Professor Susan Backhouse

The use of performance enhancing drugs, also known as doping, can represent a serious threat to an athlete’s psychological and physical health and contravenes the spirit of sport. Scholars identified attitudes towards doping as a crucial factor that indirectly influences doping behaviors. Further, prominent theoretical frameworks that are designed to explain why athletes dope state that personality traits shape doping attitudes. To date, however, scholars are yet to examine the relationship between attitudes towards doping and personality traits such as the Dark Triad. The purpose of this study was to explore the relationship between the Dark Triad and doping attitudes amongst a sample of competitive athletes. Two hundred and eighty-five athletes completed a measure of the Dark Triad and attitudes towards doping. Machiavellianism, psychopathy, and narcissism all correlated positively with attitudes towards doping. Machiavellianism and psychopathy explained 29% of the variance in attitudes towards doping, whereas narcissism did not independently contribute to the variance in doping attitudes. These results reveal that athletes who score highly on the Dark Triad may be more likely to dope and therefore might need targeted anti-doping education and long-term monitoring to reduce their risk of taking banned substances.

Background. Despite the Internet and the WorldWideWeb providing ready access to information on the risks and health consequences of AS misuse for all ages, AS use remains a public health concern. The aim of this narrative review is to examine the ability of negative health consequences information (NHCI) to prevent adolescent AS misuse in the era of the Internet information revolution. Methods. A search of the literature published between January 2000 and March 2014 was conducted to identify studies that examined the effect of NHCI on AS use and other healthrelated social cognitive constructs and behavior in adolescent samples. Results. No empirical study was found that specifically investigated the isolated effect of NHCI on AS use. Other health-related intervention studies - involving adolescents - showed that the severity of the consequences tied to social disapproval can be more effective than the severity tied to health consequences. Relevance of NHCI can operate as a moderator or a mediator of the relationship between NHCI and social cognitive constructs and behavior change. Pre-existing knowledge about negative health consequences functions as a mediator of the relationship between NHCI and social cognitive constructs and outcomes. Conclusion. The best way to understand the effect of NHCI on social cognitive constructs and behavior is to consider it in a larger nomological network that includes perceived severity, vulnerability, relevance and pre-existing knowledge. The review highlights gaps in the literature and suggests directions for future research. Implications for prevention programs are discussed.

Background. Despite the Internet and the WorldWideWeb providing ready access to information on the risks and health consequences of AS misuse for all ages, AS use remains a public health concern. The aim of this narrative review is to examine the ability of negative health consequences information (NHCI) to prevent adolescent AS misuse in the era of the Internet information revolution. Methods. A search of the literature published between January 2000 and March 2014 was conducted to identify studies that examined the effect of NHCI on AS use and other healthrelated social cognitive constructs and behavior in adolescent samples. Results. No empirical study was found that specifically investigated the isolated effect of NHCI on AS use. Other health-related intervention studies - involving adolescents - showed that the severity of the consequences tied to social disapproval can be more effective than the severity tied to health consequences. Relevance of NHCI can operate as a moderator or a mediator of the relationship between NHCI and social cognitive constructs and behavior change. Pre-existing knowledge about negative health consequences functions as a mediator of the relationship between NHCI and social cognitive constructs and outcomes. Conclusion. The best way to understand the effect of NHCI on social cognitive constructs and behavior is to consider it in a larger nomological network that includes perceived severity, vulnerability, relevance and pre-existing knowledge. The review highlights gaps in the literature and suggests directions for future research. Implications for prevention programs are discussed.

Background: There is a growing body of empirical evidence on demographic and psychosocial predictors of doping intentions and behaviors utilizing a variety of variables and conceptual models. However, to date there has been no attempt to quantitatively synthesize the available evidence and identify the strongest predictors of doping. Objectives: Using meta-analysis, we aimed to (i) determine effect sizes of psychological (e.g. attitudes) and social-contextual factors (e.g. social norms), and demographic (e.g. sex and age) variables on doping intentions and use; (ii) examine variables that moderate such effect sizes; and (iii) test a path analysis model, using the meta-analyzed effect sizes, based on variables from the theory of planned behavior (TPB). Data Sources: Articles were identified from online databases, by contacting experts in the field, and searching the World Anti-Doping Agency website. Study Eligibility Criteria and Participants: Studies that measured doping behaviors and/or doping intentions, and at least one other demographic, psychological, or social-contextual variable were included. We identified 63 independent datasets. Study Appraisal and Synthesis Method: Study information was extracted by using predefined data fields and taking into account study quality indicators. A random effects meta-analysis was carried out, correcting for sampling and measurement error, and identifying moderator variables. Path analysis was conducted on a subset of studies that utilized the TPB. Results: Use of legal supplements, perceived social norms, and positive attitudes towards doping were the strongest positive correlates of doping intentions and behaviors. In contrast, morality and self-efficacy to refrain from doping had the strongest negative association with doping intentions and behaviors. Furthermore, path analysis suggested that attitudes, perceived norms, and self-efficacy to refrain from doping predicted intentions to dope and, indirectly, doping behaviors. Limitations: Various meta-analyzed effect sizes were based on a small number of studies, which were correlational in nature. This is a limitation of the extant literature. Conclusions: This review identifies a number of important correlates of doping intention and behavior, many of which were measured via self-reports and were drawn from an extended TPB framework. Future research might benefit from embracing other conceptual models of doping behavior and adopting experimental methodologies that will test some of the identified correlates in an effort to develop targeted anti-doping policies and programs.

BACKGROUND: Central to the work of many medical practitioners is the provision of pharmaceutical support for patients. Patients can include athletes who are subject to anti-doping rules and regulations which prohibit the use of certain substances in and out of competition. This paper examines the evidence on medical practitioners' knowledge, attitudes and beliefs towards doping in sport. METHODS: A systematic search strategy was followed. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches limited to English language articles published between 1990 and 2010. Articles were assessed for relevance by two independent assessors and the results of selected studies were abstracted and synthesised. Outcomes of interest were knowledge, attitudes and beliefs in relation to doping in sport. RESULTS: Six studies met the inclusion criteria and were examined in detail. Samples reflected a range of medical practitioners drawn from the UK, France (2), Greece, Italy and Ireland. The investigations varied with respect to outcome focus and quality of evidence presented. CONCLUSION: Whilst the extant empirical research posits a negative attitude towards illegal performance enhancement combined with a positive inclination towards doping prevention, it also exposes a limited knowledge of anti-doping rules and regulations. Insufficient education, leading to a lack of awareness and understanding, could render this professional group at risk of doping offences considering Article 2.8 of the World Anti-Doping Agency Code (WADC). Moreover, in light of the incongruence between professional medical codes and WADC Article 2.8, medical professionals may face doping dilemmas and therefore further discourse is required. At present, the current evidence-base makes it difficult to plan developmentally appropriate education to

Athlete support personnel (ASP) implement drug control policies for sport, such as anti-doping. Interviews with 39 ASP reveal how differences between policy and practice play out in their "lived experience" of anti-doping. While most ASP support the ideology underlying anti-doping at a "common sense" level (using popular drug and sporting discourses such as "drugs are bad" and sporting virtue), they are critical of anti-doping practice. Combined with no direct experience with doping, ASP saw doping as a rare event unlikely to emerge in practice. Most ASP took a laissez-faire approach to anti-doping, relying on managers to know what to do in the unlikely event of a doping incident. Despite broadly supporting the ideas of anti-doping, ASP raised concerns around implementation with regards to Athlete Whereabouts and recreational drug use. In response to hypothetical doping events, a number of ASP would seek to persuade the athlete to discontinue doping rather than meet mandatory reporting obligations. Part of this extended from conflicts between professional and anti-doping obligations (e.g. mandatory reporting and patient confidentiality). ASP demonstrate anti-doping policies are in tension with a practice that systematically normalises substance based performance enhancement early in sporting careers. Anti-doping agencies need to do more to engage with ASP as the "front line" of drug management in sport, including resolving contradictions across policies and in practice.

Background Doping in sport is a significant issue. To date, research informing doping prevention has lacked a framework guiding research priorities. To ensure research is coordinated, sustainable and focused on end-user priorities, this study co-created the first research agenda for doping prevention. Methods The Delphi method was used to develop this agenda. Based upon two substantive reviews of the doping literature and 12 focus groups across five countries, a questionnaire was developed assessing the importance of 15 research topics and identifying research questions. Eighty-two anti-doping stakeholders with relevant expertise were invited to be panel members. In Round 1, an expert panel (n = 57; 70% response rate) completed this questionnaire. In Round 2, panel members (n = 33; 58% response rate) ranked for relative importance the eight topic areas rated highest in Round 1, before doing the same for research questions within each topic. Based on these rankings, a draft agenda was created. In Round 3, panel members (n = 26; 79% response rate) rated the degree to which they accepted this agenda, the feasibility of its delivery and identified possible barriers and facilitators to implementation. Results The results of Round 1 and Round 2 were used to create a draft agenda consisting of 18 research questions stratified across eight topic areas. This agenda was either fully (n = 16) or mostly (n = 9) accepted by the panel in Round 3 (96.2%). Research topics included the effectiveness of interventions/education programmes, environmental influences, long-term development of protective and risk factors in athletes and their entourage, athletes' experiences of anti-doping procedures and athletes’ place in the anti-doping system. Conclusions A rigorous exercise created an agenda for doping prevention research. Adoption and application of this agenda should lead to better coordination, more efficient use of funding, enhanced uptake of research findings and more effective doping prevention education.

Athletes, sponsors and sport organisations all have a vested interest in upholding the values of clean sport. Despite the considerable and concerted efforts of the global anti-doping system over two decades, the present system is imperfect. Capitalising upon consequent frustrations of athletes, event organisers and sponsors, alternative anti-doping systems have emerged outside the global regulatory framework. The operating principles of these systems raise several concerns, notably including accountability, legitimacy and fairness to athletes. In this paper, we scrutinise the Clean Protocol™, which is the most comprehensive alternative system, for its shortcomings through detailed analysis of its alleged logical and scientific merits. Specifically, we draw the attention of the anti-doping community – including researchers and practitioners – to the potential pitfalls of using assessment tools beyond the scope for which they have been validated, and implementing new approaches without validation. Further, we argue that whilst protecting clean sport is critically important to all stakeholders, protocols that put athletes in disadvantageous positions and/or pose risks to their professional and personal lives lack legitimacy. We criticise the use of anti-doping data and scientific research out of context, and highlight unintended harms that are likely to arise from the widespread implementation of such protocols in parallel with – or in place of – the existing global anti-doping framework.

This study examined the influence of water ingestion on affect and perceived exertion during sub-maximal running. Fifteen endurance-trained men performed two counterbalanced 90-min treadmill runs at 70% V˙O2 max. No fluid was ingested during one trial (NF-trial), whereas a single water bolus (5.0 mL kg−1 body mass) was ingested immediately preexercise and every 20 min during exercise (2.0 mL kg−1 bodymass) in a fluid replacement trial (FR-trial). Affect and perceived exertion were repeatedly assessed and physiological changes monitored. Perceived exertion and heart rate increased significantly during the run but there were no differences between conditions. Such similarities were not reflected in the pleasure–displeasure ratings, which were maintained above baseline levels during exercise in the FR-trial but declined below baseline during the NF-trial. A significant postexercise improvement in rated pleasure–displeasure was found only in the FR-trial, leading to significantly higher ratings of pleasure–displeasure during the recovery period compared to the NF-trial. Self-reported Energy was also enhanced postexercise only in the FR-trial. Body mass decrease was significantly larger and thirst ratings were significantly higher in the NF-trial compared to the FR-trial. In summary, water ingestion attenuated the during-exercise decrease in pleasure–displeasure and elicited an improvement after prolonged, submaximal running.

