How the Iranian football coaches and players know about doping?
Doping is a phenomenon as old as the competitive sports (1, 2), although the public opinion considers doping as something modern (2). Doping in sport has been studied mainly from a biomedical point of view, even though psycho-social approaches are also key factors in the fight against doping (3, 4). Researchers in the biomedical field mostly focus on improving the detection methods, while experts in social sciences are trying to understand the psychological factors such as attitudes, environment and beliefs that can stop doping. Although the athletes' beliefs play important roles in their use of drugs, their unavailability makes it difficult to predict drug misuse and doping. World Anti-Doping Agency (WADA) promotes social, behavioral, and ethical research projects on drug misuse among athletes (3). Repeated, ongoing conversation with athletes and coaches can provide an improved understanding of the probability of doping behavior (5).These studies have been mostly conducted in Europe, Oceania and America (more than 92% of studies). Unfortunately, these studies are scarce in Asian countries, including Iran (3). Results of these limited studies are disappointing. According to a study on the high-level endurance walkers, they could mention just an average of 1.5 drugs of the list of prohibited doping drugs (6). Another research regarding health consequences of doping drugs demonstrated that only 20% of the Nigerian athletes were familiar to the side effects of anabolic steroids such as tendon injuries, acne or gynecomastia (7). In another study on French high school athletes, participants mentioned peers or health professionals as the main source of drug supply. Seven percent of them did not believe that doping is always a dangerous behavior (8). A study on 80 weight-lifters showed that the anabolic steroid users found physicians as no more reliable than their friends, internet sites, or the persons who sold them the steroids (7). In another project, 155 American athletes participating in winter games (1992) were investigated. In this study, 80% of Olympic athletes considered steroid use as a serious problem in sports and 43% of them estimated use of anabolic steroids to be more than 10% of participants (9). Football is acknowledged as the most popular sport discipline all around the world. The global organization of FIFA has united over 250 million football players in 207 countries (10). There are approximately 200000 elite players in football all over the world (11). Few studies have been conducted on doping knowledge, attitudes and behavior in football players (12), despite the need for more educational efforts to help football players in this matter. The lack of systematic or reliable data about the extent of drug use in professional football is evident today (13). Although the prevalence of doping in football seems to be decreasing, more rigorous collaboration and thorough investigation is needed on issues such as banned substances, detection methods and data collection worldwide. Banned and harmful substances are easily available and their use does not usually require a medical prescription (10). Unlimited quantities of drugs such as anabolic steroids can be effortlessly bought over the internet. Since the number of positive samples and cases of recreational drugs such as marijuana and cocaine has increased in the recent years, they have to be addressed closely (10). Another study on more than 1000 African amateur football players showed that more than half denied any kind of knowledge about the prohibited substances. Also, it was claimed by about 68 % of the players that they knew nothing about anabolic steroids. In this study, the players have reportedly vague knowledge of doping. The vague knowledge of doping has also been reported by researchers in other studies on high-level sportsmen (14). Another research study on the Asian under 23 football players focusing on awareness, knowledge and attitudes towards doping also verifies the limited knowledge of the players about prohibited substances and anti-doping bodies in football such as WADA or AFC anti-doping committee. These limited investigations give the readers the opportunity to gain an insight into the overall lack of knowledge and awareness of doping related matters among football players (15). Asia was the place where this type of survey in football was conducted for the first time. These kinds of studies need to be extended beyond the state, nation and continents since they can help and educate all the players as the main target population that can spread the message of anti-doping and Fair Play (16). As a consequence, need for more detailed investigation of athletes' knowledge and attitudes toward doping and its various fields seems mandatory. Existing findings verify the lack of proper knowledge in the field of doping among the football players (16). Collecting such informative data would be necessary and appropriate before taking any preventive measure. FIFA's anti-doping strategy relies mainly on education and prevention (14, 17). FIFA also recognizes that the education of players, coaches and medical personnel in contact with football players is likely to be even more essential in the fight against drugs in sport and creating a culture that recognizes that doping has no place in football (11).
