The effects of permitted forms of performance enhancement on determinants of doping in UK student-athletes

Summary: 

Although non-prohibited forms of performance enhancement have the potential to facilitate doping, it may be possible to develop interventions that help undermine such effects. However, there is a lack of research investigating how interventions focused on educating athletes to enhance performance through non-prohibited means can most effectively be presented to deter progression to doping. This research qualitatively examined factors that may lead university athletes to consider doping, and how non-prohibited forms of performance enhancement can be presented most effectively as alternatives to doping.

There has also been a lack of research examining the effects of non-prohibited performance enhancement techniques on doping over time. To address this, we also examined which non-prohibited forms of performance enhancement were used by university athletes, and longitudinally investigated whether use of such approaches influenced changes in moral and functional doping attitudes. The overarching objective of the project was to answer the following research questions:
1. What non-prohibited forms of performance enhancement are commonly used by university athletes?
2. How can non-prohibited forms of performance enhancement be presented most effectively to portray them as alternatives to – rather than precursors for – doping?
3. What are the effects over time of using nutritional supplements, medications and performance enhancing technology on explicit functional and moral doping 
attitudes and automatic associations for doping in university athletes?
4. Does disparity between explicit functional and moral doping attitudes influence doping moral disengagement in university athletes over time?

Methodology

For the work package 1, data collection took place between March 2020 and March 2021 and included five focus groups (18 athletes) and 10 individual semi-structured interviews. The athletes were engaged in competitive sports at various British university. The sports represented were netball, rugby, basketball, triathlon, distance running. Interviews and focus groups were conducted remotely via zoom software due to the Covid-19 pandemic. Focus groups and interviews followed pre-determined schedules. The investigating issues included: (a) university athletes’ knowledge and use of non-prohibited (supplements, OTC medication, technology) and prohibited (i.e., doping) methods of performance enhancement, (b) the notion of a sliding scale of performance enhancement, (c) whether non-prohibited and prohibited forms of performance enhancement are ever assimilated with – or influence – one another, and (d) how non-prohibited means of performance enhancement can be presented to athletes so they are viewed as alternatives to – rather than prerequisites for – doping. 

The work package 2 involved longitudinal data collections with two separate samples of university athletes. Sample 1 contained 180 athletes while sample 2 contained 205. Both from various British university athletes.

Results

Data analysis for both the individual interviews and focus group interviews led to the identification of three overarching themes: (a) education and knowledge on diet, (b) factors influencing supplement use, and (c) gateway effects and intervention development.

Regarding  education and knowledge on diet, the university athletes had received a minimal amount of education on diet and nutrition, and in general their levels of knowledge in this area were low. With respect to factors influencing supplement use, these consisted of both sport (e.g., the competitive level of the athlete, peer influences, coach/personal trainer impacts) and non-sport (e.g., lack of education and knowledge on food preparation, financial considerations, social media, and influencers) factors. More specifically, university athletes were more likely to use supplements if they competed at higher levels, had peers, coaches, or personal trainers who promoted their use, were limited in their knowledge on how to prepare food, were exposed to social media influences promoting their use, or perceived supplements to be cheaper than real food.

Finally, in terms of gateway effects and intervention development, several university athletes believed supplement use increased university athletes’ chances of going on to use prohibited substances and methods.

Significance for Clean Sport

This mixed-methods project has (a) extended our knowledge on factors influencing university athletes’ performance enhancement practices, (b) provided insight from university athletes on gateway effects on doping and how to design interventions to strengthen athletes’ reasons not to dope, (c) established a quantitative evidence supporting a causal link between non-prohibited means of performance enhancement and doping attitudes, and (d) identified attitudinal profiles indicating athletes who may be most at risk of doping.