Walking the line? An investigation into elite athletes' sport-related use of painkillers and their willingness to use analgesics to train or compete when injured

Pain and injuries are inevitable occupational hazards and health risks in athletes’ working lives. The sport-related use of analgesics with and without injury is widespread. Taking analgesics to compete while injured is conceptualised as a sickness-presenteeism problem. This study examines the complexity of the sport-related use of analgesics in elite sport. A mixed-method design was adopted consisting of a survey (n=775) and interviews (n=21) with elite athletes. Many athletes reported a sport-related use of analgesics. Analgesics had commonly been used to enable an injured athlete to: compete in an important match; train during an important period; qualify for an important match/final; and keep one’s position on the team or have one’s contract prolonged. Particularly team-sport athletes had experience of such use. Apart from the therapeutic use of analgesics, they were sometimes integrated into different routines, for example enhancing performance, avoid lowering performance, aiding recovery, training/competing injured, and prophylactic use. Simultaneously, many had refrained from using or sought to minimise their sport-related use of analgesics; reasons were related to: trust in/feeling the body, side-effects, knowledge and social norms. Social norms and interaction with support personnel played a key role. Physiotherapists and doctors often advised athletes on analgesics, but self-administered use was widespread. How risk cultures manifested themselves varied greatly between sports, and gender differences were scarce. Although, ‘absenteeism’ is also present a majority of athletes would be willing to ‘walk the line’, using analgesics to compete when injuries may threaten their career or sporting success

An (un)desirable trade of harms? How elite athletes might react to medically supervised 'doping' and their considerations of side-effects in this situation

Background The zero-tolerance approach to doping in sport has long been criticised. Legalising ‘doping’ under medical supervision has been proposed as a better way of protecting both athletes’ health and fair competition. This paper investigates how elite athletes might react if specific doping substances were permitted under medical supervision and explore athletes’ considerations about side-effects in this situation. The results are interpreted using a framework, which views elite sport as an exceptional and risky working environment.  Methods 775 elite athletes (mean age: 21.73, SD=5.52) representing forty sports completed a web-based questionnaire (response rate: 51%) presenting a scenario of legalised, medically supervised ‘doping’.  Results 58% of athletes reported an interest in one or more of the 13 proposed substances/methods. Athletes’ interest in a specific product was linked to its capacity to enhance performance levels in the athletes’ particular sport and depended on gender and age. 23% showed interest in either one or more of erythropoietin (EPO), anabolic-androgenic steroids (AAS), blood transfusions and/or Growth Hormone if permitted and provided under qualified medical supervision. Male speed and power sports athletes of increasing age had the highest likelihood of being interested in AAS (41%, age 36), female motor-skill sports athletes had the lowest (< 1%, age 16). 59% feared side-effects. This fear kept 39% of all athletes from being interested in specific substances/methods whereas 18% declared their interest despite fearing the side-effects. Conclusion Interpreting results with the understanding of sport as an exceptional and risky working environment suggests that legalising certain 'doping' substances under medical supervision would create other/new types of harms, and this 'trade-off of harms and benefits' would be undesirable considering the occupational health, working conditions and well-being of most athletes. Assessing the risks and harms produced/reduced by specific drugs when considering sport as a precarious occupation may prove useful in composing the Prohibited List and reducing drug-related harm in sport

Momentum lost or creating new constellations? Insights from an exercise-at-work project during the Covid-19 pandemic - a mixed methods approach

Exercise-at-work programmes have been identified as venues to decrease inequalities in physical activity and exercise between socioeconomic groups and to improve employees' health and wellbeing. Drawing on a multiple institutional logics perspective and adopting a mixed-methods approach, this paper investigates how employees, exercise-ambassadors and managers at five Danish workplaces experience Covid-19 induced changes to a 1-year exercise-at-work project, and how these changes impacted upon the workplace. Our results suggest that Covid-19 and the altered format of exercise and delivery polarized employees' opportunities for exercise at work. However, the generally positive experiences of exercise-at-work activities and their influence on social environment and collaboration (identified prior to Covid-19 lockdown) remained among those employees who continued with activities. Self-organized adaptions and models of employee exercise which emerged suggest that community logic endured despite the crisis. We show how Covid-19 induced organizational changes led to interplays between institutional logics, with family and state logics becoming more prominent. Specifically, the exercise-at-work programme changed from an aligned model, with complementary logics and minimal conflict, to a model where logics of profession and corporation became dominant at the expense of community logic (exercise-ambassadors activities), but constrained by a state and a family logic

