A Qualitative Investigation of Athletes’ Views on Clean Sport

Background. Doping is a real problem in sport and continues to be one of the most controversial topics, despite significant advancements in doping prevention. Lack of knowledge of the anti-doping regulations is one of the risk factors for doping. Currently, anti-doping education is focused on clean sport promotion. Therefore, the aim of this study is to explore the views on clean sport and doping prevention among athletes from various sports. Methods. A qualitative approach was used to examine athletes’ views on clean sport. Following a purposeful sampling technique, we interviewed eight men and one woman (Mage = 24.00, SD = 2.73 years) who were compet - ing in various sports at the national level or above in Lithuania. Reflexive thematic analysis was used to analyse the data. Results. Analysis of interview data allowed to distinguish the following three broad themes related to athletes’ views on doping education and recommendations for improving it. The research participants shared their thoughts about the concept of clean sport, possible reasons that may encourage athletes to compete in sport clean, and dis - cussed clean sport education. Conclusion. Clean sport can be understood as cheating-free sport. Possible reasons to compete clean in sport are unwillingness to experience shame and fear of damaging health. Athletes believe that current doping prevention is ineffective. Our findings show the importance of clean sport education for young athletes, however, adult education about clean sport could be more difficult.


INTRODUCTION
T he World Anti-Doping Agency (WADA) tries to create a doping-free sport world with the help of anti-doping education.However, doping still poses a problem in sport and continues to be one of the most controversial topics, despite significant advancements in doping prevention (Boardley et al. 2021).Doping is said to pose a danger to athletes' health (Adami, et al. 2022) and welfare as well as to the integrity of sport (Backhouse, Griffiths, & McKenna, 2018).Up to 57% of athletes participate in doping, so the prevalence of doping is quite high (Ulrich et al., 2018).Lack of knowledge of the anti-doping regulations is one of the risk factors for doping (Chan et al., 2016).Research has revealed that athletes have poor knowledge of doping (Hallward & Duncan, 2019).Therefore, an increase in knowledge of the anti-doping rules could reduce the risk of athletes doping.In recent years, various sports organisations, such as WADA (2021), and researchers have paid attention to the concept of clean sport (Petróczi & Boardley, 2022).
Currently, anti-doping education is focused on clean sport promotion (WADA, 2021).Clean sport does not include the use of illegal substances or forbidden methods.In other words, it can be understood as cheating-free sport (Petróczi et al., 2021).Clean athletes obey the rules and their performance and success are purely determined by both natural talent and effort.Doping is but one example of rule-breaking under this definition of "clean sport", which includes all types of cheating (Petróczi & Boardley, 2022).It means that cheating in sport can be understood in a broader sense, not only as doping use (Petróczi et al., 2021;Šukys et al., 2019;).Clean sport is also associated with moral values (Mortimer et al. 2021).Mortimer et al. (2021) research findings highlighted that athletes' decision to compete clean in sport is based on morality, and, for this reason, moral values are essential for clean sport.It was found that five spirits of sport values were related to clean sport likelihood, such as ethics/fair play/honesty, respect for rules/laws, dedication/commitment, teamwork, and community/ solidarity.Moreover, moral and competence sport values had a direct effect on clean sport likelihood.Woolway et al. (2021) examined relationships between general values, Spirit of Sport values, and the importance of clean sport, and how these differ across five European countries.Study results found positive correlations between the perceived importance of clean sport and honesty and ethics and respecting the rules of sport.In addition, significant differences between athletes' nationality and their perceived importance of clean sport were also found, which allowed the authors to conclude that anti-doping education programs should consider athletes' different value-priorities across countries.Some anti-doping programmes were developed to spread the word about clean sport, such as UK Athletics' Clean Sport programme, which proved successful in preventing unintentional doping up to three months later.The programme was effective in eliminating unintentional doping in athletes, but the results showed that it was not successful in preventing intentional doping in the long term (Hurst, Ring, & Kavussanu, 2020).Therefore, it is necessary to continue looking for ways to effectively educate athletes about anti-doping.In order to better reveal the importance of clean sport in the prevention of anti-doping, several qualitative scientific studies were conducted on this topic.Shelley, Thrower, and Petroczi (2021) revealed that anti-doping policies are not applied evenly in every country and are not currently successful at preventing doping.Therefore, doping is seen as a serious problem in sport.In a secondary analysis using a large group of elite athletes from five different European countries, Martinelli et al. (2023) demonstrated that clean athletes are nonetheless negatively harmed by doping in various ways, even when they are not directly defrauded of opportunities and medals by cheaters.
Although possible reasons for doping in sport has attracted attention from many researchers (e.g., Morente-Sanchez & Zabala, 2013;Ntoumanis et al., 2014;Ring & Hurst, 2019;Ring, Kavussanu, & Mazanov, 2019), there is still a lack of knowledge about clean sport and doping education, especially qualitative research that would investigate this issue in depth.Therefore, the purpose of the current study is to explore the views on clean sport and doping prevention among athletes from various sports in Lithuania.