The message that emanates from textbooks and research papers is that exercise invariably ‘makes you feel good’. Despite such assertions, many people still avoid continued exercise participation and given the complex and multifaceted relationship between exercise and affect, this presents a paradox worthy of discussion. Therefore,the purpose of this paper is to consider the generality of the conclusion that exercise makes people feel better by illustrating that (a) negative affective changes can occur during exercise, (b) measurement approaches can fail to assess potentially relevant negative affective states, (c) examining only changes from pre- to post-exercise may miss negative changes during exercise, and (d) analysing changes at the level of group aggregates might conceal divergent patterns at the level of individuals or subgroups. Data from several studies will be presented to illustrate these points and highlight the importance of methodology and measurement when examining such complex and multifaceted relationships.

KEY POINTS - Athletes’ use of supplements is highly prevalent across sport and competitive levels. High prevalence is combined with indiscriminate use. This remains a concern in sport as it can lead to negative health effects and the risk of committing an anti-doping rule violation. - Consequences of committing an anti-doping rule violation through supplement use are significant for competitive athletes (e.g., ineligibility from major competitions, loss of medals and funding) due to the principle of strict liability (if it is in the athlete’s body, the athlete is responsible for it). - The principle of strict liability interacts with a growing and professionally marketed industry that is poorly regulated. Consequently, competitive athletes can find themselves in a vulnerable and risky position when it comes to consuming supplements. - Where risk-benefit analysis supports the use of a supplement, it is critical that athletes adhere to risk minimized supplement use guidance (RMSUG) published by a professional body or organization (e.g., International Olympic Committee Consensus Statement on Supplements). - Athletes must have the capability (e.g., knowledge and skills), opportunity (e.g., physical access, social support) and motivation (e.g., beliefs and habits) to adhere to RMSUG. - Adopting a behavioral approach to understanding adherence to RMSUG helps us identify what needs to change to protect athletes from unintentionally doping through indiscriminate 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.

UK Sport's athlete-centred 100% Me education campaign is designed to increase understanding and promote the benefits of drug-free sport to the entire sporting community. It seeks to ‘create a generation of sportsmen and women who know they do not need to use prohibited substances or methods to be successful.’ The programme has the backing of some of the biggest names in British sport, including Beijing Olympic gold medallists. In order to ensure a wide network of support and dissemination 100% Me is delivered through three main strands: Ambassadors, Outreach and Accreditation. This workshop is designed for athlete support personnel who want to ensure that they are well placed to take the lead in the global fight against drugs in sport and who want to provide accurate, relevant and up-to-date information on drug-free sport to their athletes. The workshop will encompass prohibited substances and supplements, checking medication and drug testing. Moreover, the workshop will consider what it means to be 100% Me, alongside the presentation of case studies as examples of drug use in sport. This workshop aims to assist delegates to: • gain an insight into the 100% Me education campaign; • increase their knowledge and understanding of anti-doping issues; • ensure they are well placed to provide accurate, relevant and up-to-date information on drug free sport to their athletes. 1 Sports Medicine Australia supported speaker.

It was hypothesized that there would be significant differences in mental toughness among athletes of different: (a) achievement level, (b) gender, (c) age, (d) sporting experience, and (e) sport type (team vs. individual and contact vs. non-contact sports). Participants were 677 athletes and consisted of sports performers competing at international (n = 60), national (n = 99), county (n = 198), club/university (n = 289), and beginner (n = 31) levels. Results revealed a significant relationship between mental toughness and gender, age, and sporting experience. However, achievement level and the type of sport an athlete participated in was not significantly associated with mental toughness.

URPOSE: We have previously reported that overweight and obese individuals exhibit significant decreases in pleasure in response to treadmill exercise performed at a speed 10% higher than the self-selected level (Ekkekakis & Lind, 2006, Int J. Obes). The present follow-up study was designed to investigate the possibility that this phenomenon is associated with thermoregulatory difficulties in obese individuals. METHODS: Eleven normal-weight (5F, 6M; Age: 18-36 yr; BMI: 16.8-24.9 kg/m2) and 13 obese (8F, 5M; Age: 21-39 yr; BMI: 30.0-50.6 kg/m2) adults participated in two 20-min bouts of treadmill exercise, one at self-selected (SS) speed (0% grade) and one at a speed 10% higher (+10%) than SS. Ingestible temperature capsules (CorTemp, HQ Inc, Palmetto, FL) were used to monitor core temperature and the Feeling Scale (FS; Hardy & Rejeski, 1989) was used to assess self-reported pleasure-displeasure. RESULTS: There were no differences in core temperature between the normal-weight and obese groups. However, FS showed significant negative correlations with core temperature only in the obese group and only in response to +10% (Min 15: r = -0.67, P = .012; Min 20: r = -0.71, P = .007). CONCLUSIONS: Thermoregulatory factors may contribute to the apparent increased sensitivity of obese individuals to high levels of exercise intensity, posing a challenge for exercise prescription in this population.

Objectives: The popularity of walking is assumed to be due to this activity being pleasant. However, evidence of affective beneficence remains scarce. Instead, activities, including walking, that may not exceed certain thresholds of intensity and duration are presumed to lack sufficient potency to improve affect. In anticipation of investigations designed to explore the role of affect in mediating the walking–adherence relationship, we present and test a methodological platform for clarifying the walking–affect link. Design: Randomized experimental-vs-control group design (Study I) and randomized AB-vs-BA group design (Study II). Methods: Two studies are described to illustrate the utility of the proposed approach. Affect was conceptualized as a dimensional construct and assessed repeatedly during and after the walks. Results: Short, self-paced walks increase self-reported energy among active middle-aged and older adults. Conclusions: The proposed framework could be useful in investigations of the walking–affect–adherence causal chain.

Caffeine's metabolic and performance effects have been widely reported. However, caffeine's effects on affective states during prolonged exercise are unknown. Therefore, this was examined in the present study. Following an overnight fast and in a randomised, double-blind, counterbalanced design, twelve endurance trained male cyclists performed 90 min of exercise at 70% VO2 max 1 h after ingesting 6 mg kg−1BM of caffeine (CAF) or placebo (PLA). Dimensions of affect and perceived exertion were assessed at regular intervals. During exercise, pleasure ratings were better maintained (F(3,38) = 4.99, P < 0.05) in the CAF trial compared to the PLA trial with significantly higher ratings at 15, 30 and 75 min (all P < 0.05). Perceived exertion increased (F(3,28) = 19.86, P < 0.01) throughout exercise and values, overall, were significantly lower (F(1,11) = 9.26, P < 0.05) in the CAF trial compared to the PLA trial. Perceived arousal was elevated during exercise but did not differ between trials. Overall, the results suggest that a moderate dose of CAF ingested 1 h prior to exercise maintains a more positive subjective experience during prolonged cycling. This observation may partially explain caffeine's ergogenic effects.

The exercise psychology literature includes an intriguing, albeit not frequently discussed, paradox by juxtaposing two conclusions: (a) that exercise makes most people feel better and (b) that most people are physically inactive or inadequately active. In this article, we propose that this might be an artifact rather than a paradox. Specifically, we question the generality of the conclusion that exercise makes people feel better by proposing that (a) occasional findings of negative affective changes tend to be discounted, (b) potentially relevant negative affective states are not always measured, (c) examining changes from pre- to postexercise could miss negative changes during exercise, and (d) analyzing changes only at the level of group aggregates might conceal divergent patterns at the level of individuals or subgroups. Data from a study of 12 men participating in a 90-min walk–run protocol designed to simulate the demands of sports games (e.g., soccer) are used to illustrate these points.

The concept of mental toughness is widely used, but empirical evidence is required to fully understand this construct and its related variables. The purpose of this paper was to explore the relationship between: (a) mental toughness and coping, (b) mental toughness and optimism, and (c) coping and optimism. Participants were 677 athletes (male 454; female 223) aged between 15 and 58 years (M age = 22.66 years, SD = 7.20). Mental toughness correlated significantly with 8 of the 10 coping subscales and optimism. In particular, higher levels of mental toughness were associated with more problem or approach coping strategies (mental imagery, effort expenditure, thought control, and logical analysis) but less use of avoidance coping strategies (distancing, mental distraction, and resignation). Eight coping subscales were significantly correlated with optimism and pessimism. In conclusion, the relationships observed in this study emphasize the need for the inclusion of coping and optimism training in mental toughness interventions. © 2007 Elsevier Ltd. All rights reserved.

Background: The 'False Consensus Effect' (FCE), by which people perceive their own actions as relatively common behaviour, might be exploited to gauge whether a person engages in controversial behaviour, such as performance enhancing drug (PED) use. Hypothesis: It is assumed that people's own behaviour, owing to the FCE, affects their estimation of the prevalence of that behaviour. It is further hypothesised that a person's estimate of PED population use is a reliable indicator of the doping behaviour of that person, in lieu of self-reports. Testing the hypothesis: Over- or underestimation is calculated from investigating known groups (i.e. users vs. non-users), using a short questionnaire, and a known prevalence rate from official reports or sample evidence. It is proposed that sample evidence from self-reported behaviour should be verified using objective biochemical analyses. In order to find proofs of concept for the existence of false consensus, a pilot study was conducted. Data were collected among competitive UK student-athletes (n = 124) using a web-based anonymous questionnaire. User (n = 9) vs. non-user (n = 76) groups were established using self-reported information on doping use and intention to use PEDs in hypothetical situations. Observed differences in the mean estimation of doping made by the user group exceeded the estimation made by the non-user group (35.11% vs. 15.34% for general doping and 34.25% vs. 26.30% in hypothetical situations, respectively), thus providing preliminary evidence in support of the FCE concept in relation to doping. Implications of the hypothesis: The presence of the FCE in estimating doping prevalence or behaviour in others suggests that the FCE based approach may be an avenue for developing an indirect self-report mechanism for PED use behaviour. The method may be successfully adapted to the estimation of prevalence of behaviours where direct self-reports are assumed to be distorted by socially desirable responding. Thus this method can enhance available information on socially undesirable, health compromising behaviour (i.e. PED use) for policy makers and healthcare professionals. The importance of the method lies in its usefulness in epidemiological studies, not in individual assessments.

Athlete support personnel (ASP) failing to meet responsibilities under the World Anti-Doping Code risk sanction. It is unclear whether the poor knowledge of responsibilities seen in sports physicians and coaches applies to other ASP (e.g., administrators, chiropractors, family, nutritionists, physiotherapists, psychologists, and trainers). A purposive sample of Australian ASP (n = 292) responded to a survey on knowledge of anti-doping rules (35 true/false questions), ethical beliefs and practice, and attitudes toward performance enhancement. Some ASP declined to participate, claiming doping was irrelevant to their practice. Physicians were most knowledgeable (30.8/35), with family and trainers the least (26.0/35). ASP reported that improvements were needed to support anti-doping education (e.g., basis for anti-doping) and practice (e.g., rules). ASP also had a slightly negative attitude toward performance enhancement. Linear regression showed that being a sports physician, providing support at the elite level, and 15 years of experience influenced knowledge. The results confirm gaps in knowledge, suggesting that stronger engagement with ASP anti-doping education and practice is needed. Applying the principles of andragogy could help foster active engagement through emphasis on active inquiry, rather than passive reception of content. Future work on the context within which ASP experience anti-doping is needed, exploring acquisition and translation of knowledge into practice.