Sponsor networks and business relations orchestrated by team sport clubs

Purpose  This study investigates firms’ reasons and motives for becoming sponsors and how they benefit from this networking engagement by exploring sponsorship networks associated with two Danish team sport clubs – a Premier League football club and a second-division handball club.  Design/methodology/approach  Two online surveys were conducted with firms associated with the networks during the autumn and winter of 2013/14 (N=116). The questionnaire was theoretically anchored in existing sponsorship literature, business network research and social capital theory.  Findings  The results show that business logics were the dominating reasons for joining the network. A large proportion of the respondents reported having increased their number of business (32%) and social (26%) relations with other network members after joining the network. Furthermore, 37% of the respondents reported having made business agreements with companies external to the network via network contacts, which supports ideas of bridging social capital. More than half the respondents (59%) preferred doing business with network members rather than with non-members.  Originality/value  By investigating a local and regional sport-club context, the paper adds to our knowledge about sponsorship networks. It emphasizes the potential importance of team sport clubs for the business landscape, thus maintaining that sport clubs fulfill an important role for local communities beyond being mere entertainment industries

Results from a survey with volunteers at the European Kortbane Championships in swimming in Herning 2013

This study is part of a larger project: the Event Based Innovation Project (EVINN). The project is funded by the EU. The study is part of the project "Event Organisation". The goal is to optimize the organization of sports events. The project is a collaboration between researchers from the University of Gothenburg, Oslo Idrettshojskole (NIH), Aarhus University and the University of Southern Denmark. In each country the volunteers' experiences were examined at a width event and an elite event.The results from this study will be compared with results from Gothenburg Varget 2013 and a similar race in Norway, as well as results from three elite events respectively: Norway, Sweden and Denmark. In Denmark volunteers involved in the organization of Aarhus City Half Marathon 9th. June 2013 were also examined. In the longer term, the study results lead to one or more peer-reviewed articles and a handbook. The results can be beneficial to the organizers of the EAM in swimming (Herning Municipality, Sport Event Denmark and the Danish Swimming Federation) and others who organize similar major events that requires many volunteers

Resultater fra en spørgeskemaundersøgelse med frivillige hjælpere ved Europæiske Kortbane Mesterskaber i svømning i Herning 2013

This study is part of a larger project: the Event Based Innovation Project (EVINN). The project is funded by the EU. The study is part of the project "Event Organisation". The goal is to optimize the organization of sports events. The project is a collaboration between researchers from the University of Gothenburg, Oslo Idrettshojskole (NIH), Aarhus University and the University of Southern Denmark. In each country the volunteers' experiences were examined at a width event and an elite event.The results from this study will be compared with results from Gothenburg Varget 2013 and a similar race in Norway, as well as results from three elite events respectively: Norway, Sweden and Denmark. In Denmark volunteers involved in the organization of Aarhus City Half Marathon 9th. June 2013 were also examined. In the longer term, the study results lead to one or more peer-reviewed articles and a handbook. The results can be beneficial to the organizers of the EAM in swimming (Herning Municipality, Sport Event Denmark and the Danish Swimming Federation) and others who organize similar major events that requires many volunteers

An evaluation of prevention initiatives by 53 National Anti-Doping Organizations: Achievements and Limitations

Background One main purpose of the World Anti-Doping Agency is to harmonize anti-doping efforts, including the provision of anti-doping education. A multifaceted approach to doping prevention can play a key role in preventing intentional and unintentional doping. This article aims to systematically record and evaluate doping prevention approaches in the form of information and education activities of national anti-doping organizations (NADOs) and assess the extent to which a multifaceted doping prevention approach has been realized. Methods Data on anti-doping information and education activities of 53 NADOs were collected via a survey and an online search of the NADOs’ websites. Prevention activities were classified into knowledge focused, affective focused, social skills, life skills, and ethics and values based. The implementation of the prevention activities was assessed by 4 independent raters using a modified visual analogue scale. Results In total, 59% of the NADOs (n = 38) returned the survey and 70% (n = 45) had information available online. The data were combined for the visual analogue scale assessment. Overall, 58% of the NADOs (n = 37) reported offering activities including elements of all 5 approaches. Results of the raters’ assessments indicated that the knowledge-focused approach was best implemented; the implementation of the other 4 approaches was largely unsatisfactory. The most common barriers to implementing doping prevention programs reported by the NADOs were lack of resources (n = 26) and difficulties in collaborating with sports organizations (n = 8). Conclusion Results show a discrepancy between NADOs’ self-report data and the implementation assessment. Even though the NADOs indicated otherwise, most of their education-based approaches did not address aspects of the visual analogue scale (e.g., resisting peer pressure) and only a few programs were ongoing. Possible explanations might be found in the reported barriers (e.g., financial). Concrete guidelines defining multifaceted, values-based education, and best practice examples should be developed to indicate how to include all 5 approaches in prevention