Study design.
A qualitative approach was used because the study questions were exploratory in nature.According to Creswell and Creswell (2017), qualitative research is a method for examining and comprehending the meaning that individuals or groups assign to social or human situations.With the help of this method, it was possible to have indepth and varied interviews with the participants and delve deeply into their perspectives on clean sport and doping prevention.
Participants and procedures.In the current research, eight athletes (Male = 7, Female = 1) were interviewed upon approval from the university research ethics board.Athletes were eligible if they were older than 18 years of age and had competed in any sports at national level or above in Lithuania.In order to collect a variety of viewpoints and opinions, a deliberate attempt was made to recruit a varied sample of participants from various sports and athletic backgrounds.The athletes were recruited from various sports, such as fitness (n = 1), football (n = 1), basketball (n = 2), sailing (n = 1), karate (n = 1), bodybuilding (n = 1), and swimming (n = 1).Participants were between 20 and 28 years old (M age = 24.00,SD = 2.73 years) and had been active in the chosen sport from 7 to 17 years (M experience = 11.25,SD = 3.62 years).
Data Collection.To learn more about athletes' views on clean sport and doping education, semi-structured one-on-one interviews were conducted.Doping itself is a difficult subject that has a stigma; thus, athletes may not have felt comfortable talking about subjects related to doping.Nevertheless, the interviewer had to create a comfortable environment for the athletes in order to discuss their views on clean sport and doping education.The first author conducted each interview at a time that worked best for the athletes.The athletes gave their consent for the interview to be recorded after being guaranteed that all responses would be kept anonymous.
"Can you start by telling me a history of your sports career?" was the opening question of the interview, which was meant to get to know the athletes and their athletic backgrounds.The interview guide was developed by both authors of this study and included questions to explore the athletes' views on clean sport and doping education., such as: "Have you ever wondered what clean sport means in general?What is clean sport for you?
In your opinion, what are the reasons that encourage athletes to compete clean in sport?"A pilot study is recommended for any type of research, with no exception of qualitative interviews (Thomas et al., 2023).Hereby, first, pilot study was conducted with two athletes that helped to ensure that interview questions are meaningful and clear to the athletes.The main study was conducted with athletes from various sports clubs from Lithuania.Each interview lasted between 45 minutes and 1 hour and 15 minutes.Participants verbally consented to give the interviews and to be recorded over the phone.Also, important questions and observations were recorded in notes.
Data Analysis.Reflexive thematic analysis was used to analyse the data; it was chosen expressly for its emphasis on the subjectivity of the researcher and its deliberate interaction with the data during interpretation (Braun & Clarke, 2019).To increase familiarity with the material, the transcripts were first read and reread while listening to the audio recordings.In regard to the research questions, notes and interesting points were made and recorded.The information was then organised into themes.Finally, pertinent quotations were chosen to illustrate each theme, and the results section was written using those.
Quality Criteria.The evaluative criteria of this study were impact, coherence, credibility, and transparency (Smith & Caddick, 2012).Coherence was attained by thematic analysis of the transcripts, which took into account information from all of the athletes and produced themes that synthesised their different views.Exact verbal quotes from interviews were used in the text to ensure credibility.The more experienced author served as a "critical friend" to confront and question data gathering, assumptions and interpretations of the data, ensuring transparency.By identifying themes with significance for future study and practical actions that may be taken to build and create new doping prevention programs, impact was achieved.
It was important to provide a more diverse approach to the topic of clean sport and to share the varied views of athletes, therefore athletes of different ages, both male and female, participating in various sports (team and individual), were included in the study.In addition, the research participants were informed that there are no correct answers and that they should feel free and unrestrained to share their opinions.