So, the present study aimed to determine the Iranian football coaches and players' knowledge regarding the list of prohibited drugs and adverse effects of popular misused drugs. It also tries to assess their attitudes toward critical points of doping.
3. Patients and Methods
The study was performed as a cross-sectional survey. It was carried out in different cities of Iran selected by randomized clustered sampling method. The study was approved by Football Federation of Islamic Republic of Iran. The sample consisted of 375 participants (including 239 football players [63.7%] and 136 coaches [36.3%]) from all 6 geographically identified districts of Iran (Center, North, North West, North East, South West and South). On July 2011 to December 2012, all football coaches and players of selected teams were interviewed in place to ask for their participation in the survey. They received information about the study (the background of the project and project objectives, the possibility of refusing to answer specific questions, etc.) and a questionnaire was distributed. Participation in the study was voluntary and the subjects were free to withdraw from the study without any prejudicial consequences. Confidentiality and anonymity were ensured for the responders. The research team adapted the questionnaire from studies published elsewhere and included the national doping experts' opinion (18-20).
This questionnaire consists of 88 different questions. It is subdivided into:
1. Questions on definition of doping (10 items)
2. Questions on popular drugs (17 items)
3. Questions on side effects of anabolic steroids (15 Items)
4. Questions on attitude toward use of sport supplements (8 items)
5. Questions on attitude toward the best anti-doping strategy (12 items)
6. Questions on attitude toward the main rationale of sport authorities to combat against doping (7 items)
7. Questions on attitude toward the main consultants of athletes for drug misuse (10 items)
8. Questions on football coaches and players' estimates of where the athletes buy the banned drugs (9 items)
Validity and reliability of this questionnaire were tested beforehand with 30 subjects as a pilot study. To test internal consistency and test-retest reliability, we used Cronbach's alpha and Kappa coefficient of agreement, respectively and internal consistency (Cronbach's alpha = 0.72) and test-retest reliability (Range of Kappa coefficients of agreement for different subscales = 70-97%) of this questionnaire were regarded favorable. The questionnaires were processed, and the data collected were analyzed using the SPSS ver. 17 software. Quantitative variables are described as mean (standard deviation) and categorical variables are presented as frequency (percentage). Comparisons between players and coaches in quantitative and qualitative parameters were made by t test and Chi square, respectively. The significance threshold used was P < 0.05.
Table 1 shows the frequency of true answers to questions aimed to assess football coaches and players' knowledge in three fields of doping definitions, familiarity with banned drugs and side effects of anabolic steroids. Regarding doping definitions, power enhancement using special nutritional supplements were regarded as doping in about 40% of participants. On the subject of familiarity of football coaches and players with generic names of popular prohibited drugs, a few athletes knew amphetamines as doping agents. The frequency of true answers was a little higher in the case of corticosteroids and diuretics. Regarding side effects of anabolic steroids, football coaches and players were not so familiar with side effects of these drugs, especially tendon injuries and hyperlipidemia which football coaches and players selected as true answers only in 32.5% and 37.6% of cases, respectively. The frequency of true answers was slightly more in some other side effects such as aggression, alopecia, drug dependence, gynecomastia, infertility and acne. Level of participants' knowledge toward each field was categorized using sum score of true answers in each field (1 point for each true answer). These scores were presumed good, moderate and poor, if the calculated sum scores were more than 70%, 40-70% and less than 40%, respectively. Distribution of football coaches and players by their knowledge in three categories of doping definition, familiarity with drug names and side effects of anabolic steroids is presented in Table 2.
Accordingly, knowledge of football coaches and players in three categories of doping definitions, recognition of prohibited drugs and side effects was poor or moderate in 45.4%, 88.6% and 96.5% of cases, respectively. Table 3 illustrates the attitudes of football coaches and players toward different fields of doping, including supplement use and the best anti-doping strategy (multiple choice questions).Table 4 demonstrates the attitudes of football coaches and players toward different fields of doping, including the main rationale of sport authorities to combat against doping and the main consultants of athletes for drug misuse and where the athletes buy the banned drugs (Single choice questions).