One of the fundamental challenges in anti-doping is identifying athletes who use, or are at risk of using, prohibited performance enhancing substances. The growing trend to employ a forensic approach to doping control aims to integrate information from social sciences (e.g., psychology of doping) into organised intelligence to accelerate the pursuit of clean sport. Beyond the foreseeable consequences of a positive identification as a doping user, this task is further complicated by the discrepancy between what constitutes a doping offence in the World Anti-Doping Code and operationalized in doping research. Whilst psychology plays an important role in developing our understanding of doping behaviour in order to inform intervention and prevention, its contribution to the array of doping diagnostic tools is still in its infancy. At the same time, we must acknowledge that socially desirable responding confounds self-reported psychometric test results. Further, the cognitive complexity surrounding test performance means that the response-time based measures and the lie detector tests for revealing concealed life-events (e.g., doping use) are prone to produce false or non-interpretable outcomes in field settings. Differences in social-cognitive characteristics of doping behaviour that are tested at group level (doping users vs. non-users) cannot be extrapolated to individuals; nor these psychometric measures used for individual diagnostics. In this paper, we present a position statement calling for policy guidance on appropriate use of psychometric assessments in the pursuit of clean sport. We argue that both self-reported and response-time based psychometric tests for doping have been designed, tested and validated to explore how athletes feel and think about doping in order to develop a better understanding of doping behaviour, not to establish evidence for doping. A false 'positive' psychological profile for doping (or even failing to produce a definite negative profile) affects not only the individual ‘clean’ athlete but also their entourage, their organisation and sport itself. The proposed policy guidance aims to protect the global athletic community against social, ethical and legal consequences from potential misuse of psychological tests, including applications as forensic diagnostic tools in both practice and research.

INTRODUCTION: It has been reported that perceptions of exertion are attenuated during prolonged cycle exercise, following CHO ingestion. However, no studies to date have examined the influence of such feedings on psychological affect during prolonged exercise, even though affect and perceived exertion are different constructs. PURPOSE: To examine the influence of regular CHO beverage ingestion on affect (pleasure-displeasure) and perceived exertion during prolonged cycle exercise. METHODS: In a randomized, double-blind, counterbalanced design, nine endurance trained males cycled for 2 h at 70% VO2max on two occasions, separated by 1 wk. On each occasion, they consumed either a water placebo (PLA) or a 6.4% carbohydrate-electrolyte solution (CHO) immediately before they cycled (5 mL x kg(-1) body mass) and every 15 min thereafter (2 mL x kg(-1) body mass). Pleasure-displeasure was assessed before, during, and after the prolonged bout of cycling. RESULTS: During exercise, reported pleasure initially improved and was subsequently maintained in the CHO trial, in contrast to a decline reported in the PLA trial. Ratings of pleasure-displeasure were more positive during recovery in the CHO trial compared with the PLA trial (P < 0.05) and the only significant increase (P < 0.05) in pleasure occurred 15 min postexercise in the CHO trial only. RPE increased (P < 0.05) over the course of the bout of cycling and was lower (P < 0.05) 75 min into exercise in the CHO trial. Immediately postexercise, plasma glucose concentration was higher in the CHO compared with the PLA trial (P < 0.05). A main effect of trial was found for plasma cortisol concentration, with higher values reported in PLA trial. CONCLUSION: Results suggest that CHO ingestion enhanced feelings of pleasure during and following prolonged cycling and highlighted the importance of assessing not only "what," but also "how" a person feels.

OBJECTIVE: The aim of this study was to examine the metabolic responses during 1 h of brisk walking, 3 h after ingesting high glycemic index (HGI) and moderate glycemic index (MGI) breakfasts. DESIGN AND SUBJECTS: Six females completed three treadmill walking trials (approximately 50% VO2 max), separated by at least 1 month. Three hours before walking, they ingested either water or a HGI or MGI breakfast. The MGI breakfast consisted of a mixture of an HGI breakfast cereal and low GI carbohydrate (CHO) foods. The GI values of the HGI and MGI meals were 77 and 51, respectively. SETTING: The study took place in the School of Sport and Exercise Sciences at Loughborough University, Loughborough, UK. RESULTS: In the HGI and MGI trials, plasma glucose and serum insulin concentrations peaked 15 min into the postprandial period. At the onset of exercise, plasma insulin concentrations were twofold higher in the HGI (31.5+/-7.7 microl U l(-1)) than in the MGI trial (15.2+/-1.9 microl U l(-1)) (P<0.05). However, there were no differences in substrate utilization between the two CHO trials. CONCLUSION: These results suggest that although the addition of LGI CHO foods to an HGI breakfast cereal reduces the overall GI of the meal, the metabolic response to exercise is similar to that following a breakfast comprised entirely of HGI foods.

This study was designed to determine the effects of ingesting a carbohydrate (CHO) solution on affective states and rating of perceived exertion (RPE) during prolonged intermittent high-intensity exercise. Seventeen male soccer players completed a prolonged intermittent high-intensity exercise protocol for 90 min on two occasions, separated by at least 7 days. Participants consumed either a 6.4% CHO (0.6 g/kg body mass (BM)/h) or an artificially sweetened placebo (PLA) solution immediately before (8 mL/kg BM) and every 15 min (3 mL/kg BM) during exercise in a double-blind, counterbalanced design. Pleasure–displeasure, perceived activation, RPE and plasma glucose concentration was assessed. The results showed that compared with the CHO trial, perceived activation were lower in the placebo trial during the last 30 min of exercise and this was accompanied by lowered plasma glucose concentrations. In the CHO trial, RPE was maintained in the last 30 min of exercise but carried on increasing in the PLA trial. Therefore, CHO ingestion during prolonged high-intensity exercise appears to elicit an enhanced perceived activation profile that may impact upon task persistence and performance. This finding is in addition to the physiological and metabolic benefits of the exogenous energy supply.

Invitation to present at Tackling Doping in Sport 2016

In this paper we argue that whilst protecting clean sport is critically important to all stakeholders, alternative anti-doping protocols that put athletes in disadvantageous positions and/or pose risks to their professional and personal lives lack legitimation. We discuss the issues arising from naïve and inexpert use of anti-doping data and scientific research in the broader context of anti-doping and sport integrity, and call for scientific rigour, a solid evidence base and transparency in alternative anti-doping systems.

This chapter contains sections titled: Anxiety Depression Mood and affect Cognitive function Self‐esteem Health‐related quality of life Conclusions References Anxiety Depression Mood and affect Cognitive function Self‐esteem Health‐related quality of life Conclusions References

World Anti-Doping Agency (WADA) is the global governing body for anti-doping in sport and aims to “bring consistency to anti-doping policies and regulations within sport organizations and governments” worldwide. This chapter sets out to provide an updated review and discussion of current estimates of doping prevalence in elite sport. It covers analytical data from WADA-accredited laboratories, along with direct and indirect estimates of doping use reported in the literature. As with self-reported data, social projections of doping use also evidence-biased perception, where the bias is a function of involvement, sensitivity of the behaviour and the reference frame in which the estimation is solicited. Typically, projected questioning leads to higher doping prevalence estimates compared to official laboratory estimates and self-reported doping behaviour. Intelligence on the prevalence of doping in elite sport is critical to the development of anti-doping policy and practice, and the implementation and evaluation of interventions.

Although research investigating doping in sport is burgeoning, there is still a lack of proxy measures of doping behaviour that have undergone extensive psychometric testing. To address this issue, we modified a previously used measure of doping willingness in sport and tested aspects of validity and reliability across four studies. In Study 1, we provided support for the face and content validity of the items, and then found support for the factor structure of the scale in a sample of athletes (N = 205) using confirmatory factor analysis. In Study 2, we collected data from an independent sample of athletes (N = 236) to provide further evidence for the factor structure of the scale using confirmatory factor analysis as well as provided evidence for concurrent and discriminant validity. In Study 3, a further independent sample of athletes (N = 144) completed the scale and provided support for discriminant and predictive validity of the scale. In Study 4, we collected data from a further independent sample (N = 74) to provide support for the test-retest reliability, and stability of items. Lastly, a confirmatory factor analysis was conducted on the samples across Studies 3 and 4, and the composite sample across all four studies which provided further support for the factor structure of the final 8-item scale. Taken together, these findings provide psychometric support for the scale to be used to measure the willingness of athletes to use banned substances to help facilitate future research investigating doping in sport.

Moral identity and moral disengagement have been linked with doping likelihood. However, experiments testing the temporal direction of these relationships are absent. The authors conducted one cross-sectional and two experimental studies investigating the conjunctive effects of moral identity and moral disengagement on doping likelihood (or intention). Dispositional moral identity was inversely (marginally), and doping moral disengagement, positively, associated with doping intention (Study 1). Manipulating situations to amplify opportunities for moral disengagement increased doping likelihood via anticipated guilt (Study 2). Moreover, dispositional moral identity (Study 2) and inducing moral identity (Study 3) were linked with lower doping likelihood and attenuated the relationship between doping moral disengagement and doping likelihood. However, the suppressing effect of moral identity on doping likelihood was overridden when opportunities for moral disengagement were amplified. These findings support multifaceted antidoping efforts, which include simultaneously enhancing athlete moral identity and personal responsibility alongside reducing social opportunities for moral disengagement.

The beneficial effects of acute carbohydrate (CHO) supplementation on exercise performance have been well described. Also reported is the attenuation of perceived exertion and enhancement of affect during prolonged exercise following CHO ingestion. However, no studies to date have assessed the impact of the type of CHO ingested on affective responses during moderate intensity exercise, lasting 60min or less. Therefore, the aim of the present study was to investigate the effects of consuming a galactose (GAL) CHO drink versus a glucose (GLU) CHO or placebo (PLA) drink before and during exercise on affect and perceived exertion. Nine recreationally active females undertook three trials, each consisting of running for 60min at 65% VO2max followed immediately by a 90min rest period. Prior to (300ml) and at every 15min during exercise (150ml), participants consumed either a GLU or GAL drink each containing 45g of CHO, or an artificially-sweetened PLA drink. Ratings of pleasure-displeasure and perceived activation were measured throughout exercise and the rest period and measures of perceived exertion were measured during exercise. Plasma glucose and serum insulin were significantly greater throughout exercise and rest following the GLU trial compared with the GAL and PLA trials (P<0.05). Measures of perceived activation and pleasure-displeasure were not enhanced nor RPE reduced as a result of ingestion of a CHO solution. In conclusion, the GAL beverage elicited a more favourable metabolic profile in the exercising females but this did not translate into an enhanced affective profile. Indeed, CHO ingestion had no noticeable effect on the assessed psychological indices during 60min of moderate-intensity exercise in females. It is suggested that the maintenance of a positive affective profile may be explained more by the level of hydration as opposed to fuel availability. Therefore, those seeking to use beverages containing CHO to enhance their exercise experience may take note of these findings as this practise appears unjustified. © 2013 Elsevier Ltd.