GRADE IT : a literacy-based assessment tool for 'Generating Research-Based Assessment Data to Evidence the ImpacT of Anti-doping Education' via athletes' capability to make the right decision

The International Standard for Education (ISE) mandates Code Signatories to plan, deliver, and evaluate anti-doping education. Performance-based evaluation of anti-doping education requires alignment between educational goals, content, and defined outcomes. Based on an existentialist teaching and learning philosophy, we aimed to develop and test an anti-doping impact evaluation tool, to assess the impact of anti-doping education on doping awareness, literacy (DAL), perceived trust, and legitimacy. We propose that the impact of anti-doping education is best captured through assessment of situation-specific (social) cognitive mediators of actions that influence athletes' choices in the context of sport-related goals. In phase one, we aimed to develop and test the Generating Research-based Assessment Data to Evidence the ImpacT of anti-doping education (GRADE IT) evaluation tool that comprised a set of social cognitive components: anti-doping knowledge, DAL, perceived trust, and legitimacy of anti-doping (organizations). In phase two we assessed whether anti-doping education impacts knowledge, the three DAL stages (functional, interactive, and critical literacy), perceived trust and legitimacy. Phase one enrolled 986 junior elite athletes, and we showed that all GRADE IT components performed well. After revision of the tool for phase two, we validated the assumption that anti-doping education impacts the likelihood that athletes will make the “right” choice (based on a new set of data from 1,255 junior elite athletes). Comprehensive education was associated with higher scores for all stages of DAL, as well as perceived trust and legitimacy. Even athletes reporting no education had positive scores for all included outcomes, supporting the assumption that most athletes wish to engage in clean sport behaviors and might need anti-doping education not to prevent them from doping, but rather to reinforce their commitment to clean sport. In conclusion, GRADE IT, which is available in 23 languages, is a suitable tool for application to young, emerging athletes to satisfy the ISE requirement for evaluating anti-doping education programs. Researchers and practitioners alike are advised to collect additional data to further validate the tool for adult athletes, and to apply it longitudinally to identify if changes in doping prevention policies have a delayed effect on DAL, perceived trust, and legitimacy

Health promoting sports federations: theoretical foundations and guidelines

BackgroundResearchers and policy-makers have highlighted that the potential for organized sports to promote health has been underexploited. Sports clubs have limited capacity to promote health due to their voluntary nature and have called for support from their national sports federations. The present article provides guidelines, based on the theoretical principles of health promoting sports clubs and an analysis of practical tools and proven strategies, to support national sports federations to invest in health promotion (HP).MethodsA qualitative iterative study was undertaken, based on five 2-h meetings of a group of 15 international researchers in HP in sports clubs. Notes and minutes from meetings, as well as shared outputs were analyzed based on the health promoting sports club framework.ResultsGuidelines developed for national sports federations to promote health includes a definition of a health promoting sports federation (HPSF), a description of how the settings-based approach to HP adapts to national sports federations, as well as practical applications of health promoting sports club’s intervention strategies. The analysis of existing tools also demonstrated that most tools are centered on a single dimension of health (social, mental, physical, spiritual or community), and often on a specific health topic. Furthermore, they do not cover HP as a continuous long-lasting process, but are generally short-term programs. The HPSF clarifies theoretical concepts, their practical implementation via case studies and outlines intervention components and tools useful for sports federations in their implementation of HP.ConclusionThe guidelines developed in this study are intended to facilitate national sports federations to acknowledge/understand, reinforce/underpin and foster current and further investment in HP