Due to different methods and instruments used, it is not prudent to directly compare data from previous studies regarding knowledge of athletes about doping. Our study shows variable knowledge of Iranian football coaches and players in different categories of doping. Fortunately, overall knowledge of participants regarding doping definitions is good. More than 50% of participants were well familiar with doping definitions. Interestingly, the most frequent correct answer was tampering with doping sample collection. This may reflect the over-emphasis of public media on numerous cases of reported tampering in the country. Another interesting matter was that 25% of participants did not consider the presence of a prohibited substance in urine sample as doping. Also, more than 2/3 of participants knew that doping violation is not just related to the athletes and may involve physicians or coaches. When the knowledge level of Iranian football coaches and players was assessed in the field of drug names, more than one third of participants (37.3%) had poor knowledge. More than half (60%) of the participants declared lack of knowledge in this subject. The most common drugs that participants knew were cannabis (81.6%) and morphine (79.5%), respectively. It is in accordance with a similar study in which anabolic steroids and cannabis were substances that athletes had heard much about, compared with amphetamines and erythropoietin (14). Participants were not familiar enough with amphetamine (28.5%) and salbutamol syrup (42.4%) as prohibited drugs. Such inappropriate awareness of doping by high level sportsmen has been also reported in other studies (14). Almost 50% of participants did not regard corticosteroids as prohibited drugs. Since glucocorticosteroids are widely used in the management of sports related injuries, as well as in the disorders of the musculoskeletal system, it may result in some cases of doping among Iranian athletes (21). Also, approximately 50% of Iranian football coaches and players were not familiar with the generic name of nandrolone as a doping drug. Similarly, another study on wrestlers showed that more than 50% of wrestlers were not familiar with the names of anabolic steroids and popular generic drugs of this group such as testosterone and nandrolone (7). Although Creatine is one of the most popular supplements used to improve athletic performance (22), more than 60 percent of participants consider creatine as a doping drug. In other words, contrary to the classification of Australian Institute of Sport (AIS) in which creatine is categorized in the group A supplements with established evidence for legal performance enhancing performance, safety and efficacy (1), football players considered it as a doping agent, which demonstrates the lack of proper knowledge about supplements notwithstanding the high prevalence of anabolic steroid use which has been reported in the literature (23). The knowledge of participants about side effects of anabolic steroids was poor and more than 50% of participants were not familiar with side effects of anabolic steroids. It is comparable to the results of a similar study done on wrestlers, in which less than 30% of athletes knew the most common side effects and almost 40% did not have any idea about side effects (2). Also, in a prospective cross-sectional study, Tyrolean junior athletes aged between 14 and 19 years, the overall knowledge especially regarding side effects of prohibited substances were poor (24, 25). Only, 3.5% of participants had good knowledge regarding the side effects (more than 70% correct answers). Only near 1/3 of participants were familiar with tendon injuries and hyperlipidemia as the side effects of anabolic steroids (32.5% and 37.6%, respectively). Among all participants, only 48 participants (12.8%) were familiar with all definitions of doping and none were completely knowledgeable (full score) about the names of popular prohibited drugs and side effects of anabolic steroids. Interestingly, the knowledge scores of football players and coaches were better in comparison to free-style wrestlers in a similar knowledge and attitude study, which may reflect the results of continuous antidoping educational courses conducted by the medical committee of national football federation (2). There was not a significant difference between coaches and players in the case of knowledge. This means that knowledge of coaches as the first- line consultants of athletes is not better than players. So, educational programs should focus on coaches to facilitate the proper data transfer between coaches and players. Regarding participants' idea about supplement use, more than 80% of participants believe that supplements may contain prohibited substances. This belief