Tackling doping in sport : a call to take action on the dopogenic environment

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)

Co-creating a social science research agenda for clean sport : an international Delphi study

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

"The ripples are big": Storying the impact of doping in sport beyond the sanctioned athlete

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

A call for policy guidance on psychometric testing in doping control in sport.

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

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Comfort in big numbers: does over-estimation of doping prevalence in others indicate self-involvement?

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

The influence of water ingestion during prolonged exercise on affect

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