RESULTS
Three concepts were identified following the analysis.Within the concept of clean sport, six themes were included (without doping, according to the rules, no match-fixing, fair play, honesty, moral).Three themes emerged by describing reasons to compete clean in sport (shame, health, honesty).Clean sport education included six themes (coach education, media, young athletes' education, adult athletes' education, state, school).

The concept of clean sport. When examin-
ing the concept of clean sport, first of all, research participants shared their thoughts on how they understand the meaning of words "clean sport".Some of the participants mentioned the concept of dirty sport in relation to clean sport.Dirty sport was associated with immorality.
" Research participants discussed that honesty is a part of clean sport: "Athletes compete cleanly when they don't dope and behave honestly" (Participant 7).Also, morality was associated with clean sport, in other words, clean sport was described as "moral and not associated with cheating" (Participant 5).
Thus, from the information obtained from the research participants about the concept of clean sport, it can be seen that athletes associate clean sport with honesty, morality, non-doping, absence of match-fixing, fair play and following sport rules.In contrast, dirty sport is associated with immorality.
Reasons to compete clean in sport.After clarifying what is a clean sport, the participants discussed possible reasons for competing in sport clean.When examining the possible reasons that would lead to an athlete's decision to compete in sports clean, the most frequently mentioned answers in the interviews were shame, honesty and health.
The research participants shared their thoughts that the unwillingness to experience shame can stop athletes from using doping and encourage them to compete clean: "the unwillingness to experience shame of having used and being banned from sport (Participant 7)".Research participants shared their opinions that the unwillingness to harm their health encourages athletes to compete in sports clean.The participants said that athletes do not use doping and thus choose clean sport because "they don't want to damage their health..." (Participant 6).Participants also mentioned honesty as an important reason to encourage athletes to not cheat and compete in a clean way.Research participants said that athletes "want to remain honest" (Participant 6).
Clean sport education.Research participants shared their thoughts on who should take the initiative of clean sport education.Most believed that the role of coach in clean sport education is very important.The influence of media on education was also discussed.Also, participants shared some thoughts about differences in clean sport education between young and adult athletes.
The participants thought that coach has a greatest effect on athletes' education on clean sport, therefore coach should take the lead in educating athlete."I think the role of the coach is the most important.Society also...But the coach is the most important."(Participant 5).Also, participants believed that media could help to educate athletes on clean sport by advertisements."The media could advertise more, but the question is whether it would affect the athletes..." (Participant 5).
The participants of the study believed that it is necessary to educate young athletes on clean sport topic, stating that such athletes have the greatest possibility to change future sport.
"...it is important because young athletes are a new generation and if some changes are desired, it must start with the young generation, so it is necessary to explain to them that doping is not good" (Participant 7).
The participants reasoned that it is important to show young athletes the clean way in sport so that they could understand the health consequences.They said that education is "important so that he [athlete] does not choose a wrong way.In order to protect his health" (Participant 6).
However, when discussing about adult education, the opinions of participants differed.Some participants stated that there is a need to educate adult athletes because adult athletes may one day be coaches who will pass on their knowledge to younger generations and become role models for the athletes.
"That athlete, maybe, will be a coach after his career, so he will already know everything and will pass on information to others" (Participant 2).Other respondents were of the opinion that it is too late to educate adult athletes about clean sport because their personalities have already been formed and their opinion about doping will no longer change.
"...when a human has already formed personality...I think it's hard to get bad things out of him and usually athletes who are caught doping, they continue to use doping anyway, so it would be more difficult for older people to explain that" (Participant 4).Thus, from the reflections of the research participants, it can be seen that education about clean sport is necessary, especially for young athletes.All participants believed that young athletes should be educated on clean sport, however they disagreed about the education of adult athletes, as some of the participants believed that adult athletes have already formed personalities and their opinion about doping is difficult to change.When considering who should be involved in clean sport education, both coach and media were mentioned.
Research participants shared their thoughts on possible doping prevention and discussed who should take the initiative to make doping prevention more effective in order to stop the spread of doping use.The following were distinguished: state, school, sports organisations and anti-doping organisations.After sharing their thoughts about existing doping prevention programs in the country, participants' opinions on doping prevention differed.Some of participants believed that prevention is sufficient and effective, as this is shown by the statistics of doping prevalence and clearly indicated penalties for anti-doping rules violations.
" However, other participants believed that doping prevention is not effective enough.They based their opinion on the fact that doping is a persistent problem in sports, therefore the anti-doping prevention should be improved more.
"I don't think that the prevention of doping is sufficient at the moment... Doping exists.Doping in sport has not disappeared anywhere..." (Participant 6) When sharing their thoughts on who should take action so that athletes could learn more about the harm of doping, the participants said that the involvement of the state is important: "I think there should be education at the state level" (Participant 5).Schools were also mentioned in the interviews, and it was stated that because athletes get to know the concepts of doping at a very young age, the prevention should also take place at very young age: "I think schools should already talk about doping to children.Because often athletes start playing sports as children... or teenagers.I think...I think we should talk about doping when they're young" (Participant 6).According to the majority of participants, the current prevention activities of anti-doping organisations are insufficient.

