Investigating anti-doping roles of athlete support personnel working with international disabled athletes in six European nations using the COM-B Model and Theoretical Domains Framework

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