Objectives Despite a growing body of literature examining the social psychology of doping in sport, stressors and coping as potential doping risk and or protective factors have received scant attention. The aim of this study was to explore permitted and prohibited substances when coping with stressors among a sample of rugby players. Design Underpinned by our relativist ontology and our constructionist epistemological position, we conducted a qualitative study using semi-structured interviews. Methods Following criterion-based sampling, we interviewed three women and eight men (Mage = 22.64, SD = 2.66 years) who were competing in rugby league (n = 7) or rugby union (n = 4) at national level one or above in the United Kingdom. We recursively used six phases of reflexive thematic analysis to analyze the data, and enhanced rigor by focusing on a worthy topic, coherence, rich rigor, credibility, and making a significant contribution. Results The sampled players used permitted and prohibited substances to cope with stressors (e.g., injury, pressure to perform, selection) and perceived these substances to be helpful during injury rehabilitation; to facilitate sleep, performance, recovery, and selection; and to adjust bodyweight and composition. The health risks of permitted and prohibited substances, anti-doping rules, parents, and the athlete’s persona had both protective and vulnerability roles. Conclusions The findings highlight the rugby players’ diminished capacities to anticipate, cope with, resist, and recover from the surroundings, opportunities, and conditions that promote potentially harmful permitted and prohibited substance use in rugby. Collective and coordinated action should be taken to reduce player vulnerability.

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.

Background In sport the narrative is changing from anti-doping to pro-clean sport. Yet, our understanding of what ‘clean sport’ means to athletes is notably absent from the literature. Objectives Working together with elite athletes and National Anti-Doping Organisations (NADOs), this study explored the meaning and importance of ‘clean sport’ and ‘clean athlete identity’. Design Community-based participatory research design was employed to explore (a) how elite athletes define clean sport and being a clean athlete; (b) the hopes and challenges associated with clean sport and being a clean athlete; and (c) what can be done in anti-doping to elicit clean sport. Methods Five elite athletes in five European countries (Germany, Ireland, Netherlands, Slovenia and United Kingdom) were recruited as co-researchers by their respective NADOs, trained for their role as co-researchers and individually interviewed. Seventy-seven elite athletes were then purposefully recruited for 12 athlete-led national focus groups. Finally, the five athlete co-researchers and five athlete participants took part in one 2.5-hour long international focus group. Results Reflexive thematic analysis resulted in generating four overarching themes: ‘clean is being true to the self’, ‘clean performance enhancement has multiple meanings’, ‘clean is not a solo act’ and ‘the problems and solutions are systemic’. Collectively, the themes showed that the clean athlete identity is generally rooted in upbringing, early experiences and love of sport; and characterised by continued, intrinsically motivated commitment to fundamental values and morals acquired in childhood. In contrast, the concept of clean performance-enhancement is highly idiosyncratic and flexible. Elite athletes value anti-doping efforts but their experiences of disparity and unfairness in doping control undermine their trust in anti-doping. Conclusion Clean athlete identity is a social endeavour and artefact, which needs to be reflected in and developed through evidence-informed anti-doping interventions. Raising athletes' voices via co-collaboration and participatory research can be an enriching experience for athletes and researchers alike, and a worthwhile endeavour for sport organisations with responsibility for anti-doping. To make anti-doping education personally relevant, the richness of individual interpretation of ‘clean’ for the self (i.e., clean athlete identity) and performance-enhancement must be acknowledged, respected and cultivated.

Protecting clean sport, and the rights of athletes to a clean sport environment, is at the centre of anti-doping policies. To better support and enable clean athletes and sport, an understanding of the clean athlete lifeworld is required. The current study explored the ways that clean athletes are personally affected by others’ actual or suspected instances of doping and anti-doping rule violations, and by aspects of the anti-doping system. Qualitative Secondary Analysis (QSA) was used to re-analyse and interpret 13 focus group transcripts generated from the ‘Research-Embedded Strategic Plan for Anti-Doping Education Clean Sport Alliance Initiative for Tackling Doping’ (RESPECT) project (see Petróczi et al., 2021b). The sample in the parent study included 82 self-declared clean elite athletes, from Germany, Ireland, Netherlands, Slovenia, and the UK. Reflexive thematic analysis generated three overarching themes: The harm done by clean athletes having to coexist with dopers, how clean athletes are undermined by a disingenuous interest in clean sport, and the anxiety experienced by clean athletes over mistakes that could lead to anti-doping rule violations. The impacts of doping on clean athletes – direct or indirect – are experienced by all clean athletes in some way. The results indicate that current approaches to anti-doping rule compliance frequently undermine clean athletes and the perceived legitimacy of the anti-doping system.

Nutritional supplement (NS) use is widespread in sport. This study applied an integrated social cognitive approach to examine doping attitudes, beliefs, and self-reported doping use behavior across NS users (n = 96) and nonusers (n = 116). Following ethical approval, 212 competitive athletes (age mean = 21.4, s = 4.5; 137 males) completed self-reported measures of doping-related social cognitions and behaviors, presented in an online format where completion implied consent. Significantly more NS users (22.9%) reported doping compared with nonusers (6.0%; U = 4628.0, P < 0.05). NS users presented significantly more positive attitudes toward doping (U = 3152.0, P < 0.05) and expressed a significantly greater belief that doping is effective (U = 3152.0, P < 0.05). When presented with the scenario that performance-enhancing substances are effective and increase the possibility of winning, NS users were significantly more in favor of competing in situations that allow doping (U = 3504.5, P < 0.05). In sum, doping use is three-and-a-half times more prevalent in NS users compared with nonusers. This finding is accompanied by significant differences in doping attitudes, norms, and beliefs. Thus, this article offers support for the gateway hypothesis; athletes who engage in legal performance enhancement practices appear to embody an "at-risk" group for transition toward doping. Education should be appropriately targeted.

211 – 222 The aim of this study was to explore the perceived factors that contribute to stress and negative affective states during preseason among a sample of professional rugby union players. The participants were 12 male professional rugby union players between 18 and 21 years of age (M age = 19 years, SD = 0.85). Data were collected via semistructured interviews and analyzed using an inductive content analysis procedure. Players identified training (structure and volume), the number of matches played and the recovery period, diet, sleep, and travel as factors that they believed contributed to their experience of stress and negative affective states. The present findings suggest that players may require more time to recover between matches, alongside interventions to help players manage the symptoms of stress and negative affect during times in which players are overtraining.

Over two decades, the importance of coaches as potential agents in the prevention of drug use amongst athletes has been emphasised. This article examines the published evidence on coaches' knowledge, attitudes and beliefs towards doping in sport. A systematic search strategy was followed. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches limited to English language articles published between 1990 and Jan 2011. Articles were assessed for relevance by two independent assessors and the results of selected studies were abstracted and synthesised. Outcomes of interest were knowledge, attitudes and beliefs in relation to doping in sport. Four studies met the inclusion criteria and were examined in detail. Samples reflected a range of coaches (n = 566) drawn from Norway, Italy, France and Hong Kong. The investigations varied with respect to outcome focus and quality of evidence. Despite the influential role that coaches might play in an athlete's life, few studies have examined their doping-related knowledge, attitudes and beliefs. While the existing empirical research posits support for the anti-doping movement, it also exposes a limited knowledge of doping effects or governance. The current evidence-base makes it difficult to plan targeted education to span coaching contexts. Addressing this situation in a more systematic and thorough fashion appears warranted.

The use of nutritional supplements (NS) is ubiquitous in sport with athletes looking for performance gains or ways to cope with heightened training demands. Such use involves a balance between potential benefits (e.g., through a carefully monitored NS program) and potential risks (e.g., inadvertent doping). Misinformed practice has raised serious concerns at a global level and there have been a growing number of claims of inadvertent doping through the use of NS (e.g., NS containing 1,3-dimethylamylamine or DMAA; “Rule Violations” n.d). Yet, risk does not stop at the possibility of a doping sanction. In the UK alone NS use has been cited as a factor in a number of deaths involving young and apparently healthy men and women. For example, an inquest concluded that DMAA found in Jack-3D was a contributory factor in the death of a 30-year-old runner during the 2012 London Marathon (“Claire Squires inquest” 2013). However, in the absence of clinical trials evidencing the side effects of these substances on human health, we must be cautious and avoid causal claims. Instead, supplement use risk, athletes’ reasons for using NS, and the proposition that NS use can act as a gateway to doping are the focus of the chapter. Additionally, we support calls for increased regulation of the industry and research on functional alternatives to NS.

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.

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.

BACKGROUND: Central to the work of many medical practitioners is the provision of pharmaceutical support for patients. Patients can include athletes who are subject to anti-doping rules and regulations which prohibit the use of certain substances in and out of competition. This paper examines the evidence on medical practitioners' knowledge, attitudes and beliefs towards doping in sport. METHODS: A systematic search strategy was followed. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches limited to English language articles published between 1990 and 2010. Articles were assessed for relevance by two independent assessors and the results of selected studies were abstracted and synthesised. Outcomes of interest were knowledge, attitudes and beliefs in relation to doping in sport. RESULTS: Six studies met the inclusion criteria and were examined in detail. Samples reflected a range of medical practitioners drawn from the UK, France (2), Greece, Italy and Ireland. The investigations varied with respect to outcome focus and quality of evidence presented. CONCLUSION: Whilst the extant empirical research posits a negative attitude towards illegal performance enhancement combined with a positive inclination towards doping prevention, it also exposes a limited knowledge of anti-doping rules and regulations. Insufficient education, leading to a lack of awareness and understanding, could render this professional group at risk of doping offences considering Article 2.8 of the World Anti-Doping Agency Code (WADC). Moreover, in light of the incongruence between professional medical codes and WADC Article 2.8, medical professionals may face doping dilemmas and therefore further discourse is required. At present, the current evidence-base makes it difficult to plan developmentally appropriate education to span the exposure spectrum. Addressing this situation appears warranted.

The purpose of the present study was to examine (a) the sources of sport and non-sport stress and their associated symptoms on rest days, training days, and match days and (b) the temporal aspects of sources and symptoms of stress and affective states. Professional male rugby union players (n=16) completed the Daily Analysis of Life Demands in Athletes (DALDA) and the Activation Deactivation Adjective Check List (AD ACL) for 28 days. On match days players reported that few stressors were "worse than normal." Most stressors were "worse than normal" on training days followed by rest days and more stressors were "worse than normal" on the day after a match than on match days. Further, players reported an unpleasant, low activation state across the three analysis days, suggesting they were in an overtrained state. The findings of this study demonstrate that professional rugby players experience negative affect and a multitude of sport and non-sport stressors. Early detection of stressors and negative affective states could help prevent symptoms of overtraining and burnout and facilitate optimal training and sporting performance. Coaches and practitioners are encouraged to integrate the DALDA and AD ACL in their training and performance monitoring regimes.

To inform anti-doping policy and practice, it is important to understand the complexities of doping. The purpose of this study was to collate and systematically examine the reasoned decisions published by UK Anti-Doping for doping sanctions in rugby union in the UK since the introduction of the 2009 World Anti-Doping Code. Case files were content analysed to extract demographic information and details relating to the anti-doping rule violation (ADRV), including individuals’ explanations for how/why the ADRV occurred. Between 2009 and 2015, 49 rugby union players and one coach from across the UK were sanctioned. Over 50% of the cases involved players under the age of 25, competing at sub-elite levels. Reasons in defence of the ADRV focused on functional use and lifestyle factors rather than performance enhancement. An a priori assessment of the ‘need’, ‘risk’ and ‘consequence’ of using a substance was not commonplace; further strengthening calls for increasing the reach of anti-doping education. The findings also deconstruct the view that ‘doped’ athletes are the same. Consequently, deepening understanding of the social and cultural conditions that encourage doping remains a priority.

