (iii) monitoring and delivering programmes with high degrees of fidelity; (iv) basing delivery on well-trained staff; (v) incorporating long-term ‘booster sessions’ to reinforce key messages. Now, research should contribute to an evidence-base that allows the discovery, application and evaluation of key elements of effective anti-doping education.

To protect the integrity of sport, and the health of athletes, global anti-doping programmes seek to prevent doping, and elicit anti-doping and clean sport behaviours, through education, deterrence, detection, enforcement, and rules. To guide programme development, this meta-synthesis of qualitative research applied a behavioural science framework to identify barriers and enablers to doping, anti-doping, and clean sport. A systematic search of electronic databases up to May 2022, followed by critical appraisal, resulted in 73 included articles. Fifty-two articles reported the athlete perspective, thirteen included athletes, athlete support personnel (ASP), and other experts, and eight focused on ASP only. Rigorous methods of thematic synthesis were drawn upon to construct analytical themes in line with the theoretical domains framework (TDF) and the capability, opportunity, and motivation model of behaviour (COM-B). A wide range of barriers and enablers were identified which influenced capability, opportunity, and motivation to participate in a clean sport environment. The weight of evidence pointed to limitations in the current anti-doping education system in providing athletes and ASP with the knowledge and skills to protect against doping, as well as the significant influence of social and cultural norms in shaping doping and clean sport behaviours through a shared social identity, and risky contexts leading to moments of vulnerability to doping. We identified a need for anti-doping programmes to move beyond the current focus on athlete capability, and address the opportunity and motivation components of clean sport behaviours through a targeted and tailored focus on education, training, persuasion, modelling and environmental restructuring interventions.

Objectives: Poor adherence to nutritional guidance by athletes may compromise their health and performance. Enhancing adherence is therefore an important performance and welfare strategy. The aim of this study was to qualitatively explore the barriers and enablers of elite athletes' adherence to nutritional guidelines. Design: Underpinned by our constructionist epistemological position and our relativist ontology, we conducted a qualitative study using focus groups. Methods: We used the Capability, Opportunity, and Motivation Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) to conduct focus group discussions with a purposive sample of 39 UK-based funded athletes (mean age = 23 ± 3.81), participating in either Olympic and Paralympic sport (n = 30) or professional sport (n = 9), who had access to a nutritionist. Data were analysed using reflexive thematic analysis. Results: Athlete adherence to nutritional guidance was seasonal and included inadequate energy intakes and episodes of binge eating. Underpinning these behaviours, athletes' emotional barriers (motivation) are reinforced through their social interactions within the high-performance environment (opportunity) and athletes' training environment limits developmental opportunities for food planning (capability). However, a holistic-developmental approach by the sports nutritionists (opportunity) supports athlete wellbeing and nutritional adherence. Conclusion: These findings advance theoretical understanding of the barriers and enablers of nutritional adherence amongst elite-level athletes in high-performance sport and present a number of significant implications for athlete support personnel seeking to enhance performance in demanding sporting contexts. Drawing on the Behaviour Change Wheel (BCW), recommendations include the need to 1) train and educate sports nutritionists in human behaviour, 2) update regulations for sports nutrition profession practice to acknowledge the skills required to support athletes' emotional wellbeing, 3), educate coaches on the sensitivity of body weight and composition and develop guidelines for monitoring athletes' body weight and composition in sport, 4) persuade influential leaders to develop culture guidelines that shift the performance-narrative of high-performance (i.e., environmental restructuring).

Objectives: Substance use among university student-athlete populations is a growing concern but research addressing this issue is primarily confined to the US. Also, the exposure of witnessing other student-athletes using substances and how student-athletes may respond when witnessing other athletes taking substances across countries and gender is unknown. This research aimed to address these issues. Design: A cross-sectional design was employed. Method: Student-athletes from the US (N = 208), UK (N = 201) and Canada (N = 159) completed measures of reported substance use, witnessing substance use, and (anticipated) responses to addressing peers’ substance use. Results: Chi-square and logistic regression analyses revealed that country and gender were associated with various outcomes. Key findings include that differences in substance use as a function of country was largely substance-specific, and a higher proportion of men than women reported using most supplements apart from vitamins and minerals, and dietary based supplements. A higher proportion of athletes in Canada and USA reported they would “confront the individual” if they witnessed a peer taking dietary supplements, prescription medication and banned appearance and performance enhancing substances than in UK. Also, a higher proportion of women than men reported they would “report to someone else” (e.g., coach, sport governing body) if they witnessed peers taking substances. Conclusion: Although a convenience sample from nine universities across the three countries participated in this research, our findings provide initial evidence for the role of gender and country in relation to athletes’ substance use behaviors and anticipated responses to addressing substance use. These findings underline the importance of conducting context-specific and cross-national research to help facilitate tailored substance use education for student-athletes.

Although trait perfectionism has been related to doping attitudes in athletes, research investigating variables that could account for relationships between perfectionism and doping outcomes has received scant attention. Consequently, the aim of the present study was to investigate whether perfectionism was related to doping willingness directly and indirectly via moral disengagement. We recruited a sample of 204 student athletes (M age = 19.12 years, SD = 1.17, n = 81 females - 39.70%) who completed measures of perfectionistic strivings, perfectionistic concerns, doping moral disengagement, and doping willingness. Multiple regression analyses revealed a significant positive relationship between perfectionistic concerns and doping willingness (β = .13, p < .05) and a nonsignificant relationship between perfectionistic strivings and doping willingness (β = −.01, p > .05). Moreover, bias-corrected bootstrapped indirect effects revealed that doping moral disengagement mediated the relationship between perfectionistic concerns and doping willingness (ab = .12; 95% CI = .02 to .21). The findings suggest that the relationship between perfectionistic concerns and doping extends beyond attitudes – to doping willingness – and the propensity to morally disengage explains why this is the case.

Experts from a university in Yorkshire are calling for sporting authorities to encourage athletes to report doping after groundbreaking research showed many potential whistleblowers are unsure where to turn.

An increase in the number of students entering higher education has intensified the need for 26 targeted strategies to support a wider range of student requirements. Current research suggests 27 that emotional intelligence (EI) may be associated with academic success, progression and 28 retention in university students but the use of EI screening as a prospective measure of success 29 requires further investigation. This study evaluates the utility of prospective EI screening to 30 predict progression rates, mean grades, attendance and online engagement in a sample of first 31 year undergraduate students enrolled on the same degree programme (n=358). A supportive 32 text messaging intervention was employed during potentially stressful periods of the academic 33 year in a subsection of participants (n=60) that demonstrated low total EI scores relative to the 34 cohort. Results showed no effects of EI classification on progression rates, mean grades, 35 attendance and online engagement (all P>0.418). Alternatively, the text messaging intervention 36 was associated with significant improvements compared with a matched control group for 37 progression rates (P=0.027), mean grades (P=0.026) and attendance (P=0.007). The frequency 38 of access to the virtual learning environment also tended to be higher in the intervention group 39 compared with the control group (P=0.059). In conclusion, this study did not identify any 40 benefits of EI screening as a prospective indicator of student success but provides encouraging 41 indications that a text messaging support intervention could help to improve progression rates, 42 mean grades, attendance and online engagement in first year undergraduate students. Further 43 research is warranted to develop these proof-of-concept findings.