is valuable, because the likelihood of contamination with drugs is a real risk and it is estimated that near 15% of sport supplements may be contaminated, purposefully or unintentionally, with prohibited drugs which are not declared on their labels (26, 27). Furthermore, there are some myths among athletes regarding sport supplements including the safety and purity of natural and herbal supplements (44.8% of participants). Manufacturers of supplement usually use terms such as natural and herbal in their products and thereby benefit from these athletes' myths (2). Some cases of positive drug tests may be related to this inappropriate idea. For example, the urine of a Dutch professional cyclist was found to be positive for norpseudoephedrine and ephedrine with consumption of a liquid herbal food supplement containing ephedra, which could have caused the positive doping test (28). According to the majority of participants, it is reasonable that standard supplements be introduced to athletes by sport authorities to avoid inadvertent doping. This reflects the major concerns of the players and coaches toward the supplements in use with regard to safety, efficacy and legality and is consistent with this point that 68% of participants know that supplements may be feigned. Regarding the best anti-doping strategy, participants consider that indirect strategies such as education of athletes and coaches, especially young players about harms and side effects of prohibited drugs may be more effective. However, they also found helpful to use direct measures such as increased doping testing (in and out of competition). More than 82% of participants disagreed to allow free use of all drugs which indicates their agreement with doping control. Surprisingly, more than 80% of participants supported the education of athletes about effective and safe doping methods. This conflict reflects the fact that majority of participants either cannot discriminate between doping and other methods of performance enhancement or oppose doping only because of its lack of safety and effectiveness. Another important point is that a big part of participants think doping is necessary for international success of athletes, such that 39% of athletes consider that achieving the international excellence is not probable without illegal drug use. More than half of the participants know that if it is proved that positive doping test is the consequence of contaminated supplements, the athlete will be exempted from any sanction. This means that athletes do not have a good understanding about the rule of strict liability, which is one of the main educational prerequisites of players and coaches. Regarding the main consultants of Iranian football coaches and players for drug use, participants respectively cited the team fitness trainer (31.2%), peers and friends (26.9%), coaches (8%), dietitians (8%), club owners (6.7%) and physicians (6.4%) as their main advisor. In other words, only 15% of athletes consult with a sports medicine team including physicians, physiotherapists and dietitians. These findings are partially consistent with another study on French high school athletes who declare their peers as main source of supply (16). So, it seems necessary to incorporate important groups such as team fitness trainers and coaches in the audience of educational programs as well as medical practitioners (25, 29). So, it seems in order to develop evidence-based education and awareness raising campaigns about doping (4, 30, 31), the educational process has to be intensified with the help of national associations, as FIFA medical committee has declared (32). Our study shows variable knowledge of Iranian football coaches and players in different categories of doping. Fortunately, knowledge regarding doping definition is good, but participants had poor knowledge in familiarity with the generic names of prohibited drugs and their side effects of anabolic steroids. Furthermore, improper ideas are prevalent among football players and coaches which should be addressed and modified to increase the success of any anti-doping activity.
Published online 2015 June 20.
The authors also gratefully acknowledge all of football players and their coaches in Iran, as well as Football Federation-Islamic Republic of Iran whose full participation and cooperation permitted us to conduct this research.
Dr. Tohid Seif Barghi developed the original idea and the protocol, abstracted and analyzed data, wrote the manuscript. Dr. Farzin Halabchi contributed to the development of the protocol, abstracted data, and prepared the manuscript. Dr. Heydar Hosseinnejad contributed to implementation. Dr. Jiri Dvorak helped with paper revision
This study was supported by Tehran University of Medical Sciences.