Informed by athletes’ psychological needs, the current qualitative study developed, implemented, and evaluated a 15-month mental skills training (MST) program for elite youth athletes. The MST was divided into 3 phases that included a 9-month preintervention, a 2-month intervention, and a 4-month evaluation phase. The intervention consisted of 3 interactive workshops that were delivered to 11 competitive British youth tennis players (8–15 years of age) and their coach (age 34). The intervention was informed by data that were collected throughout a 9-month preintervention phase including longitudinal observations, field notes, and semistructured interviews. The intervention was evaluated over 4 months through observations, field notes, athlete-workshop data, and a semistructured interview with the coach. Results reinforced the value of the longitudinal preintervention phase by highlighting that the establishment of rapport between the researcher and athletes enhanced the meaningfulness and content of the MST program. In addition, an increase in athletes’ use and regulation of psychological skills and characteristics (PSCs) was identified as a result of athletes’ improved understanding of psychological skills (i.e., self-talk, imagery, performance routines) and characteristics (i.e., focus, emotional control, PSCs). Finally, the MST program fostered a shared subject-specific language between athletes and their coach, enhancing the openness and frequency with which PSCs were talked about. Practical guidelines for future sport psychology interventions with youth athletes and their coaches are provided. Lay Summary: A 15-month mental skills training program was conducted with youth tennis players to enhance their ability to regulate their focus and emotional control. Practical guidelines for future interventions with youth athletes and their coaches are provided.

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.

Athletes exist and function in an environment of complex relationships; however, little is known about the influence of particular relationships for athletes’ attitudes, beliefs and behaviors towards doping in sport. Among adolescent and young adult athlete populations, parents and coaches have been highlighted as particularly influential, but when and how they influence athletes in this context is unknown. Therefore, this study aimed to explore the role of significant others in this domain. Design: Cross-sectional qualitative methodology. Method: Semi-structured interviews were conducted with 14 British (M = 8) track and field student-athletes. Thematic analysis was employed to analyze the transcripts. Results: Prominently, the parent-athlete relationship influenced athletes’ lives in and beyond sport. Parents shape(d) athletes’ personal morals by establishing their initial sense of right and wrong. In turn, this appears to guide athletes’ decision-making and behaviors even after leaving the family home. Additionally, parents impacted the trajectory of participants’ athletic careers and their approach toward sport in general. Ensuing from this, participants exhibit a desire to give back to their parents. Cumulatively, the parent-athlete relationship (in)directly deters athletes from doping. Conclusion: Given the enduring significance of the parent-athlete relationship for shaping athletes’ attitudes, experiences and behaviors towards doping, parents should be prioritized with targeted anti-doping education. Specifically, parents should be provided with doping knowledge (e.g., risks, warning signs, consequences), and then equipped and empowered to transmit this information to athletes. Such an approach has the potential to simultaneously increase the engagement of parents and athletes in anti-doping efforts and education.

Revisions to global anti-doping policy and growing evidence of systematic doping in sport means athletes and athlete support personnel are increasingly encouraged to ‘blow the whistle’ on doping. Yet, individuals’ thoughts, feelings, and anticipated behaviours in reporting wrongdoing of this kind are unknown, hindering its promotion. To inform current anti-doping efforts, this study explored student-athletes’ anticipated behaviours relative to blowing the whistle on performance enhancing drug (PED) use and their underpinning attitudes. Design: Qualitative methodology. Method: Semi-structured interviews were conducted with 28 track and field university student-athletes from the UK (N = 14) and US (N = 14). Transcripts were analysed using thematic analysis. Results: Addressing doping presents a true moral dilemma and is not a dichotomous process whereby athletes either report doping or do nothing. Instead, four options for addressing others’ PED use emerged: (1) confront PED user directly, (2) report to ‘someone’, (3) report to anti-doping ‘authorities’, or (4) ignore the behaviour. Underpinned by relational concerns and empathy, direct confrontation was participants’ preferred approach to addressing doping. Conclusion: Student-athletes are reluctant to blow the whistle on doping so the currently promoted method for reporting wrongdoing may be met with resistance. Instead, student-athletes indicate a willingness to personally confront PED users, which has the potential to protect both the doping athlete and whistleblower, while simultaneously reducing the presence of PEDs in sport. Thus, these findings serve to stimulate debate and discussion within anti-doping efforts regarding the possibility of confrontation being encouraged as an effective deterrent to sport doping.

Objective: The purpose of this paper was to extend current doping research efforts by shifting the focus away from a doping-user perspective to examine the experiences of elite athletes that have been personally affected by other athletes doping behaviours. Design: This research works within the interpretive paradigm, adopting relativist ontology and transactional/subjectivist epistemology. Method: Conversational interviews were conducted with ‘competitive’ (N = 2) and ‘retired’ (N = 2) elite Track and Field athletes from multiple countries. In order to communicate the findings in a way that captures the complexity of the issue, whilst also appealing to the athletes this issue affects, creative non-fiction stories were used to present the findings. Results: Two stories were created; one incorporating the ‘competitive’ athletes’ experiences and one presenting the ‘retired’ athletes’ accounts. The stories detail financial, emotional, and relational implications stemming from others’ use of performance enhancing drugs. Critically, the impact is not ephemeral; the retired athletes detailed the long-term implications of their experiences. Meanwhile, the competitive athletes suggest that given the current state of sport, they regularly have to defend their status as ‘clean athletes’. Thus, the ripples of doping in sport appear to be far reaching and enduring. Conclusions: Incorporating a novel mode of knowledge production within the doping literature, the stories presented here demonstrate elite athletes’ candid accounts of being impacted by others’ doping behaviours in sport. This study also emphasises the value of adopting novel and creative approaches to data collection and representation within the field of doping research.

This paper qualitatively explores national level athletes' willingness to report doping in sport. Following ethical approval, semi-structured interviews were conducted with nine national level athletes from rugby league (n = 5) and track and field athletics (n = 4). Thematic analysis established the main themes within the data. Contextual differences existed around the role that athletes perceived they would play if they became aware of doping. Specifically, track and field athletes would adopt the role of a whistle-blower and report individuals who were doping in their sport. In comparison, the rugby league players highlighted a moral dilemma. Despite disagreeing with their teammates' actions, the players would adhere to a code of silence and refrain from reporting doping. Taking these findings into account, prevention programs might focus on changing broader group and community norms around doping. In doing so, community members' receptivity to prevention messages may increase. Moreover, developing skills to intervene (e.g., speaking out against social norms that support doping behavior) or increasing awareness of reporting lines could enhance community responsibility for doping prevention. In sum, the findings highlight the need to consider the context of sport and emphasize that a one-size-fits-all approach to anti-doping is problematic.

Design: Ten competitive athletes (M = 5, F = 5) representing five different sports (field hockey, boxing, football, triathlon, rugby) were recruited through convenience sampling to undertake a semi-structured interview to enable a qualitative analysis of athletes' lifelong athletic careers. Method: Verbatim transcripts were analysed using an established three-stage coding process to identify the common themes within the narratives. Results: Personal and situational protective factors were identified in the accounts. Personal factors included: (i) a strong moral stance against cheating; (ii) an identity beyond sport; (iii) self-control; and (iv) resilience to social group pressures. Situational factors included secure attachments to people at all stages of the athlete's life. This facilitated both the promotion of moral decision making and assisted in the development of anti-doping attitudes. When situational factors – such as a pro-doping climate – arose, key attachments in the athletes' lives interplayed with personal factors to reduce the risk of doping. Conclusions: These findings offer insights into factors that protect competitive athletes against using PEDs in sport and further our understanding of the complex interaction between risk and protective factors at individual, psychosocial and societal levels among competitive athletes. As a complex behaviour, doping in sport cannot be prevented by solely focussing on the individual athlete; contextual factors beyond the athlete's control also impact on this behaviour. Thus, a paradigm shift is warranted to move beyond an athlete-centred approach to anti-doping.

To enable preventive measures to be designed, it is important to identify modifiable distal and proximal factors underlying doping behavior. This study investigated aspects of the prototype willingness model in relation to doping. A cross-sectional study was conducted involving 729 competitive athletes. Following ethical approval, athletes (mean age = 28.8 ± 10.1 years; 63% male) completed an online questionnaire, which assessed doping-related attitudes, norms, prototype perceptions, outcome expectancies, and behavioral willingness. Using hierarchical multiple regression analysis, 54.4% of the total variance in willingness to dope was explained. Specifically, past doping, attitudes, and favorability of performance enhancing substance user prototypes were the strongest unique predictors of willingness to dope. Athletes appeared most willing to dope if they were to suffer an injury, a dip in performance, or think others are doping and getting away with it. National-level athletes displayed significantly greater willingness to dope (Kruskal-Wallis γ2 = 35.9, P < 0.001) and perceived themselves as significantly more similar to a doper (Kruskal-Wallis γ2 = 13.4, P = 0.004) than athletes competing at any other level. The findings highlight the importance of extending anti-doping provision beyond elite-level sport and the need to target athletes' doping-related perceptions.

Objectives The purpose of this qualitative study was to utilize the Capability, Opportunity, Motivation - Behavior model (COM-B) to: (1) evaluate athlete knowledge and understanding of current asthma-related anti-doping regulations, (2) explore the impact of environmental and societal influences on athletes with asthma, and (3) examine athlete perception of asthma medication use in competitive sport.Methods: Semi-structured interviews were conducted with ten competitive endurance athletes (five athletes with asthma and five without asthma). Interviews were guided by the COM-B model and transcripts were analyzed inductively and deductively using reflexive thematic analysis.Results: Mapping the experiences and perceptions of athletes against an established behavioral framework identified that: (1) athletes’ possess limited knowledge and understanding of the World Anti-Doping Agency (WADA) Prohibited List and Therapeutic use exemption (TUE) policy with respect to asthma medication; (2) the use of sub-optimal diagnostic methods is commonplace and increases the risk of misdiagnosis and unnecessary inhaler therapy; (3) negative media portrayal of high-profile asthma-related doping allegations impacts public opinion and contributes to the perception of wrongdoing within the sporting community.Conclusion: The novel application of behavioral science highlights several factors that may contribute to asthma medication avoidance and promote misuse in competitive sport. The findings from this study provide a foundation for the development and implementation of targeted education programmes, and it is hoped that employing this approach will ultimately improve overall perceptions of asthma treatment in athletes, which is necessary to maintain respiratory health, optimize performance and protect the integrity of sport.

This study investigated whether motivational climate was associated with prosocial and antisocial behavior in youth athletes directly and indirectly via social support (i.e., emotional and esteem support), perspective taking, and moral disengagement. Two-hundred and seventy-five youth team sport players (156 boys; 119 girls) aged 11 to 16 years completed questionnaires assessing the study variables. Structural equation modelling revealed that mastery climate was positively associated with prosocial teammate behavior both directly and indirectly via social support. Mastery climate was also indirectly associated with prosocial opponent behavior via social support and perspective taking. Mastery climate was negatively associated with antisocial behavior towards opponents and teammates indirectly via social support, perspective taking, and moral disengagement. Performance climate was positively associated with antisocial behavior towards teammates directly and indirectly via moral disengagement: It was also indirectly associated with antisocial behavior towards opponents via moral disengagement. Our findings extend understanding about the variables that might explain relationships between motivational climate and moral conduct in youth athletes. Implications for sport practitioners are considered, especially in relation to approaches that could help foster moral character in young people through sport.