DISCUSSION
The aim of this study was to better understand how athletes comprehend the concept of clean sport, what possible reasons could encourage athletes to compete in sport clean, and their perceptions of clean sport education.
The research revealed that athletes understand clean sport as not only a sport without doping but also as a sport without cheating in a broader sense.In other words, no match-fixing, rule-breaking and opponent-threatening. Athletes compared clean sport to fair play.It means that athletes do not differentiate doping from other forms of cheating.This is in line with previous research by Petróczi et al. (2021) and Šukys et al. (2019), where doping represents just one form of cheating.
Furthermore, athletes perceived clean sport as a moral sport, where honesty is an important value.Similarly, Mortimer et al. (2021) conducted research where clean sport likelihood was positively predicted by sport values, such as honesty.
Our findings highlight that possible reasons to compete clean in sport are unwillingness to experience shame and fear of damaging health.Indeed, according to other research, doping is anticipated to lead to feelings of shame and guilt (Erickson et al., 2015).Also, it is not surprising that athletes felt fear of harming their health when using doping.The potential health damage by using doping has been revealed by many studies (e.g., Adami, et al. 2022).
Our study revealed interesting findings that athletes believe in the importance of clean sport education, especially in young athletes, however, they thought that it is ineffective to educate adult athletes about anti-doping.It must be noted that Hoberman (2013) has expressed scepticism about the effectiveness of moral messages with adult athletes, nevertheless, it might still be important for clean sport education.
Finally, according to the study, athletes stated that the current prevention of doping is insufficient.Athletes feel the prevalence of doping in sports and it affects them.It may be argued that anti-doping prevention is believed to be insufficient because most anti-doping programs have been shown to be effective only in the short-term, e.g., Clean Sport programme (Hurst, Ring, & Kavussanu, 2020).
This study revealed interesting views on clean sport from athletes' perspective.However, at the same time, this study is not without limitations.Since the beginning of the interviews, quite a few athletes have associated the questions with doping.And when expressing opinions about doping, athletes are not always very inclined to speak openly, even if they are guaranteed anonymity.This study did not delve into the athletes' personal experiences with doping.Therefore, when continuing such research, it would be relevant to examine deeply how clean sport is perceived by athletes who have used or are currently using doping.

CONCLUSIONS
Our research concluded that clean sport can be understood as a cheating-free sport, where doping represents just one form of cheating.Possible reasons to compete clean in sport are unwillingness to experience shame and fear of damaging health.Our findings highlight the importance of clean sport education, specifically in young athletes, however, adult clean sport education can be problematic.Furthermore, athletes believe that current doping prevention is ineffective.