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Tohid Seif Barghi [1,2]; Farzin Halabchi ; Jiri Dvorak ; Heydar Hosseinnejad 
 Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
 Doping Control Committee, Football Federation of Islamic Republic of Iran, Tehran, IR Iran
 FIFA Medical Assessment and Research Centre (F-MARC) and Schulthess Clinic, Zurich, Switzerland
 Department of Anesthesiology, Shahrood Beranch, Islamic Azad University, Shahrood, IR Iran
* Corresponding author: Farzin Halabchi, Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: 2161192282, E-mail: email@example.com
Received: October 9, 2014; Revised: January 8, 2015; Accepted: January 23, 2015
Table 1. Frequency of Correct Answers to Questions Aimed to Assess Knowledge (a) Subdivision Correct Frequency of Correct Answer Answers Players Coaches Doping definitions Administration of prohibited Yes 185 (77.4) 109 (80.1) substances by physician Announcement of special financial No 174 (72.8) 101 (74.3) rewards for moral enhancement Enhancing performance with high No 181 (75.7) 102(75) altitude training Inadvertent use of prohibited Yes 160 (66.9) 78 (57.4) drugs by athletes Power enhancement using special No 92 (38.5) 54 (39.7) nutritional supplements Presence of prohibited substance Yes 179 (74.9) 104 (76.5) in doping urine sample Refusing to doping sample Yes 177 (74.1) 107 (78.7) collection Tampering with doping sample Yes 196 (82) 117 (86) collection Trafficking in prohibited Yes 168 (70.6) 91 (66.9) substances by coach Use of vitamins and nutritional No 191(79.9) 109 (80.1) supplements Drug names Amino acids No 118 (49.4) 61 (44.9) Amphetamine Yes 115 (48.1) 72 (52.9) Antibiotic No 145 (60.7) 88 (64.7) Antihistamin No 117 (49) 68 (50) Cannabis Yes 192 (80.3) 114 (83.8) Corticosteroids Yes 131 (54.8) 66 (48.5) Creatine No 89 (37.4) 55 (40.4) Diazepam No 84 (35.3) 46 (33.8) Diuretics Yes 127 (53.1) 74 (54.4) Expectorant syrup No 134 (56.3) 80 (58.8) Growth hormone Yes 145 (62) 95 (70.4) Laxatives No 86 (37.6) 53 (39.6) Metocarbamol No 81 (34) 52 (38.2) Morphine Yes 189 (79.1) 109 (80.1) Nandrolone Yes 123 (51.7) 67 (49.3) Salbutamol syrup Yes 104 (43.7) 55 (40.4) Vitamin E No 169 (71) 101 (74.3) Side effects of anabolic steroids Aggresion Yes 156 (65.5) 100 (74.6) Alopecia Yes 146 (61.3) 90 (67.1) Arthritis No 41 (17.8) 15 (11.4) Constipation No 29 (12.1) 10 (7.4) Cough and dyspnea No 53 (22.3) 22 (16.4) Drug dependence Yes 142 (60.7) 80 (59.3) Gastric ulcer No 30 (12.6) 17 (12.7) Gynecomastia Yes 137 (58.3) 88 (66.2) Hyperlipidemia Yes 88 (37.6) 53 (39.3) Infertility Yes 145 (60.9) 86 (64.2) Muscle weakness No 80 (33.6) 40 (29.9) Nausea and vomiting No 29 (12.2) 12 (9) Severe acne Yes 155 (65.1) 85 (63.4) Sleepiness No 37 (15.5) 17 (12.7) Tendon injuries Yes 67 (28.5) 55 (41.4) Subdivision Frequency of P Value Correct Answers Total Doping definitions Administration of prohibited 294 (78.4) 0.12 substances by physician Announcement of special financial 275 (73.3) 0.16 rewards for moral enhancement Enhancing performance with high 283 (75.5) 0.70 altitude training Inadvertent use of prohibited 238 (63.5) 0.001 drugs by athletes Power enhancement using special 146 (38.9) 0.54 nutritional supplements Presence of prohibited substance 283 (75.5) 0.76 in doping urine sample Refusing to doping sample 284 (75.7) 0.34 collection Tampering with doping sample 313 (83.5) 0.53 collection Trafficking in prohibited 259 (69.1) 0.65 substances by coach Use of vitamins and nutritional 300 (80) 0.29 supplements Drug names Amino acids 179 (47.7) 