OBJECTIVE: To examine the effects of consuming a galactose carbohydrate (CHO) drink on substrate oxidation, postexercise satiety, and subsequent energy intake. METHODS: Nine recreationally active eumenorrheic females undertook 3 trials, each consisting of running for 60 minutes at 65% VO2peak followed immediately by a 90-minute rest period. Prior to (300 ml) and at 15-minute intervals during exercise (150 ml), participants consumed either a glucose (GLU: GI 89) or galactose (GAL: GI 20) drink, each of which contained 45 g of CHO, or an artificially sweetened placebo (PLA). Following the rest period, participants were provided with an ad libitum test lunch and asked to record food intake for the remainder of the day. RESULTS: Plasma glucose was significantly greater throughout exercise and rest following the GLU trial compared with the GAL and PLA trials (P < 0.05); however there were no differences in CHO oxidation. Hunger was significantly lower (P < 0.05) throughout the GAL compared to the GLU and PLA trials. There were no significant differences between trials for energy intake during the postexercise meal. Overall net energy balance for the 24 hours was negative in both the GAL (-162 ± 115 kcal; P < 0.05 vs GLU) and PLA trials (-49 ± 160 kcal). CONCLUSIONS: Results demonstrate that ingesting a solution containing GAL before and during exercise can positively impact postexercise satiety and energy balance throughout the day, compared to a more readily available and widely consumed form of CHO. Despite this, there appears to be no apparent benefit in consuming a CHO beverage on fuel utilization for this moderate exercise intensity and duration.

BACKGROUND AND OBJECTIVES: Theories of dyadic coping and empirical literature have intermittently and inconsistently highlighted antecedents and outcomes of dyadic coping. The purpose of this review was to systematically identify the antecedents and outcomes of dyadic coping in close personal relationships. DESIGN: A PRISMA-guided systematic review and narrative synthesis. METHODS: Literature searches were conducted using CINAHL, PubMed, PsycINFO, and citation pearl growing to identify studies that were relevant to the aim of the review. The search strategy and exclusion criteria led to a final sample of 46 studies that each highlighted antecedents and outcomes of dyadic coping among married couples. Each study was critically appraised and analyzed using narrative synthesis. RESULTS: The narrative synthesis highlighted five antecedents (learning, gender, relationship characteristics, relationship role, and cultural influences) and two outcomes (relationship functioning and personal health) of dyadic coping. CONCLUSION: The review exposes inconsistencies in the conceptualization of dyadic coping, highlights a range of antecedents that influence dyadic coping, and suggests that dyadic coping can have positive benefits for relationship functioning and personal health. The findings have implications for future research and practice (e.g. when working with couples to improve relationship functioning).

Objectives: Despite widespread acceptance that coping is an interpersonal phenomenon, sport psychology research has focused largely on athletes' and coaches’ ways of coping individually. The aim of this study was to qualitatively explore coping from an interpersonal perspective (i.e., dyadic coping) in coach-athlete relationships. Methodology and methods: Antecedents and outcomes of dyadic coping were discussed with five coach-athlete dyads. We conducted individual interviews with athletes and coaches and then one interview with each coach-athlete dyad. Interviews were analyzed using dyadic analysis and composite vignettes were created to present the data. Methodological rigor was enhanced by focusing on credibility, resonance, rich rigor, significant contribution, and meaningful coherence. Results: Five themes were identified. These represented the essence of dyadic coping (theme: the essence of dyadic coping), antecedents of dyadic coping (themes: lock and key fit, friendship and trust, communication of the stressor), and outcomes of dyadic coping (theme: protection and support). The first theme captures coaches' and athletes’ understanding of dyadic coping. The antecedent themes represent the factors that were necessary for dyadic coping to occur. Protection and support relates to the positive nurturing environment that was discussed as an outcome of dyadic coping. Conclusion: The results extend published research by exploring antecedents and outcomes of dyadic coping in sport. The findings highlight that dyadic coping was prevalent in coach-athlete relationships when various antecedents (lock and key fit, friendship and trust, communication of the stressor) existed. Protection and support were pertinent outcomes of dyadic coping that contributed to personal and relationship growth.

Objectives: The purpose of this study was to make an original contribution to sport psychology literature by offering a substantive grounded theory of dyadic coping in coach-athlete relationships. Specifically, this study aimed to capture the development and manifestation of dyadic coping for coaches and athletes operating in individual sports. Design: Using constructionist grounded theory methodology as a guide, a theory of dyadic coping was constructed by the authors, 13 coaches, 15 athletes, and five sport and exercise psychology practitioners. Method: Theoretical sampling procedures ensured that data collection was directed by the developing theoretical concepts, rather than a set of predefined criteria. We conducted individual interviews (n = 16) with coaches and athletes, and one 90-minute workshop with coaches, athletes, and sport and exercise psychology practitioners. Methodological rigor was enhanced by focusing on credibility, originality, resonance, and usefulness. Results: The theory proposes that when coaches and athletes appraise a stressor communicated in their dyad as significant and meaningful, they use dyadic coping to protect themselves and their coach-athlete relationships. This process is moderated by a number of personal (e.g., personality), relationship (e.g., length), and organizational (e.g., leadership behaviors) characteristics. Conclusion: The theory presented here represents a notable shift in thinking away from coping as an individual process and toward coping as an important interpersonal phenomenon. This type of coping can have long-term effects on coaches’ and athletes’ relationship functioning, well-being, and performance.

To prevent the spread of infection during matches and training activities is a major challenge facing all sports returning from the enforced COVID-19 shutdown. During training and matches, rugby league players make contact with others which can result in SARS-CoV-2 virus transmission. While these interactions characterise the appeal of the game, a number of them can be avoided, including shaking hands and conversing after the match. This paper presents a framework underpinned by behavioural science (capability, opportunity, motivation and behaviour model, COM-B) to support stakeholders in helping players adopt new social distance norms and behaviours. This framework helps to ensure the players have the capability, opportunity, and motivation to adopt new COVID-19 risk minimising behaviours, which they will need to commit to 100%.

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.

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.

Asthma is prevalent in athletes and when untreated can impact both respiratory health and sports performance. Pharmacological inhaler therapy currently forms the mainstay of treatment; however, for elite athletes competing under the constraints of the World Anti-Doping Code (Code), a number of established therapies are prohibited both in and/or out of competition and/or have a maximum permitted dose. The recent release of medical information detailing inhaler therapy in high-profile athletes has brought the legitimacy and utilisation of asthma medication in this setting into sharp focus. This narrative review critically appraises recent changes to anti-doping policy and the Code in the context of asthma management, evaluates the impact of asthma medication use on sports performance and employs a theory of behaviour to examine perceived determinants and barriers to athletes adhering to the anti-doping rules of sport when applied to asthma.

Aim: This study explored athletes' perceived prototypes of performance enhancing substance (PES) users and non-users to facilitate a broader understanding of the risk/protective factors for doping use. Method: A cross-sectional study was conducted involving n = 147 current/ex-competitive athletes. Following ethical approval, athletes (mean age = 25.51, SD = 8.47 years; 40.8% male) from 30 sports completed an online open-ended questionnaire. Participants were required to describe their perceived positive and negative images of PES users and non-users. Inductive content analysis established the main themes within the data. Results: The perceived prototypes of PES users and non-users were most commonly related to: motivation to succeed, confidence, commitment, temperament, fear of competition, rule abiding, reliability and sociability. Characteristically, PES users were seen as motivated, confident, unreliable and rule breakers, whereas non-users were perceived to be role models, reliable and risk averse. Conclusion: The results suggest athletes' perceptions of PES user characteristics may not be solely negative. Athletes who perceive PES user prototypes favourably may be vulnerable to dopingvia motivation that is elicited from future possible selves. Therefore, athletes' perceptions of PES user and non-user prototypes may act as risk/protective factors for doping. Implications: Tailored anti-doping should target athletes' prototype perceptions to enhance the prevention of doping in sport. © 2012 Elsevier Ltd.

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.

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.

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.

Widespread allegations of doping in sport consistently make front page news. The findings of an independent commission for the WADA1 underscore the importance of moving beyond a focus on individual athletes to concurrently address individual, social and environmental factors in anti-doping policy and practice (socioecological perspective).

Designing and implementing successful dietary interventions is integral to the role of sports nutrition professionals. Despite this, no review has evaluated sports nutrition interventions and consequently their active ingredients are not defined. This systematic review aimed to identify the behavioural strategies used in sports nutrition interventions and to explore any relationship between the strategies employed and intervention effects. SPORTDiscus, MEDLINE, CINAHL, PubMed, and SCOPUS were searched for behavioural interventions that aimed to change athletes' dietary behaviour. Behavioural interventions were eligible for inclusion provided pre and post-measures of dietary intake were reported. The protocol adheres to Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols (PRISMA-P). Each study was coded against the “Template for Intervention Description and Replication” (TIDieR) checklist and the Behaviour change technique (BCT) taxonomy v1. Only 19 BCTs are currently employed within sports nutrition interventions suggesting that 80% of the available BCTs are not being used. Only three studies were theory informed and the standard of reporting across all studies requires substantial improvement. However, the majority of studies reported changes in athletes’ dietary behaviour post-intervention. This review highlights an absence of evidence-informed approaches defining the professional practice of sports nutrition and illuminates a limited application of BCTs within the sports nutrition field. Consequently, the authors provide a framework and guide for intervention development to increase rigour and effectiveness of future sports nutrition interventions. PROSPERO registration number: CRD42018072283.

Objectives: To examine athletes’ implicit and explicit prototype perceptions of performance enhancing substance (PES) users and non-users. Design: A cross-sectional mixed-method study. Methods: Competitive athletes from 39 sports (N=226; mean age= 27.66±9.74 years; 59% male) completed four self-report questions and two Brief Implicit Association Tests online, assessing prototype favourability and similarity of PES users and non-users. Results: Athletes explicitly associated themselves with a non-user (M= 3.13±0.92) more than a PES user (M= 0.56±0.88) and perceived a non-user (M= 89.92±14.98) more favourably than a PES user (M= 13.18±21.38). Indexing behaviour on self-reports, doping contemplators did not differ from ‘clean’ athletes in their perceptions of PES user prototypes while dopers perceived PES users favourably and similar to themselves. In comparison, doping contemplators paired the concept of 'dopers' easier with themselves than with others, while clean athletes and dopers had no preference for either pairing (D = -0.33, -0.08 and 0.01, respectively). All groups demonstrated some degree of preference for ‘good and doper’, moving from slight to moderate to strong preference in the groups of clean athletes, dopers and contemplators, respectively (D = -0.20, -0.37 and -0.80, respectively). Conclusions: Results suggest that doping contemplators may have a positive bias towards doping which is not endorsed in self-reports. Implicit preferences, along with the disparity between the implicit and explicit measures of athletes’ doping-related prototype perceptions advance understanding of doping behaviour and make a unique contribution to research methodology. Factors influencing the interplay between explicit and implicit endorsements of PES user prototypes warrant further research.

Objectives: This paper qualitatively explores national level athletes’ perceptions of their role in keeping sport clean. Design: A qualitative design was utilised to enable an in-depth examination of athletes’ views on reporting doping behaviour. Method: Following ethical approval, semi-structured interviews were conducted with nine national level athletes from rugby league (n = 5) and athletics (n = 4; female = 2). Thematic analysis established the main themes within the data. Results: Contextual differences existed around the role that athletes perceived they would play in keeping sport clean. The track and field athletes indicated that they would adopt the role of a whistleblower whereas the rugby league players would adhere to a code of silence. Specifically, track and field athletes would report individuals who were doping in their sport although it was evident that the majority were unaware of the protocol for doing this. In comparison, the rugby league players highlighted a moral dilemma by suggesting they would refrain from reporting a team mate despite disagreeing with their actions. Conclusions: Prevention programmes should enhance efforts to change broader group and community norms around doping in sport. In doing so, community members’ receptivity to prevention messages may increase. Moreover, developing skills to intervene (i.e., speaking out against social norms that support doping behaviour) or increasing awareness of reporting lines could enhance community responsibility for clean sport. The findings highlight the need to consider the context of sport and emphasise that a one size fits all approach to anti-doping is not appropriate.