0.54 Amphetamine 107 (28.5) 0.65 Antibiotic 233 (62.1) 0.70 Antihistamin 185 (49.3) 0.95 Cannabis 306 (81.6) 0.32 Corticosteroids 197 (52.5) 0.37 Creatine 144 (38.4) 0.83 Diazepam 130 (34.7) 0.61 Diuretics 201 (53.6) 0.68 Expectorant syrup 107 (28.5) 0.79 Growth hormone 240 (64) 0.26 Laxatives 139 (37.1) 0.44 Metocarbamol 133 (35.5) 0.65 Morphine 298 (79.5) 0.65 Nandrolone 190 (50.7) 0.90 Salbutamol syrup 159 (42.4) 0.65 Vitamin E 270 (72) 0.60 Side effects of anabolic steroids Aggresion 256 (68.3) 0.19 Alopecia 236 (62.9) 0.22 Arthritis 56 (14.9) 0.190 Constipation 39 (10.4) 0.263 Cough and dyspnea 75 (20) 0.339 Drug dependence 222 (59.2) 0.938 Gastric ulcer 47 (12.5) 0.908 Gynecomastia 225 (60) 0.274 Hyperlipidemia 141 (37.6) 0.952 Infertility 231 (61.6) 0.350 Muscle weakness 120 (32) 0.748 Nausea and vomiting 41 (10.9) 0.523 Severe acne 240 (64) 0.694 Sleepiness 54 (14.4) 0.735 Tendon injuries 122 (32.5) 0.023 (a) Data are presented as No. (%). Table 2. Frequency of Football Coaches and Players by Their Knowledge in Three Fields of doping a' b Knowledge Good Players Coaches All Doping definitions 129 (54) 76 (55.9) 205 (54.7) Name of prohibited drugs 27 (11.3) 16 (11.8) 43 (11.5) Side effects of anabolic 10 (4.2) 3 (2.2) 13 (3.5) steroids Knowledge Moderate Players Coaches All Doping definitions 71 (29.7) 40 (29.4) 111 (29.6) Name of prohibited drugs 113 (47.3) 79 (58.1) 192 (51.2) Side effects of anabolic 104 (43.5) 63 (46.3) 167 (44.5) steroids Knowledge Poor Players Coaches All Doping definitions 39 (16.3) 20 (14.7) 59 (15.7) Name of prohibited drugs 99 (41.4) 41 (30.1) 140 (37.3) Side effects of anabolic 125 (52.3) 70 (51.5) 195 (52) steroids (a) Finally, mean of knowledge scores for doping definitions, drug names and side effects of anabolic steroids were compared between players and coaches and showed no significant differences (P = 0.96, 0.39 and 0.74, respectively). (b) Data are presented as No. (%). Table 3. Ideas About Toward Different Fields of Doping (Five-Point Likert Scale) Ideas About Supplement Use Strongly Agree Agree If used properly, they have 145 (38.7) 139 (37.1) great effects on athletes' performance and success. Although supplements may not 5 (1.3) 78 (20.8) have significant benefit, they are harmless. Use of sport supplement is 23 (6.1) 48 (12.8) waste of money without any benefit. They may contain prohibited 84 (22.4) 225(60) substances Natural and herbal supplements 56 (14.9) 112 (29.9) are safe and harmless. Athlete who have a good and 201 (53.6) 102 (27.2) healthy diet, does not need any supplement Without supplement use, no 13 (3.5) 61 (16.3) athlete can reach a good status in professional sport. To avoid inadvertent doping, 184 (49.1) 149 (39.7) it is better to introduce standard supplements to athletes by sport authorities Ideas about the best anti- Completely Agree doping strategy Agree Allow free use of all drugs 28 (7.5) 11 (2.9) Use of indirect measures 113 (30.1) 144 (38.4) including cultural interventions Enhance doping control via 90 (24) 213 (56.8) increased in-competition testing Enhance doping control via 78 (20.8) 191 (50.9) increased out of competition testing Educate athletes about 141 (37.6) 161 (42.9) effective and safe doping methods Educate athletes about harms 220 (58.7) 118 (31.5) and side effects of prohibited drugs Educate coaches about harms 232 (61.9) 119 (31.7) and side effects of prohibited drugs Educate youth about harms and 230 (61.3) 119 (31.7) side effects of prohibited drugs Increase doping sanctions for 130 (34.7) 150 (40) doping offence Consider heavy financial 145 (38.7) 90 (24) penalties for doping offence Consider imprisonment for 73 (19.5) 63 (16.8) doping offence Deprive doping offenders from 27 (7.2) 34 (9.1) all citizenship rights Ideas About Supplement Use Neither Disagree Strongly Agree Nor Disagree Disagree If used properly, they have 46 (12.3) 31 (8.3) 14 (3.7) great effects on athletes' performance and success. Although supplements may not 102 (27.2) 140 (37.3) 50 (13.3) have significant benefit, they are harmless. Use of sport supplement is 90 (24) 141 (37.6) 73 (19.5) waste of money without any benefit. They may contain prohibited 44 (11.7) 22 (5.9) 0 (0.00) substances Natural and herbal supplements 91 (24.3) 97 (25.9) 19 (5.1) are safe and harmless. Athlete who have a good and 42 (11.2) 28 (7.5) 2 (0.5) healthy diet, does not need any supplement Without supplement use, no 34 (9.1) 163 (43.5) 104 (27.7) athlete can reach a good status in professional sport. To avoid inadvertent doping, 25 (6.7) 17 (4.5) 0 (0.00) it is better to introduce standard supplements to athletes by sport authorities Ideas about the best anti- Fair Disagree Completely doping strategy Disagree Allow free use of all drugs 32 (8.5) 119 (31.7) 185 (49.3) Use of indirect measures 81 (21.6) 25 (6.7) 12 (3.2) including cultural interventions Enhance doping control via 37 (9.9) 18 (4.8) 17 (4.5) increased in-competition testing Enhance doping control via 73 (19.5) 15 (4) 18 (4.8) increased out of competition testing Educate athletes about 38 (10.1) 19 (5.1) 16 (4.3) effective and safe doping methods Educate athletes about harms 36 (9.6) 1 (0.3) 0 (0.00) and side effects of prohibited drugs Educate coaches about harms 20 (5.3) 4 (1.1) 0 (0.00) and side effects of prohibited drugs Educate youth about harms and 17 (4.5) 5 (1.3) 4 (1.1) side effects of prohibited drugs Increase doping sanctions for 76 (20.3) 17 (4.5) 2 (5) doping offence Consider heavy financial 84 (22.4) 30 (8) 26 (6.9) penalties for doping offence Consider imprisonment for 102 (27.2) 90 (24) 47 (12.5) doping offence Deprive doping offenders from 51(13.6) 151 (40.3) 112 (29.9) all citizenship rights Table 4. Ideas about different fields of doping (Single choice) (a, b) Variables Frequency Main rationale of anti-doping activities To maintain athlete's health 143 (38.1) To maintain sport dignity 33 (8.8) To create a fair medium for 148 (39.5) athletes' competition To prevent national scandals 34 (9.1) To combat unreasonable world 7 (1.9) records To combat trafficking of 0(0.00) prohibited drugs Others 10 (2.7) Main consultant of athletes Physicians 24 (6.4) Friends 101 (26.9) Club owners 25 (6.7) Physiotherapists 3 (0.8) Dietitians 30 (8) Coach 30 (8) Drugstore vender 1 (0.3) Senior athletes 3 (0.8) Team bodybuilders 117 (31.2) Others 41 (10.9) Main places where the athletes buy the banned drugs Club 47 (12.5) Athletes 34 (9.1) Special supplement stores 83 (22.1) Buy on foreign trips 18 (4.8) Drugstores 23 (6.1) Prescription by physician 0 (0.00) Black market 99 (26.4) Technical Staff (Technical team) 7 (1.9) Others 64 (17.7) (a) Comparison of ideas regarding other doping fields showed no significant difference between players and coaches (P > 0.05). (b) Data are presented as No. (%).
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|Title Annotation:||Research Article|
|Author:||Barghi, Tohid Seif; Halabchi, Farzin; Dvorak, Jiri; Hosseinnejad, Heydar|
|Publication:||Asian Journal of Sports Medicine (AsJSM)|
|Date:||Jun 1, 2015|
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