Behaviour is shaped by the interactions between a person, their social sphere and their environment. Yet research into doping in sport has largely focused on the athlete and the individual factors that influence prohibited substance use. Owing to the stigma associated with doping, it can be difficult to undertake research with those who have committed anti-doping rule violations. However, a lot can be learnt from the experiences and reflections of those who are immersed within a specific context and sporting environment. Therefore, the purpose of this study was to explore national level athletes’ perceptions of what influences willingness to dope in athletics and rugby league. Through semi-structured interviews, nine national level athletes drew upon their sporting histories to identify specific situations in their sport where they thought athletes might be willing to dope. Whilst considering the behaviour of others, they also drew upon their own personal experiences and the resources available to them as national level athletes to consider how these might give rise to doping vulnerability. In doing so, participants were empathetic and shared their perceptions of why some athletes might intentionally dope in their sport. These shared perceptions further our understanding of the complexity of doping in sport and underscore the importance of optimising the environment in order to help athletes cope with the demands of sport and thwarting the development of a self-fulfilling prophecy.

Inconsistencies in the use and definition of psychological terms within the talent development literature have been identified. To advance the scientific field, the creation of a shared language is recommended. This review aimed to systematically (i) identify terms used in empirical studies to describe psychological components purported to facilitate athletes' development; (ii) analyse definition and meanings of these terms; and (iii) group, label and define terms into meaning clusters. A systematic review using a narrative approach to synthesise information was conducted. A comprehensive literature search of SPORTDiscus, PsycINFO, PsycARTICLES, and ERIC was completed in May 2015. In total 21 empirical studies, published between 2002 and 2015, met the inclusion criteria and were included in the narrative synthesis. Thematic analysis was used to analyse the findings. Identified psychological terms were categorised as psychological skills or psychological characteristics. Psychological skills were defined as athletes’ ability to use learned psychological strategies (e.g., self-talk) to regulate and facilitate the enhancement of psychological characteristics. Psychological characteristics were defined as predispositions that impact upon athlete development (e.g., self-confidence). Despite being relatively enduring and consistent across a range of situations, psychological characteristics can be regulated and enhanced through the use of psychological skills.

Illness prevention is essential for athlete health management, but little is known about its uptake in sport. Prior to the pandemic, the International Olympic Committee (IOC) published a consensus statement recommending illness prevention guidelines are implemented in sports. Yet, little is known about guideline uptake. Therefore, this study aimed to explore the (1) illness experiences of rugby players and athlete support personnel and (2) barriers and enablers to illness prevention guideline uptake in rugby, using the lens of behaviour change theory. In a bid to inform and enhance athlete welfare, we sought to amplify the voices of participants through qualitative inquiry. Between August 2020 and May 2021, 16 semi-structured interviews were undertaken with players and athlete support personnel working across rugby. Analysis was conducted using Braun and Clarke’s reflexive thematic analysis. Prior to COVID-19, participants deemed illness to be of little concern, with experience of illnesses and the global pandemic critical enablers to guideline uptake. The rugby environment was a barrier to illness prevention, particularly in women’s and academy teams where resource deficiency was highlighted. ‘Rugby identity’ acted as both a barrier and enabler with participants’ passion for rugby driving both guideline adherence and non-adherence. Tackling resource inequalities between men’s and women’s cohorts is critical to effectively implement guidelines. Coach and player education is essential, and emphasis must be placed on continuing preventative behaviours adopted due to COVID-19. Our findings offer new insight into illness prevention, moving away from prevailing quantitative research, and instead voicing players’ experiences.

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.

Background Despite the increasing presence of chefs in professional football and their influence on nutrition provision, evidence on the specific roles and responsibilities of chefs remains limited. This study aimed to explore the role(s) of chefs and describe the characteristics of catering services within English professional football. Methods Sixty-two chefs (56 males, 6 females) in club supervisory positions within the top four divisions of the English male football pyramid were surveyed during the 2022–2023 season. Results Participants were predominantly male, aged 35–44 years, and employed on full-time permanent contracts. Sixteen participants had the term ‘performance’ in their contracted job title. Participants averaged 24 years of chef work experience, 8 years of football-specific experience, and 45 working hours per week. Twenty-nine participants had responsibility for providing nutrition advice to players, whereas the vast majority used nutritional supplements and produced bespoke nutritional items as part of the catering services provided. Most participants rated their sport nutrition knowledge from ‘good’ to ‘excellent’ although only 18 had undertaken formal sport nutrition training. Fifty-one participants frequently followed a periodised nutrition approach, however 31 lacked defined nutrition targets. Tasks such as travelling to fixtures, hotel menu planning, and hotel food provision were most frequent in the Premier League. Catering services in the Premier League mostly operated year-round, seven days a week, employing 4 or more chefs, and spending £6,000 or more per week, with declining operations, costs, and staffing towards the lower divisions. Forty-nine services covered male academy teams alongside the male senior team. Only 15 covered female senior teams, of which 7 extended coverage to female academy teams. Conclusions Chefs undertake key roles both at and away from the club training ground to implement sport nutrition strategies. Inconsistencies in strategy implementation and catering practices were identified, along with league disparities and gender inequalities in service provision. Our findings underscore the need for a quality-assurance framework for accreditation and increased opportunities for chef-tailored sport nutrition education. We advocate for the title ‘sport chef’, and the establishment of a regulatory body to support the practice of chefs working in professional football.

Background Body mass and composition (fat and fat-free mass) manipulation is a common practice in sport, yet it can pose significant risks to athlete health and wellbeing. Practitioners must continually adapt to the growing body of evidence to implement safe, effective and context-specific practice. Objective This scoping review aimed to summarise dietary recommendations for altering body mass or composition in male and female, adult non-disabled athletes and appraise how these expert-group led recommendations have evolved over time. Methods Electronic databases, including SCOPUS, PubMed, SPORTDiscus, CINAHL Complete and APA PsycINFO were searched (last search 2 August 2024) without date restrictions. Papers were included if they provided dietary recommendations for altering body mass or composition in adult non-disabled athlete populations and were published by an expert organisation. Results From 6068 records screened, 73 documents were included, comprising 45 consensus statements, 27 position stands and 1 practice guideline, endorsed by 14 organisations and developed by 328 experts from 25 countries. Athletics (n = 19), aquatics (n = 7) and team sports (n = 5) were the most represented, leaving many sports underrepresented. A total of 50 documents were standalone rather than part of an updated series. Only 40 papers addressed specific targets, rates or timing of outcome changes. Individualised, realistic and health-focussed targets were recommended, aligned with the athlete’s sport, position, sex, age and competition phase, with gradual changes (e.g. 0.5–1.0 kg/week fat loss) to enhance performance. Common strategies for altering body mass and composition included creating an energy surplus (500–1000 kcal/day) or deficit (250–1000 kcal/day), maintaining energy availability above 30 kcal/kg fat-free mass/day, and periodising carbohydrate intake (3–12 g/kg/day) on the basis of training demands. Protein intake (1.6–2.4 g/kg/day) was recommended across 4–6 feeds from high-quality sources, alongside targeted supplements such as creatine, whey protein and a multi-vitamin and mineral. Recommendations focussed minimal attention on nutrients such as fats, fibre or micronutrients, and the language used was often vague, leaving significant room for interpretation. Conclusions Developing sport-specific, behaviourally anchored and regularly updated dietary recommendations, informed by athlete and multidisciplinary team input, is recommended. This approach would provide actionable, athlete-centred strategies that effectively support body composition goals whilst prioritising health, wellbeing and performance. OSF Registration https://doi.org/10.17605/OSF.IO/B4YJT

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.

The role of dispositional mindfulness on stress in student-athletes and factors that mediate this relationship has yet to be examined. Accordingly, the purpose of this study was to investigate the relationships between the facets of mindfulness and life stress in student-athletes and whether these relationships are mediated through coping effectiveness and decision rumination. Participants were 202 student-athletes who completed validated measures of dispositional mindfulness, student-athlete life stress, decision rumination and coping effectiveness in sport. Results indicated that the acting with awareness and non-judging facets of mindfulness were negative predictors of life stress, whereas the observe facet was a positive predictor of life stress. Mediation analyses revealed that these relationships were mediated through coping effectiveness and decision rumination. Findings provide new insight into the role dispositional mindfulness plays on student-athlete perceptions of life stress and implications for practitioners are discussed.

Objectives This study aimed to address voids in academic literature by exploring the consequences of performance expectations from the perspective of a retired athlete. Methodology An instrumental case study was used to capture the experiences of a retired female athlete who had been exposed to performance expectations throughout her career. Six conversational life story interviews were conducted with the athlete and the data were represented in two portrait vignettes. Results The vignettes provide a rich and holistic account of the participant’s experiences of performance expectations. Salient points that are detailed throughout the vignettes include: i) the consequences (e.g., fear of failure, perceptions of pressure, magnification of intrapersonal expectations) of media expectations for the athlete; ii) factors that the athlete perceived to influence the consequences of media expectations (e.g., the amount of media attention received); iii) the cumulative consequences (e.g., nausea, lack of perceived control, butterflies) of interpersonal expectations from multiple perceivers (e.g., the media, coaches, the public, opponents); and iv) the presence of a fear culture associated with expectations, which had ramifications for the athlete’s well-being and their ability to talk about their experiences. Conclusions This article offers a novel insight to the multi-modal consequences of performance expectations for an athlete, the dominant role that the media played in shaping the athlete’s experiences, and the athlete’s inability to disclose her experiences of expectations. Stakeholders are encouraged to develop their own meanings, interpretations, and evaluations of the vignettes, and apply their interpretations to policy and practice.

The purpose of this study was to understand how performance expectations conveyed within print and digital media manifest and how these expectations are reported at specific time points (i.e., before, during, and after a major sporting event). A total of 9,236 media reports were analysed using inductive content analysis, each of which made reference to one of eight Great British athletes (Mage = 23.00, SD = 2.67 years) who competed at the London 2012 Olympic (n = 4) or Paralympic (n = 4) Games. The results highlight that the media regularly reported content associated with performance expectations of high-performance athletes before, during, and after the 2012 Games. The formation of these expectations appears to be an evolving process that is subject to change dependent on athletes’ previous performances. Factors that were highlighted by the media as influential in athletes meeting performance expectations included the athlete’s ability to cope with pressure and the home advantage. The media’s response to athletes’ performance appeared to differ according to whether or not the athlete had achieved the initial expectation. The findings also suggested that expectations were related to the athlete’s support staff (e.g., coaches) as well as the athletes. These results indicate that performance expectations of athletes are a key focus of media reports ahead of a major competition, and that these expectations are likely to influence the content presented within the media reports. The results also demonstrate the importance of performance expectations to key stakeholders (e.g., coaches, sport psychologists, athletes) within high-performance sport.

Background Despite the importance of evidence-based nutrition in elite football, Premier League players often exhibit sub-optimal dietary behaviours, highlighting the need for improved guideline implementation. Purpose This study used the COM-B model and Theoretical Domains Framework (TDF) to explore sport nutritionists’ perceived barriers and enablers to applying the UEFA Consensus Statement on Nutrition. Method Twelve lead sport nutritionists from English Premier League clubs took part in semi-structured interviews (1 hour ± 44 mins). The interviews were structured using the COM-B and TDF and analysed thematically. Results Six key themes were identified, representing six barriers and two enablers, encompassing all three components of the COM-B model and seven TDF domains. Psychological capability barriers included challenges in changing players’ dietary behaviours. Reflective motivation was hindered by doubts regarding the scientific basis of carbohydrate and body composition guidelines, alongside concerns over players’ ability to practically adhere to carbohydrate recommendations. Physical and social opportunity barriers involved restricted time and support for ongoing personal and professional development. Practitioners desired greater autonomy over the nutrition service, which was either enabled or constrained by the club’ social environment. As an enabler, female practitioners’ strong interpersonal skills (psychological capability) supported implementation; however, they also faced gender-related challenges navigating male predominate environments, making the social opportunity for implementation more complex. Conclusion Implementing nutrition guidelines in elite football is challenging. Overcoming barriers-by boosting practitioner confidence, belief in guidelines, professional development support, and autonomy-is key to improving uptake of UEFA recommendations and enhancing player dietary adherence in the English Premier League.

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.

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).

Research has identified psychological skills and characteristics (PSCs) perceived to facilitate talented youth athletes’ development. However, no systematic categorization or synthesis of these PSCs exists to date. To provide such synthesis, this systematic review aimed to identify PSCs perceived as facilitative of talented youth athletes’ development, group and label synonymous PSCs, and categorize PSCs based on definitions established by Dohme, Backhouse, Piggott, and Morgan (2017). PRISMA systematic-review guidelines were employed and a comprehensive literature search of SPORTDiscus, PsycINFO, PsycARTICLES, and ERIC completed in November 2017. Twenty-five empirical studies published between 2002 and 2017 met the inclusion criteria. Through thematic analysis, 19 PSCs were identified as facilitative of youth athletes’ development—8 were categorized as psychological skills (e.g., goal setting, social-support seeking, and self-talk) and 11 as psychological characteristics (e.g., self-confidence, focus, and motivation). The practical implications of these findings are discussed.

Athlete adherence to nutritional guidance is critical for optimal health and performance, yet little is known about the barriers and enablers to athletes’ dietary behaviours within high-performance sport. To advance understanding, we applied a theoretical lens derived from the Capability, Opportunity, Motivation–Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) to explore the qualitative accounts of sports nutritionists. Five focus groups comprising sports nutritionists working in Olympic and Paralympic sport (n = 14), professional sport (n = 6), or both (n = 6) were undertaken. Thematic analysis was conducted and the interpretations of the findings were guided by COM-B and the TDF. To achieve nutritional adherence, the behavioural analysis identified the need to intervene across all three COM-B components and at least five associated TDF domains (e.g., decision-making processes, reinforcement, social influences, behavioural regulation and environmental context and resource). For the first time, the findings illustrate the complex interplay of the training setting with the capabilities, opportunities, and motivation of the practitioners, athletes and coaches. By applying established behavioural science theories to sports nutrition, the foundations for the development of targeted and multifaceted behavioural interventions addressing athlete dietary adherence in high-performance sport have been laid.

Background Adolescent male academy footballers often fail to meet nutritional recommendations, placing them at increased risk of compromised growth, health, and performance. Guided by the Behaviour Change Wheel, this study aimed to select and specify dietary behaviours to underpin a sport nutrition service within an English Football League Championship academy. Two Nominal Group Technique (NGT) workshops (mean duration = 2 h 20 min) were conducted with four experienced sport nutritionists, three of whom were currently employed at the club, and one recently employed. Participants generated, ranked, and refined behaviours through structured group discussion, and a follow-up questionnaire. Audio data were descriptively analysed to provide contextual insight into behaviour selection and prioritisation. Results Twenty-four behaviours were generated, from which a prioritised top 10 were identified. The three highest-ranked behaviours were: (1) consuming ≥ 3 main meals (≥ 900 kcal or 13 kcal·kg⁻¹) and 2 snacks daily (≥ 350 kcal or 5 kcal·kg⁻¹); (2) consuming ≥ 3 carbohydrate portions (40–50 g or 0.5–0.75 g·kg⁻¹) per main meal, and ≥ 1 per snack; and (3) consuming a protein portion (25–30 g or 0.4 g·kg⁻¹) at ≥ 4 eating occasions daily. Collectively, these behaviours formed the “meal frequency and portion size guidance.” Additional behaviours ranked within the top 10 included fruit and vegetable intake, attendance at club-provided meals, hydration practices, and cooking from the club recipe app. Practitioners reported challenges conceptualising behaviours, often defaulting to macronutrient prescriptions, and found prioritisation difficult given the number of valuable behaviours identified. Nonetheless, the iterative NGT process facilitated consensus and provided actionable, evidence-based nutritional guidance. Conclusion This study demonstrates the suitability of the NGT for co-producing and prioritising dietary behaviours in male academy footballers. The approach effectively structured practitioner insights to identify priority areas for sport nutrition service delivery. However, the time-intensive nature of the behavioural analysis highlights the need for greater behavioural science capability within sport nutrition practice. Defining what athletes should do, rather than just focusing solely on nutrient-based prescriptions, is essential for designing effective, theory-informed behavioural interventions. These findings provide a foundation for designing targeted interventions to support the health, wellbeing, and performance of male academy footballers.

OBJECTIVES: Full-contact football-code team sports offer a unique environment for illness risk. During training and match-play, players are exposed to high-intensity collisions which may result in skin-on-skin abrasions and transfer of bodily fluids. Understanding the incidence of all illnesses and infections and what impact they cause to time-loss from training and competition is important to improve athlete care within these sports. This review aimed to systematically report, quantify and compare the type, incidence, prevalence and count of illnesses across full-contact football-code team sports. DESIGN/METHODS: A systematic search of Cochrane Library, MEDLINE, SPORTDiscus, PsycINFO and CINAHL electronic databases was performed from inception to October 2019; keywords relating to illness, athletes and epidemiology were used. Studies were excluded if they did not quantify illness or infection, involve elite athletes, investigate full-contact football-code sports or were review articles. RESULTS: Twenty-eight studies met the eligibility criteria. Five different football-codes were reported: American football (n=10), Australian rules football (n=3), rugby league (n=2), rugby sevens (n=3) and rugby union (n=9). One multi-sport study included both American football and rugby union. Full-contact football-code athletes are most commonly affected by respiratory system illnesses. There is a distinct lack of consensus of illness monitoring methodology. CONCLUSIONS: Full-contact football-code team sport athletes are most commonly affected by respiratory system illnesses. Due to various monitoring methodologies, illness incidence could only be compared between studies that used matching incidence exposure measures. High-quality illness surveillance data collection is an essential component to undertake effective and targeted illness prevention in athletes.

The purpose of this study was to quantify the total energy expenditure (TEE) of international female rugby union players. Fifteen players were assessed over 14-days throughout an international multi-game tournament, which represented two consecutive one-match microcycles. Resting metabolic rate (RMR) and TEE were assessed by indirect calorimetry and doubly labelled water, respectively. Physical activity level (PAL) was estimated (TEE:RMR). Mean RMR, TEE, and PAL were 6.60 ± 0.93 MJ.day-1, 13.51 ± 2.28 MJ.day-1 and 2.0 ± 0.3 AU, respectively. There was no difference in TEE (13.74 ± 2.31 vs. 13.92 ± 2.10 MJ.day-1; p = 0.754), or PAL (2.06 ± 0.26 AU vs. 2.09 ± 0.23 AU; p = 0.735) across microcycles, despite substantial decreases in training load (total distance: -8088 m, collisions: -20 n, training duration: -252 min). After correcting for body composition, there was no difference in TEE (13.80 ± 1.74 vs. 13.16 ± 1.97 adj. MJ.day-1, p = 0.190), RMR (6.49 ± 0.81 vs. 6.73 ± 0.83 adj. MJ.day-1, p = 0.633) or PAL (2.15 ± 0.14 vs 1.87 ± 0.26 AU, p = 0.090) between forwards and backs. For an injured participant (n = 1), TEE reduced by 1.7 MJ.day-1 from pre-injury. For participants with illness (n = 3), TEE was similar to pre-illness (+0.49 MJ.day-1). The energy requirements of international female rugby players were consistent across one-match microcycles. Forwards and backs had similar adjusted energy requirements. These findings are critical to inform the dietary guidance provided to female rugby players.

Objective Within women’s rugby league (n=12 teams), we (1) identified modifiers for head-to-head contacts informed by sport partners (eg, players, coaches, match officials); (2) compared head-to-head contact and concussion rates to the previous two seasons following a one-season tackle technique coaching intervention and (3) explored barriers and enablers of the intervention. Methods A multi-method design was used. Part 1: Mitigation strategies were identified by sport partners reviewing footage of head-to-head contacts, informing the development of a coach-targeted tackle technique intervention. Part 2 evaluated the intervention, comparing head-to-head contact and concussion incidence rates (IRs). Interviews with coaches and players (n=6) explored barriers and enablers to effective implementation and compliance with the intervention. Results Sport partners reported tacklers were more responsible for head-to-head contacts and lowering the tackle height was the most frequently suggested mitigation strategy preintervention and postintervention. Head-to-head contact rates were significantly lower during the intervention than preintervention (IR 59; 95% CI 56 to 62 vs IR 28; 95% CI 25 to 30/1000 tackle events); however, concussion rates showed no difference. Perceived barriers to the intervention included underdeveloped physical and technical foundations of players, lack of knowledge and understanding of the intervention and its purpose, and the environmental context and lack of resources in women’s rugby league. Beliefs about the consequences of the tackle and concussion were perceived as barriers and enablers. Conclusions Head-to-head contact rates were significantly lower; however, concussion rates did not decrease following a tackle technique coaching intervention. Reduced head-to-head contacts are potentially due to an increased focus on head injury reduction and increased player/coach awareness and support.

To establish the criterion-assessed energy and fluid requirements of female netball players, 13 adult players from a senior Netball Super League squad were assessed over 14 days in a cross-sectional design, representing a two- and one-match microcycle, respectively. Total energy expenditure (TEE) and water turnover (WT) were measured by doubly labeled water. Resting and activity energy expenditure were measured by indirect calorimetry and Actiheart, respectively. Mean 14-day TEE was 13.46 ± 1.20 MJ day−1 (95% CI, 12.63–14.39 MJ day−1). Resting energy expenditure was 6.53 ± 0.60 MJ day−1 (95% CI, 6.17–6.89 MJ day−1). Physical activity level was 2.07 ± 0.19 arbitrary units (AU) (95% CI, 1.95–2.18 AU). Mean WT was 4.1 ± 0.9 L day−1 (95% CI, 3.6–4.7 L day−1). Match days led to significantly greater TEE than training (+2.85 ± 0.70 MJ day−1; 95% CI, +1.00– +4.70 MJ day−1; p = 0.002) and rest (+4.85 ± 0.70 MJ day−1; 95% CI, +3.13–+6.56 MJ day−1; p < 0.001) days. Matches led to significantly greater energy expenditure (+1.85 ± 1.27 MJ; 95% CI, +0.95–+2.76 MJ day−1; p = 0.001) than court-based training sessions. There was no significant difference in TEE (+0.03 ± 0.35 MJ day−1; 95% CI, −0.74–+0.80 MJ day−1; p = 0.936) across weeks. Calibrated Actiheart 5 monitors underestimated TEE (−1.92 ± 1.21 MJ day−1). Energy and fluid turnover were greatest on match days, followed by training and rest days, with no difference across weeks. This study provides criterion-assessed energy and fluid requirements to inform dietary guidance for female netball players.